Possible links between alcohol and insomnia

Individuals with insomnia have difficulty maintaining a consistent sleep schedule. Experts state that acute insomnia lasts up to a few days to weeks, while chronic insomnia continues for several months.

Symptoms

Insomnia may be different for each person. However, some of the more common symptoms include:

• lying awake for a long time before sleeping
• sleeping for only short periods
• waking up repeatedly at night
• waking up too early

Insomnia can make it difficult to complete daily tasks. It can also negatively affect mood, which can, in turn, affect personal relationships.

Causes and risk factors

Stressful life events may cause acute insomnia. Possible causes of temporary insomnia may be:

• an unexpected job change
• cross-country move
• interpersonal conflict

Generally, females and older adults are at a higher risk for insomnia. Individuals with mental health conditions are also more likely to develop insomnia.

Certain medications may cause insomnia as a possible side effect. For example, people may experience steroid-induced insomnia, or antidepressants may worsen or induce sleep disorders.

An uncomfortable sleep environment can make getting a good night’s rest challenging.

Consuming certain substances, such as alcohol, can disrupt sleep schedules. This is because alcohol works as a central nervous system depressant.

Many people with insomnia may have difficulty falling asleep at night. As a result, they may consume alcohol to speed up falling asleep, but evidence shows this technique does not improve sleep quality.

2020 research suggests that alcohol impacts the part of sleep known as rapid eye movement (REM). Drinking heavily over time can also disrupt the chemical messengers in the brain, which can affect sleep.

Studies estimate that 36–91% of people experiencing alcohol dependence may have insomnia.

Likewise, long-term reliance on alcohol for sleep can contribute to an alcohol use disorder (AUD). Drinking a small amount of alcohol may help people fall asleep more quickly initially, but over time, individuals will need to consume more alcohol to achieve the same effect.

Individuals who have attention deficit hyperactivity disorder (ADHD) are also particularly affected by insomnia. A 2020 study found that people with ADHD are more likely to consume alcohol to treat their insomnia symptoms.

There is a higher prevalence of insomnia in people with ADHD and AUD, but consuming alcohol to manage insomnia generally worsens sleeplessness. It can even increase the risk of developing AUD.

Studies have shown that short-term alcohol use can shorten the time it takes to fall asleep. It can also improve the first half of a night of sleep.

However, in the second half of a night’s sleep, alcohol diminishes the amount of REM sleep. Alcohol’s negative effects on sleep quality worsen after several nights of drinking.

Drinking alcohol before sleep also affects the cardiovascular system. A 2018 study found that drinking before bed elevated heart rate during sleep. It also negatively impacts the recovery that the body experiences during sleep.

People who drink alcohol before sleep are also more likely to experience breathing difficulties at night. They will also experience shorter periods of sleep, resulting in less restful sleep overall.

Individuals living with AUD experience much poorer sleep quality than those who consume moderate amounts of alcohol. They experience limited REM sleep, which can affect their health.

Having a beverage containing alcohol in the evening from time to time may slightly disrupt sleep, but consuming alcohol for multiple nights in a row or every night carries a greater risk of insomnia.

An inadequate amount of quality sleep can have many effects on health. Long-term sleep deprivation can increase the risk of different health conditions. These include:

• type 2 diabetes
• obesity
• depression
• cardiovascular diseases

A 2019 study showed that individuals who sleep for under 6 hours each night have a 20% higher chance of heart attack than individuals who sleep between 6 and 9 hours.

Visit our hub to learn more about the science of sleep.

The Centers for Disease Control and Prevention (CDC) recommend that if a person consumes alcohol, they should drink it several hours before going to bed. This gives the body time to metabolize the beverages.

Additionally, low-to-moderate alcohol consumption is always the best practice for minimizing sleep disruptions or health concerns. The CDC defines moderate drinking as two or fewer drinks for males, and one or fewer for females, in a given day.

If a person chooses to consume alcohol, drinking in moderation several hours before bed is the best practice for avoiding sleep disturbances.

Learn more about moderate drinking.

Lifestyle changes such as avoiding alcohol hours before sleep may be sufficient for treating mild, short-term insomnia.

However, other recommendations include the following:

• avoiding caffeine in the late afternoon and evening can promote restful sleep
• staying away from computer or telephone screens before bedtime can also promote relaxation
• having a consistent bedtime routine, which may include the following:
  • taking a bath
  • stretching gently
  • journaling

More severe cases of chronic insomnia may require different treatment strategies. Different forms of therapy, mindfulness, meditation, or hypnotherapy, can address insomnia symptoms.

Certain medications and supplements can also encourage a good night’s sleep. These may include:

• melatonin
• antipsychotic medications such as quetiapine
• select antidepressants

Treating these conditions may be necessary as some individuals experience insomnia due to other health issues.

Ultimately, no two cases of insomnia are the same, and no treatment plan is right for everyone. Anyone experiencing insomnia should speak with a doctor to learn more about what treatments may work best for them.

Below are some common questions around alcohol and sleep quality.

How does alcohol affect sleep apnea?

Consuming alcohol may present a higher risk of developing sleep apnea. In a 2018 study, researchers found that alcohol increases this risk by 25%.

People with sleep apnea should consider avoiding or reducing alcohol consumption. A person can speak with a doctor to discuss the best way to treat and manage their condition.

Are there any differences in how alcohol affects males or females?

Males consume more alcohol than females. However, females are more susceptible to its effects.

Females who drink alcohol have a higher risk of:

• hangovers
• alcohol-induced liver inflammation
• heart issues
• issues with memory
• some cancers

How does alcohol withdrawal affect insomnia?

Many people with AUD experience insomnia during withdrawal. Other symptoms of alcohol withdrawal can also worsen insomnia. These may include:

• headaches
• anxiety
• elevated blood pressure
• stomach issues

Can alcohol cause anxiety that leads to insomnia?

Many people with AUD also experience anxiety. They may turn to alcohol to reduce their anxiety symptoms, which also increases insomnia, exacerbating their anxious feelings.

Research shows that between 33% and 40% of people who consume alcohol experience mild to severe anxiety. Anxiety symptoms can cause or worsen insomnia for some individuals.

Treating anxiety can help reduce insomnia and improve overall sleep quality.

Alcohol — even in moderate amounts — can disrupt healthy sleeping patterns. For some individuals, consuming alcohol can cause or exacerbate insomnia.

Long-term alcohol use negatively affects REM cycles and decreases sleep quality. Over time, sleep deprivation can increase the risk of several chronic health conditions.

When a person drinks alcohol, doing so in small or moderate amounts several hours before sleep can reduce the chance of sleep issues.