Alcohol and sleeplessness have a long and complicated history together. Alcohol is one of the first lines of defense people turn to when they have difficulty sleeping. A recent study of the general population revealed that 13% had used alcohol in the past year specifically as a sleep aid. This is greater than the number who had turned to over the counter sleep aids, and more than double the number who had used prescription medication.
But there is a dark side to the relationship between alcohol and the night person. Many people feel that they have no choice but to take a drink to fall asleep at night. The fact is, in many circles, a so-called functional alcoholic is treated with more respect than someone who has trouble getting up in the morning. While it is quite true that alcohol can help a person fall asleep faster, especially those that have difficulty in falling asleep, we will learn that alcohol actually contributes to sleep problems, since it has a negative effect on the quality of sleep.
What about the social connections between alcohol and night people? Let's suppose that it's midnight and you are wide awake. In fact, it's your personal prime time. Being an otherwise normal person, you would like to spend time around other people. Where are you going to go? In most cases, you can't go to a movie. You can't take a class at the local community college. In fact, you have very few options. But you can usually find a bar open until at least 2 AM. In fact, if local laws didn't force bars to close in most areas, many would be open all night. It's no wonder that night owls flock to the local drinking establishment. When the bars close, lonely, and with little else to do, many people misguidedly turn to the bottle for comfort or recreation. Consider these facts: It's quite accepted, even expected, that people will drink late into the evening. On the other hand, it's almost scandalous to have a drink before noon. The term night cap stopped referring to an article of clothing a long ago. Night time and drinking have become virually synonymous. People expect night owls to drink.
While we are on the subject of bars, let's address the issue of closing time. In most parts of the United States, the law proscribes the sale of alcohol between certain hours. For example, in California liquor sales are prohibited between 2 and 6 AM. What is accomplished by such a regulation? More than one in three fatal accidents in the United States involves drinking. This is a statistic that is commonly used by those who want to prohibit or limit alcohol sales and use or increase penalties for drinking and driving. A statistic that is not as well known, nor as well studied, is the number of fatal accidents that involve drowsiness. Some estimates are that 30% or more of fatal accidents involve a driver who has fallen asleep. Another statistic: the most common times to be involved in an accident are from 3-4 AM and 3-4 PM, not coincidentally the same time as the circadian rhythm of most people is at its lowest point. Now put these facts together. What happens when you serve alcohol, a depressant, to someone until 2 AM, then tell them they have to go home at the point in the day when they are most prone to falling asleep? The natural consequence is going to be accidents caused by the fatal combination of intoxication and sleepiness. A question that deserves more research is how many drunk drivers involved in accidents were asleep at the time of their accident. This is certainly not an endorsement of drinking and driving, regardless of how sleepy you may or may not be. But the question remains: what good is accomplished by closing bars in the early morning hours? Do the benefits really justify the cost to public safety? If such laws have any benefit, and this is questionable, certainly a different closing time would seem to make more sense.
How does alcohol affect sleep? Is drinking an effective way to treat insomnia? Many believe that it is. Alcohol does hasten the onset of sleep, especially in those who have trouble falling asleep. Alcohol can even give the appearance of delivering deeper sleep, as anyone who has tried to wake someone who has "passed out drunk" can attest. But the fact is that alcohol causes disturbances to sleep, especially 3 to 4 hours into a nights sleep. Normal sleep occurs in a series of cycles. We have several different kinds of sleep. There is light sleep, REM (rapid eye movement) sleep, during which most dreaming occurs, and a level of deeper sleep. Each of these cycles is important to proper functioning during waking hours, especially REM and deep sleep. Alcohol disturbs the rhythms of these cycles, causing us to miss out on the benefit of these sleep cycles. The consequences for those who drink themselves to sleep are exactly what they are usually trying to avoid. During the second half of sleep, sleep is lighter, and those who drink are prone to awakening, and in having trouble returning to sleep. They have more difficulty getting up in the morning, particularly when "hungover." They are less alert and more inclined to have accidents, even days later. The clincher is what happens when they try to fall asleep the next night. They will have trouble doing so without having another drink, thus starting a vicious cycle. Over time, the body becomes dependent upon alcohol in order to fall asleep. The longer this cycle continues, the greater the dependence, and the more alcohol is required to fall asleep. It is a cycle best not begun.
Special concern should be shown my those who suffer from sleep apnea. Alcohol causes the pharyngeal muscles to relax, which makes snoring more frequent. This means that drinking before bedtime may also adversely affect the sleep of the person who sleeps next to you. It also means that if they drink before bedtime, your sleep might be compromised, even if you choose to abstain. Drinking in moderate to higher levels causes the air passage to constrict, which can cause episodes of apnea in those who do not normally have such symptoms. Alcohol consumption, especially within 3 or 4 hours of bedtime, can increase the effects of sleep apnea. Some of the inconvenient effects of combining alcohol with sleep apnea can be heart attack, arrhythmia, stroke, and sudden death. This is not something to take lightly.
Here is an important consideration for those suffering from insomnia or other sleep disorders. Sleep deprivation can have a dramatic effect on your tolerance for alcohol. This means that someone who can otherwise drink a great deal and still seem sober might become drunk on just one or two drinks if they haven't had adequate sleep. If you are sleep deprived, you should never have even one drink if you might be driving later.
There is a large incidence of insomnia among alcoholics. By the same token, alcoholism is more common among chronic insomniacs. The reasons for this may be many. The social factors mentioned earlier lead many night people to abuse alcohol. The vicious cycle mentioned earlier can cause dependence upon alcohol among those experiencing insomnia, and causes insomnia among those dependent upon alcohol. Unfortunately, sleeping problems can persist for alcoholics, even years after they quit drinking. Sadly, this has been a cause of relapse for some alcoholics. When an alcoholic returns to drinking, sleeping problems seem to get better. Unfortunately, these apparent benefits are short-lived, and in the long term, the sleeping problems get worse, not better.
This information is not presented as an indictment of drinking. Not everyone who drinks is going to develop a chronic sleep disorder, no more than everyone who drinks will become an alcoholic. The bottom line is this: if you choose to drink, do so responsibly, and understand what the consequences can be. A good rule of thumb is not to have a drink within 3 hours of going to bed. And never, ever, use alcohol as a treatment for a sleep disorder or to help you fall asleep. Alcohol will always exacerbate sleeping problems. It will never help you be better rested.
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