Alcoholism And Sleep The Effects of Alcohol on Sleep Many people usually associate alcohol with sleep and sleepiness. However, the effects of alcohol on sleep are mostly negative ones, and these two things should not be interrelated at all. In order to understand how these two things are related, one must explore the depths of two different topics: alcohol and sleep. With this knowledge, one can begin to understand how alcohol and sleep are related and what effects alcohol has on sleep. Sleep is a very active process, just like consciousness.
Sleep is controlled largely by nerve centers in the lower brain stem, where the base of the brain joins the spinal cord. It is here where certain nerve cells produce chemicals, which control and regulate the two alternating states of sleep: Rapid Eye Movement Sleep (REM) and Slow Wave Sleep (SWS). REM sleep is sleep where the eyes move very rapidly. This type of sleep occurs periodically (about every 90 minutes), and occupies about 25% of sleep time. The chemical that is produced that controls REM sleep is norepinephrine, which helps regulate REM sleep and facilitates arousal in sleep. SWS sleep is a more deep, restful sleep, and is called this because the brain waves move very slowly.
This sleep occurs throughout 70% of a person’s sleeping time. SWS sleep is usually associated with dreaming. Serotonin is the chemical messenger associated with sleep onset and with the regulation of SWS. The exact roles and interactions of these and other chemical messengers in orchestrating sleep patterns are not known. Significantly, however, alcohol consumption affects the function of these and other chemical messengers that appear to influence sleep.
The average adult sleeps 7.5 to 8 hours every night. Although the function of sleep is unknown, abundant evidence demonstrates that lack of sleep can have serious consequences, including increased risk of depressive disorders, impaired breathing, and heart disease. In addition, excessive daytime sleepiness resulting from sleep disturbance is associated with memory deficits, impaired social and occupational function, and car crashes. Alcohol is a common depressant drug. It slows the brain’s activities and the activity of the spinal cord. Since alcohol affects the brain it has the potential to be abused. Alcohol rapidly enters the bloodstream and circulates to various parts of the body in a few minutes.
Alcohol comes in different varieties. Beer and ale (4-7% alcohol), wine and champagne (9-14%), and hard liquor (40-50%) are the most common kinds of alcohol. Alcohol causes many side effects in anyone who uses it, such as: dullness of sensation, lowered sensory motor skills, lowered reactive or reflexive motor responses, impaired thought processes, impaired memory, impaired judgment, sleep or sleeplessness, and in extreme cases can cause coma and death. Alcohol can also cause people to behave strangely and causes behaviors such as aggression, sexual openness, lying, and excessive talking. Alcohol not only has mental effects but physical ones as well. 70% of alcoholics and alcohol abusers suffer irreversible physical side effects, such as cirrhosis of the liver, cauliflowering of the nose and ears, permanent restructuring of the brain, including loss of long term memory, heart problems, obesity, premature dementia (partial and full), and loss of bladder control and slurred speech even when sober.
Alcohol has many effects on sleep, but these affects vary depending on the person. It is easy to categorize the people into two groups- those with alcoholism and those without alcoholism. A person with alcoholism is basically an alcoholic or a person who consumes a lot of alcohol. A person without alcoholism is the casual drinker; this is a person who drinks occasionally. For people who do not suffer from alcoholism, the effects of alcohol on their sleep and sleep patterns are different than those of people with alcoholism.
For people who do not have alcoholism, alcohol consumed at bedtime, after an initial stimulating effect, may decrease the time required to fall asleep. Because of alcohol’s sedating effect, many people with insomnia consume alcohol to promote sleep. However, alcohol consumed within an hour of bedtime appears to disrupt the second half of the sleep period. The subject may sleep fitfully during the second half of sleep, awakening from dreams and returning to sleep with difficulty. With continued consumption just before bedtime, alcohol’s sleep-inducing effect may decrease (this is because the nerve cells of the brain become used to the paralyzing effect of alcohol), while its disruptive effects continue or increase.
This sleep disruption may lead to daytime fatigue and sleepiness. The elderly are at particular risk, because they achieve higher levels of alcohol in the blood and brain than do younger persons after consuming an equivalent dose. Bedtime alcohol consumption among older persons may lead to unsteadiness if walking is attempted during the night, with increased risk of falls and injuries. Alcoholic beverages are often consumed in the late afternoon without further consumption before bedtime. Studies show that a moderate dose of alcohol consumed as much as 6 hours before bedtime can increase wakefulness during the second half of sleep.
By the time this effect occurs, the dose of alcohol consumed earlier has already been eliminated from the body, suggesting a relatively long-lasting change in the body’s mechanisms of sleep regulation. The adverse effects of sleep deprivation are increased following alcohol consumption. Studies show subjects administered low doses of alcohol following a night of reduced sleep perform poorly in a driving simulator, even with no alcohol left in the body. Reduced alertness may potentially increase alcohol’s sedating effect in situations such as rotating sleep-wake schedules and rapid travel across multiple time zones (ex. jet lag).
A person may not recognize the extent of sleep disturbance that occurs under these circumstances, increasing the danger that sleepiness and alcohol consumption will co-occur. Sleep disturbances associated with alcoholism include increased time required to fall asleep, frequent awakenings, and a decrease in subjective sleep quality associated with daytime fatigue. Abrupt reduction of heavy drinking can trigger alcohol withdrawal syndrome, accompanied by pronounced insomnia with marked sleep fragmentation. Decreased SWS during withdrawal may reduce the amount of restful sleep. It has been suggested that increased REM may be related to the hallucinations that sometimes occur during withdrawal. In patients with severe withdrawal, sleep may consist almost entirely of brief periods of REM interrupted by numerous awakenings.
Despite some improvement after withdrawal subsides, sleep patterns may never return to normal in those with alcoholism, even after years of abstinence. Abstinent alcoholics tend to sleep poorly, with decreased amounts of SWS and increased nighttime wakefulness that could make sleep fewer restoratives and contribute to daytime fatigue. Resumption of heavy drinking leads to increased SWS and decreased wakefulness. This apparent improvement in sleep continuity may promote relapse by contributing to the mistaken impression that alcohol consumption improves sleep. Nevertheless, as drinking continues, sleep patterns again become disrupted. Not only does alcohol create sleeping disorders, but it also worsens already existing sleeping disorders one may have.
Obstructive sleep apnea is one sleeping/breathing disorder affected by alcohol consumption before sleep. Approximately 2 to 4 percent of Americans suffer from obstructive sleep apnea, a disorder in which the upper air passage narrows or closes during sleep. The resulting episode of interrupted breathing wakens the person, who then resumes breathing and returns to sleep. Recurring episodes of apnea followed by arousal can occur hundreds of times each night, significantly reducing sleep time and resulting in daytime sleepiness. Those with alcoholism appear to be at increased risk for sleep apnea, especially if they snore.
Snoring is caused by the numbing of throat nerves due to alcohol consumption. In addition, moderate to high doses of alcohol consumed in the evening can lead to narrowing of the air passage, causing episodes of apnea even in persons who do not otherwise exhibit symptoms of obstructive sleep apnea. Alcohol’s general depressant effects can increase the duration of periods of apnea, worsening any existing case of obstructive sleep apnea. Obstructive sleep apnea is associated with impaired performance on a driving simulator as well as with an increased rate of motor vehicle crashes in the absence of alcohol consumption. Among patients with severe obstructive sleep apnea, alcohol consumption at a rate of two or more drinks per day is associated with a fivefold increased risk for fatigue-related traffic crashes compared with obstructive sleep apnea patients who consume little or no alcohol. In addition, the combination of alcohol, obstructive sleep apnea, and snoring increases a person’s risk for heart attack, arrhythmia, stroke, and sudden death. As mentioned previously, driving is another serious risk of drinking before sleeping.
As this interrupts a person’s sleep patterns and arouses them from sleep numerous times during the night, a person is naturally tired and fatigued the next morning. Driving fatigued behind the wheel is extremely dangerous, studies show. People fall asleep behind the wheel and put their lives and the lives of others at risk. Finally, something worth mentioning that is alcohol and sleep related is the “hangover.” This occurs the day after a person wakes up from drinking the night before, and also affects the way one sleeps. A hangover is what happens when one’s body enters alcohol withdraw and the head aches one gets are caused by extreme dehydration of their brain – their brain is literally being pulled away from their skull, leading to throbbing aches and sharp pains at attachment points like the temples and base of the neck.
A “hangover” also causes fatigue in some cases. In conclusion, alcohol has many effects on sleeping. Not only does it change sleep patterns and promote sleeping disorders, it strengthens existing ones. All effects of alcohol on sleep are negative, and people should digress from mixing these two elements together. Science.