Alcohol and sleep

Published 6 April 2006.

Those who drink alcohol seldom find that it makes them fall asleep more quickly. If you start to drink more regularly, small amounts of alcohol will not help you fall asleep anymore, but you need to drink more each time. This is because the nerve cells of the brain become used to the paralysing effect of alcohol.

High-scale consumption of alcohol has many effects on sleep. Passing out because of alcohol is not real sleep but a state of poisoning, and it is difficult to wake the person up from it. When brain functions are registered with an EEG, they show no normal stages of sleep.

Drinking heavily before going to bed prevents dreaming, i.e. REM-sleep, which is important for your mental well-being. When you have used alcohol heavily for weeks, REM-sleep begins to occur in the early hours of the morning in fragmentary periods. Your sleep is restless and you wake up easily. Eventually also falling asleep becomes more difficult. You may also wake up in the small hours and not be able to go back to sleep.
In a state of delirium tremens normal sleep does not occur. Either the person does not sleep at all or his sleep is broken and aberrant, more like a state of delusion. Alcohol relaxes the muscles of the upper respiratory tract and the throat. In milder cases this causes snoring, in more serious cases it causes the respiratory tract to collapse and apnea to occur. Some of the deaths caused by alcohol poisoning are probably due to this phenomenon.

What can you do if you can’t get to sleep?

• Do not use alcohol as “sleeping medication”. It helps only seemingly and will make your insomnia worse.
• Try listening to relaxation tapes. Relaxing will help you fall asleep or at least rest better if you lie awake.
• If you can’t get to sleep, read something that is not too exciting.
• If you wake up in the middle of the night and can’t get back to sleep, it may take you a few hours before you fall asleep again. This phenomenon is normal and is due to your “internal clock”.
• Do not sleep more for than an hour during the day. It will make it more difficult to get to sleep in the evening.
• Use medicines only temporarily. Using “pams” regularly for more than three weeks causes insomnia, problems with falling asleep and broken sleep. It makes remembering things more difficult and increases anxiety when you are awake.

Antti Holopainen
medical superintendent,
Järvenpää Addiction Hospital