How can I sleep better after addiction?

Sleep is the most important (and under-discussed) component of general health. Addiction disrupts healthy sleep habits, but a few simple changes (like going to bed and waking up at the same time EVERY day) can make a dramatic difference to the quality of your sleep. Better sleep equals a better mood, which could literally save your recovery.

In the recorded webinar below, Dr. Brian Wind Ph.D. discusses everything you need to know about sleep, including practical tips you can implement today. (Summarized in the text below the video).

Why should I care about sleep for my recovery?

Sleep is a required function to rest our body and refresh our mind. It is just as important as exercise or nutrition – the other two pillars of health.

Studies show that sleep:

  1. Increases your immunity. One study found that sleep is associated with a reduced risk of infection and improved outcomes.
  2. Helps you process and regulate your emotions. This is why you feel less extreme about your feelings the next day. The expression “sleep on it” is actually true.
  3. Slows brain aging. The data shows that a lack of sleep is a cause (not a symptom) of Alzheimer’s.
  4. Helps with your recovery by promoting a positive attitude. Sleep restores vital brain chemicals and hormones that keep your mood in check.

If you could fully grasp how important sleep was, you would make it a priority in your life. If you make it a priority, you will be willing to do things that you don’t “want” to do like cutting out the phone right before bed.

What is sleep debt?

As we lose sleep, we accumulate sleep debt. “Sleep debt” needs to be paid down. Accumulating too much sleep debt increases your risk for serious health conditions, injuries and accidents.

Most people use weekends to catch up and pay back sleep debt, but doing this can lead to a false sense of feeling rested. There are no short-cuts for paying back sleep debt, and the only way to get back on track is to maintain a healthy sleep schedule.

What is insomnia?

Insomnia occurs when individuals have trouble getting to sleep, staying asleep, or both at least 3 times per week for 3 months. It can also be caused by the perception of getting poor sleep. Insomnia is the most common type of sleep disorder.

When people have trouble sleeping enough nights in a row, the anticipation of poor sleep makes insomnia worse. The stress of trying to sleep increases alertness at bedtime which decreases sleep efficiency and keeps the individual feeling tired, but unable to sleep. 

In addition to tiredness, insomnia can cause:

  • Aches and pains
  • Mood disturbances
  • Poor concentration
  • Impaired performance or productivity

It is normal to experience temporary insomnia when you are under stress. For most people, the inability to sleep will correct itself once the stressor is removed. However, some people continue to experience sleeplessness after the triggering event is over.

Long-term insomnia has consequences that go far beyond just feeling tired, including:

  • Decreased quality of life
  • Medical problems
  • Increased healthcare costs
  • Increased absenteeism
  • Decreased productivity
  • Increased risk for psychiatric disorders
  • Increased accident risk

How is insomnia treated?

There are medications available to help with insomnia, but most people can improve their sleep just by practicing good sleep hygiene. More severe cases require a combination of medication and behavioral changes.

The treatment of choice when it comes to non-drug treatments is cognitive behavioral therapy (CBT). Cognitive behavioral therapy focuses on changing how people think, act, and feel about sleep.

How can I help my insomnia?

  1. Going to bed and waking up at the same time each day (even on weekends) is key. Your body will fall in line if you stick to the schedule.
  2. Lights are an important natural factor too. Try to keep it bright during the day and less so in the evening, and fully dark as you sleep. Turn your phone light to the lowest setting if using before bed, but try to avoid screen-time whenever possible.
  3. Melatonin is OK, but be wary that it’s not regulated in the U.S. Doses are usually way too high. Look for just 3 milligrams. Take it at the same time and try not to rely on it every day or your body will stop producing melatonin on its own.
  4. Keep the room cool. Your body temperature naturally decreases by a few degrees when you sleep, and a cooler room can help you maintain sleep longer.
  5. Caffeine is a common issue for those in recovery. Twelve hours after you drink it, a quarter of the caffeine can still be in your system. That’s like drinking a quarter of that coffee or energy drink right before you go to bed and expecting to fall asleep. You can still have caffeine, but try to cut it off before 10 AM.

Combining these sleep hygiene tools and recommendations will help you establish good sleep habits and can even eliminate sleep issues. Sleep disorders are often the result of bad habits that are reinforced over the years. Early recovery is the perfect time to make these changes part of your nighttime routine. Once you develop good sleep patterns and other healthy habits, it is much easier to stay consistent.

Do naps help insomnia?

Yes, but avoid taking long naps. Limit to 20 minutes maximum. And, always before 2 PM to avoid ruining the sleep patterns you’re working to build.

Naps are better proactive than reactive. So, nap on days where you know you won’t get as good of sleep rather than days after you already missed sleep. And, limit time in bed to form the association of sleep with the bed.

What can I do if I can’t stop my thoughts from racing?

Instead of trying to control racing, stressful or random thoughts, try to have no thoughts. If a thought comes to your mind, don’t get frustrated or run with that thought. Let it gently float away until you’re back to having no thoughts. If you’re having trouble, focus on your hands. Feel the life in your hands without labeling your feelings. Don’t fight against your mind, but quiet it peacefully.

Learning to still your mind is the most transformative mental health exercise. Unlike chasing happiness, it teaches you how to feel peace regardless of your circumstances. It makes you more resilient against relapse or related issues like depression. Any thoughts that come when your mind is clear will be to your benefit, including bettering your sleep.

What is hypersomnia?

Hypersomnia is another sleep disorder that is common in addiction and early recovery. Hypersomnia is the opposite of insomnia, where a person sleeps too much.

The top causes of hypersomnia include medications that cause sleepiness, medical problems, mental and emotional issues and disrupted sleep from external factors.

There are small changes that can make to help you break the habit of sleeping during the day:

  1. Time your caffeine to give you a boost when you would be starting to get sleepy
  2. Schedule activities during the period that you usually nap
  3. Get active before you would normally crash. It doesn’t have to be a full workout. Even a quick walk around the block will re-energize you.  

Are sleep and addiction related?

Sleep problems are a common complaint for those with substance abuse disorders. Some people develop sleep disorders during their addiction, while others turn to drugs and alcohol to deal with a preexisting sleep disorder and eventually become addicted.

For years, medication was the standard treatment for sleep disorders. Unfortunately, many sleep medications come with side effects and some are even addictive themselves. Behavioral Sleep Medicine is the use of non-pharmacological treatments for sleep disorders. Behavioral treatments are the first line of defense for someone with both addiction and a sleep disorder.

How does alcohol affect sleep?

You can improve your sleep just by staying away from alcohol. Alcohol is known for helping you get to sleep quickly because of its sedating effects, but it actually reduces sleep quality in three ways.

  1. Alcohol throws off REM sleep cycles, meaning the rest you do get is less restorative.
  2. It produces shallow disrupted sleep later in the night, particularly with high doses of alcohol.
  3. Eventually, it stops working. As people drink more, they build up a tolerance and experience less effect, leading to increased awakenings during the night.

Poorer sleep quality means that you’re still tired when you wake up, on top of a hangover. The data shows alcohol can only help you fall asleep for 4-7 days maximum. After that, the negative impacts will catch up.

What are other common sleep disorders?

Circadian Rhythm Disorders – This group of sleep disorders occurs when a person’s sleep schedule is misaligned with normal day and night cycles. Some people experience delayed sleep phase, falling asleep later at night and oversleeping in the morning. Others struggle with advanced sleep phase, which results in falling asleep earlier at night, and then waking up too early in the morning.

Treatment involves resetting your sleep schedule to normal daylight hours. Combining the following techniques will help you reset your body’s biological clock.

  • Light Therapy – exposure to bright lights can help you reset your wake and sleep cycles
  • Melatonin – Taking a melatonin supplement before bed can help you fall asleep when you should be
  • Sticking to a prescribed sleep schedule and planning naps to avoid daytime sleepiness.

Obstructive Sleep Apnea – Sleep apnea is a repeated stoppage or decrease in breathing while sleeping. It is caused by a collapse in the airways of the throat, which decreases the oxygen levels in the brain. The two hallmark signs of sleep apnea are loud snoring and daytime fatigue.

Doctors treat severe sleep apnea with devices known as Positive Airway Pressure (PAP) – a machine that you wear at night that gently pumps air through a mask into your nose and mouth. But there are quick hacks that are known to improve snoring and sleep apnea.

  • Weight loss-  Research has found that losing just 10% of body fat can have a positive impact, and in some cases, even cure sleep apnea.
  • Changing sleep position – Avoiding sleeping on your back will help keep your airways open and prevent you from snoring.
  • Oral appliances – Mouthpieces adjust the jaw to open the airway.

Restless Leg Syndrome (RLS) – A sleep disorder characterized by an uncontrollable urge to move the legs. It occurs mostly in the evening when at rest, before falling asleep. People with RLS report that moving their legs gives them temporary relief. Sometimes the restless feeling is associated with a “creepy, crawly” feeling in the legs.

Periodic Limb Movement Syndrome – leg movements that occur during sleep cycles. The symptoms occur throughout the night and cycle every 20-40 seconds.

Limb movement disorders are sometimes caused by an iron deficiency, and many people can improve their symptoms simply by taking iron supplements. Discontinuing minor stimulants caffeine and nicotine can also help. More severe cases require prescription medications that block nerve signals coming from the limbs to the brain.

Sources

Besedovsky, L., Lange, T., & Haack, M. (2019). The Sleep-Immune Crosstalk in Health and Disease. Physiological reviews, 99(3), 1325–1380. https://doi.org/10.1152/physrev.00010.2018

Dinges, D. F., Pack, F., Williams, K., Gillen, K. A., Powell, J. W., Ott, G. E., Aptowicz, C., & Pack, A. I. (1997). Cumulative sleepiness, mood disturbance, and psychomotor vigilance performance decrements during a week of sleep restricted to 4-5 hours per night. Sleep, 20(4), 267–277.

Medic, G., Wille, M., & Hemels, M. E. (2017). Short- and long-term health consequences of sleep disruption. Nature and science of sleep, 9, 151–161. https://doi.org/10.2147/NSS.S134864

Shokri-Kojori, E., Wang, G. J., Wiers, C. E., Demiral, S. B., Guo, M., Kim, S. W., Lindgren, E., Ramirez, V., Zehra, A., Freeman, C., Miller, G., Manza, P., Srivastava, T., De Santi, S., Tomasi, D., Benveniste, H., & Volkow, N. D. (2018). β-Amyloid accumulation in the human brain after one night of sleep deprivation. Proceedings of the National Academy of Sciences of the United States of America, 115(17), 4483–4488. https://doi.org/10.1073/pnas.1721694115

Stein, M. D., & Friedmann, P. D. (2005). Disturbed sleep and its relationship to alcohol use. Substance abuse, 26(1), 1–13. https://doi.org/10.1300/j465v26n01_01

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