Sleep and Addiction

The relationship between addiction and sleep and how to improve sleep while recovering from substance abuse

If you or a family member has ever struggled with drug addiction, you’ve likely experienced the negative effects of addiction on sleep. Both drug use and withdrawal symptoms can make it hard to fall asleep and sleep through the night.

This isn’t just the case for “street drugs” like cocaine or heroin, but also for alcohol, prescription medications, and some over-the-counter drugs.

But did you know that this relationship goes both ways? Just as drug use can result in sleep problems, so too can sleep issues lead to drug abuse.

In this article, we’re going to help you understand the intricate relationship between substance abuse and sleep, and what you can do to get the quality of sleep you need when you’re recovering from drug addiction.

Young man with hands clasped together
How Different Substance Addictions Interfere with Sleep
Addiction is defined as “a brain disease brought on by chronic drug use that interferes with and makes changes to brain circuitry and chemistry, and these changes lead to compulsive drug-using behaviors.”

But these changes in our brain chemistry and circuitry do more than lead to compulsive drug use; they can also lead to trouble sleeping. Substance abuse can cause both acute (short-term) and chronic (long-term) sleep difficulties. For some, this can result in sleep disorders like insomnia and sleep apnea.

Generally, taking drugs leads to chemical changes in the body that can have a direct impact on our circadian rhythm, which is the biological clock responsible for our sleep/wake cycle.

This relationship is more than a bit complicated, largely due to the wide variety of drugs available today. To understand what’s going on in relation to drug abuse and sleep, you need to look at each category of drugs individually.

Stimulants: Cocaine and Amphetamines
If you’ve ever had coffee too close to bedtime, you’ve probably experienced how stimulants can disrupt sleep. This category of drugs, which includes things like cocaine and amphetamines, increases how alert we feel. When taken too close to bedtime, they can make it incredibly hard to fall asleep.

What’s more, long-term use of stimulant drugs can impact neurotransmitter levels (brain chemicals responsible for mood, energy, learning, and more).

Take cocaine, for example. When someone uses cocaine, the energy and euphoria that they experience is due to a short-term increase in the levels of dopamine circulating in the brain. This boost in alertness can directly interfere with sleep, and chronic use can lead to a reduction in REM sleep, leading to daytime fatigue and memory difficulties.

Prescription opioids with many bottles of pills in the background. Concepts of addiction, opioid crisis, overdose and doctor shopping
When you stop using cocaine, disrupted sleep can last for months after drug cessation, with the body’s neurotransmitter levels and circadian rhythm taking time to rebalance.

Amphetamines, which are found in some prescription drugs and also in street drugs like methamphetamine, are also powerful stimulants that can wreak havoc on your quality of sleep. With a half-life of 9-15 hours, half of the drug can still be in your body when you go to bed even when you take it early in the day.

Additionally, amphetamines impact the central nervous system, keeping people awake following use, and causing sleep disturbances during withdrawal. Similar to cocaine, amphetamines can cause changes to neurotransmitters that can lead to prolonged sleep difficulties.

Depressants and Sedatives: Alcohol and Marijuana
Drinking alcohol and smoking weed can give you the impression that they will help you achieve sleep. Unfortunately, studies reveal that both short-term and long-term use of these drugs can impair your sleep cycle, usually for the negative.

Alcohol is known to help you fall asleep, but the quality of sleep that you achieve following drinking tends to be much lower than when you abstain from drinking. Additionally, alcohol use can increase your chances of experiencing sleep apnea, snoring, and nightmares.

As for marijuana use, short-term use might help with falling and staying asleep. When it comes to long-term use, however, researchers have found a negative impact on sleep quality.

People who use cannabis five times or more per week for three months or more tend to take longer to fall asleep, sleep less throughout the night, and experience less restorative, slow wave sleep than people who don’t use cannabis or use it less frequently.

Hallucinogens: MDMA and LSD
Hallucinogens like MDMA (ecstasy) and LSD (acid) can disrupt sleep in a similar way as stimulants, as these drugs too can enhance feelings of alertness. Additionally, many hallucinogens alter perception partly through their interference with the neurotransmitter serotonin, which is important for regulating sleep.

Opioids: Heroin and Pain Relievers
Opioid abuse is rampant, largely thanks to the prescription use of these pain killers (including morphine, oxycodone, codeine, and hydrocodone). Many opioid addicts are people that accidentally end up addicted to these painkillers, with some turning to heroin, another opioid when it becomes challenging to get a prescription.

While these drugs can be particularly effective at treating pain, they have a high potential for addiction and abuse, and this can result in trouble sleeping.

Opioid use results in poor sleep quality, with less restorative sleep and REM (rapid eye movement) sleep. What’s more, opioid withdrawal is well-known for making sleep exceptionally difficult.

How Sleep Deprivation Leads to Drug Abuse
While many people know that drug abuse can lead to sleep deprivation, fewer realize that sleep deprivation can result in drug addiction and abuse. There are two primary ways that this can happen:

People who struggle with insomnia or other sleep disorders will sometimes use drugs like alcohol and marijuana to help them fall asleep. Not only will these drugs not help sleep quality in the long-run, but this use can lead to substance abuse and addiction. Additionally, both prescription and over-the-counter sleep medications can lead to addiction and abuse as well.

When people don’t get enough sleep, their willpower and self-control are lower than when they do. This can lead to relapses for people with drug addictions.

Why Sleep is Important in Addiction Recovery
Overcoming substance abuse necessitates a period of drug detox, where you eventually eliminate drug use completely. This period is extremely challenging as withdrawal symptoms occur.

One of the symptoms of withdrawal is trouble sleeping. As insufficient sleep is correlated with poor self-control, it’s important for recovering addicts to do what they can to get enough sleep and reduce the chances of a relapse. What’s more, sleep helps the body and mind to recover, and physical and spiritual healing are an important part of the recovery process.

Because all substance abuse disorders are tied to disrupted sleep, learning ways to enhance your ability to sleep can help you overcome drug addictions.

Tips for Getting Quality Sleep During Addiction Recovery
There are many things that you can do to help your body develop a healthy sleep schedule. While some of these tips can help immediately, remember that it can take time and effort before results are noticed.

Human’s internal clocks are tied to the natural light/dark cycle, meaning that we are meant to sleep during dark hours and be awake during light hours. Because of this, it’s important to align your sleep hours with natural darkness whenever possible.

Additionally, you don’t want to be changing when you sleep from one night to the next. While it’s normal to extend ourselves too much over the week and “catch up” on sleep during the weekends, that’s not how our biological clocks work. It’s best to go to bed and wake up at the same time (or at least as close to it as possible) every night of the week.

Lastly, try to have this schedule be somewhere between 7 and 9 hours so that you’re getting the amount of sleep that you need. You could try a bedtime routine of sleeping from 9 PM to 6 AM every night.

Humans are sensitive to light, with bright lights (particularly blue lights like those found in electronics and fluorescent light bulbs) keeping us alert and making it difficult for us to fall asleep. If you have too much light exposure before bedtime, your internal clock is unlikely to function properly.

The best thing to do? Avoid electronics at least 2 hours before bed. If you are having trouble doing that, use blue light blocking glasses that you can put on once its dark outside to limit your blue light exposure.

Moderate exercise can help you get a good night’s sleep, but when done in the three hours before bedtime, it can actually make it harder to fall asleep. Avoid exercise before bedtime if you struggle with sleep.

If you really want to sleep throughout the night, you want to set yourself up so that you can do so. This can include turning your phone or airplane mode or do-not-disturb, sleeping somewhere that you won’t be disturbed by partners or kids coming in and out, and having your pets and kids not sleep in your bedroom if it causes sleep difficulties.

Taking a warm bath or shower about 1-1.5 hours before bed can act as a sleep aid, helping ease your body ease into sleep mode. This is thanks to the rise in temperature that occurs in the bath and the resultant fall in temperature that happens when you get out of it. This mimics a natural decrease in body temperature that occurs before bedtime when your circadian rhythm is working properly.

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