“Waking up before I get to sleep, ‘cause I’ll be rocking’ this party eight days a week!”.
Maybe you are like the Beastie Boys and you do not get enough sleep because being awake is just a lot more fun. Or maybe you are a first responder and your long hours and shift work make it nearly impossible to get good sleep. Perhaps, you are a stressed-out grown-up with a busy job, kids, laundry, a dog that needs walking and the time needed to get everything done has to come from somewhere. Or maybe you just cannot sleep until you get your online chess rating back up.
Whatever our reasons may be, none of us are better off by not getting enough sleep. It is consistently reported that a little over one-third of Americans do not get enough sleep. Lack of sleep can impact our mental health and cause or worsen issues with drugs and alcohol.
How sleep is related to mental health
When we sleep, we cycle through two primary categories, quiet sleep, and REM sleep.
During quiet sleep, we progress through four phases. Each phase produces progressively deeper sleep and our muscles relax, our breathing slows, and our body temperature drops. During quiet sleep, these physiological changes help boost immune system functioning.
REM (rapid eye movement) sleep is when we dream. REM sleep enhances our learning and memory. This sleep phase is also responsible for processing emotionally charged events.
Most of us, cycle between these phases of sleep roughly every 90 minutes.
Sleep disruption can affect neurotransmitter levels and stress hormones. This can impair our thinking and our emotional regulation. The prefrontal cortex is responsible for executive functioning. When the prefrontal cortex is switched off, we become dysregulated. We are more likely to be impulsive and irrational. Chronically sleep deprived individuals are at a higher risk of suicidal ideation. Most completed suicides take place between midnight and 4 a.m.
Sleep, anxiety, and depression
Approximately 65% - 90% of adults with major depression experience some degree of sleep difficulties. However, studies indicate that sleep problems can also put people at an increased risk of developing depression. In longitudinal studies of over 1,300 young people, sleep problems developed before their major depression did.
Sleep problems affect more than 50% of individuals with an anxiety disorder. Like the case with depression, in many cases the sleep issues preceded the anxiety. Lack of sleep exacerbates the anxiety symptoms and can impede recovery as well.
The link between sleep and substance use
Hypnos, the god of sleep lived in a dark cave, with the entrance surrounded by poppies. Suffice it to say, sleep and substances have been linked for a long time.
Many people rely on drugs or alcohol to help them fall asleep. While this tends to be effective in the short-term, it often leads to further problems. Generally, the quality of sleep is poorer, especially with regards to alcohol.
It is estimated that 20% of Americans use alcohol as a sleep-aid. Although it can help us fall asleep more quickly by depressing the central nervous system, alcohol disrupts some sleep patterns, blocks REM sleep, interrupts our circadian rhythms and can aggravate breathing problems. (Alcohol relaxes our body, including our throat muscles. So, yeah, most of us are snoring after a night of drinking.)
Reported rates of sleep problems among people with alcohol use disorder (AUD) who were in treatment, range from 25 to 72%.
Many people experience problems with sleep once they have been working toward abstaining from substances or enter treatment. If you are considering lessening or stopping your drug and alcohol use, implementing good sleep hygiene practices can help lead to success. Start practicing these now, rather than waiting until you curb your use.
Tips to improve your sleep hygiene
Sleep hygiene refers to maintaining practices that are conducive to getting a good night’s sleep, as well as reducing sleep latency (the amount of time it takes to fall asleep). Not every tip will work for every person. Consider your schedule, your needs and your lifestyle and try what you think might work for you.
1. Have established times for going to bed and waking up
2. Avoid napping too close to your bedtime
3. Do not eat too close to your bedtime
4. Avoid caffeine several hours before you want to go to sleep
5. Have a “wind down” routine each night (make your rooms darker, take a warm shower, turn off the technology, put on chill music)
6. Associate your bedroom with sleep (as opposed to the place you pay bills and eat pizza)
7. Ensure your room is dark enough and the temperature is cool and comfortable
8. Decrease alcohol intake, or use less near bedtime
9. If you are a smoker, avoid nicotine before bedtime (it is a stimulant)
10. Incorporate physical activity into your daily routine, but avoid intense exercise too close to your bedtime
11. Find a relaxation technique that works for you, such as deep breathing
12. If you cannot fall asleep after 20 minutes, get out of bed and do something relaxing
Getting support when you need it
If you are dealing with substance use, burnout, grief or just life stressors and you need help, reach out. Substance Use Therapy is committed to helping you get the support you need to feel better, live better, and yes, sleep better too.
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About the Author:
Kimberly May, LPC, LMFT is a therapist at Substance Use Therapy in Austin, TX. Kimberly works with individuals, couples and families whose lives have been affected by substance use. By utilizing a harm reduction framework, Kimberly works effectively with people in any stage of use. In addition to substance use, she works with other issues such as anger, gambling, anxiety and grief. Contact today to schedule a no-charge, 30 minute, in-person consultation. *Note: telephone and telehealth sessions are currently available.