Sleep Problems Bedevil Ex-Drinkers
Posted on: Friday, 15 August 2003, 06:00 CDT
By Kathleen Doheny, HealthDay Reporter
HealthDayNews -- Sleep problems among former drinkers can persist for months or years, a new study finds.
Problems getting to sleep are more common than staying asleep, the researchers report in the August issue of Alcoholism: Clinical & Experimental Research.
University of Calgary psychologist Shawn Currie and his team studied 63 recovering alcoholics, all sober at least one month but less than five years. They evaluated their sleep not in a sleep lab for one night -- the standard approach -- but rather at home for a week.
"We looked at sleep problems in a different way," Currie says. "Most of the research prior to this study has people spend one night in a sleep lab. We used portable sleep monitors -- they look like a wristwatch -- and we did it for seven nights."
The researchers "wanted to find out how bad the insomnia is," he says. There is a tendency for insomniacs to exaggerate.
The participants also filled out a sleep log for two weeks.
"We found out they definitely had sleep problems," Currie says. They tended to be short sleepers, sleeping less than six hours a night.
More than half of the subjects reported that sleep problems had started before the onset of their alcohol dependence. They reported more problems getting to sleep, overall, than staying asleep. In the general population, just 10 percent to 15 percent of people have chronic insomnia, Currie says.
While he can't say there is a cause-and-effect relationship between the high rate of sleep problems and the alcohol dependence, the topic needs further study, he says.
Other research has also found many alcoholics had sleep problems before their alcohol problem, suggesting the sleep difficulty might predispose one to develop alcohol problems. For instance, insomniacs might get in the habit of having a nightcap just to sleep better.
When alcoholics are drinking, the alcohol induces rapid sleep onset and deeper sleep the first half of the night, but causes sleep to become very fragmented the second half of the evening as blood alcohol levels fall, Currie says.
Sleep seems to improve after alcoholics have abstained for three to six months, other research shows, but disrupted sleep can continue even longer.
Why recovering alcoholics have sleep problems that linger isn't clear, Currie says. It is believed that with chronic alcoholism the effect of alcohol over time changes brain chemistry in a way that disrupts the normal way sleep is regulated.
As prevalent as the problems were, Currie adds, "I don't want to leave the impression that is it all bad news." There are lots of recovering alcoholics whose sleep patterns return to normal after they quit drinking.
The new study "confirms some previous findings," says Dr. Kirk J. Brower, an associate professor of psychiatry at the University of Michigan Medical School in Ann Arbor and executive director of Chelsea Arbor Addiction Treatment Center, affiliated with the university.
This is the first study, Brower says, to use wrist monitors on alcohol-dependent recovering patients and predicts this home monitoring will now be included in future studies, either as a substitute or a supplement for sleep lab monitoring. While sleep monitoring is the gold standard, it has been criticized for not capturing the total sleep picture, he says.
For those whose sleep problems persist, Currie recommends learning mental relaxation and other non-pharmaceutical approaches. While many alcoholics in recovery get offered sleeping pills by their physicians, Currie says, medication is not a good long-term solution.
"We tell our patients that sleep is an important part of their recovery," Brower says. Fatigue boosts the risk for relapse, it is widely believed. To avoid that, Brower says, "we teach them good sleep habits." These include not napping during the day, avoiding caffeine immediately before bedtime, and keeping regular bedtimes and wake-up times.
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On the Net:
National Institute on Alcohol Abuse and Alcoholism
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