While researching this article I came across a method used by doctors and scientists to measure the seriousness of insomnia cases in patients. It is called the Insomnia Severity Index. If you have never struggled with insomnia, it is hard to know exactly what people are talking about when they describe the symptoms that come with serious insomnia. A few months ago, a close friend of mine was struggling with insomnia. He described to me, repeatedly, his problems with cognition, an inability to get work done, and an overall “fogginess” or “cloudiness” of thought, possibly all from not being able to sleep. Indeed, many people will have heard the term “brain fog”, but that term can be used in different contexts unrelated to insomnia. I told my friend multiple times, even though I could tell that what he was suffering from was serious, and even though I was willing to do anything to help him, I was not able to truly imagine what this extreme sleep deprivation was doing to his mind and thought processing.
Then, out of the blue, without ever having experienced that kind of problem before, I began having those same symptoms after a few nights without sleep. I had experienced a tragic loss in my family, but beyond that, the causes of this sudden sleeplessness are unknown to me. The way my friend had described it was the best possible description; it is a fog that comes over your brain after too much time without enough sleep. I had gone 2 nights, and maybe a bit more than that, without any sleep. Suddenly in the middle of the late afternoon, I began to feel a strange difficulty finishing sentences and planning out my thoughts in an orderly way, the types of things that come to you completely naturally and you never think about them, until there is a problem. I didn’t know what to do. I sat in a shower for 40 minutes, trying to wash away this terrible, and incredibly scary, feeling that had come over me. Without going into too much detail about the entire episode, only finally getting some sleep made things better. It is terrifying to feel your cognition slipping away. For the rest of my life, I will always take sleep and sleep problems much more seriously.
Neither my friend’s insomnia, nor my own, were related to alcohol. I don’t drink, and my friend is only a light social drinker. The causes of insomnia, however, are varied and can be different for every person. My friend was dealing with stressful situations in his work and personal life. I was dealing with the sudden loss of a close family member. Many people with alcoholism also deal with severe insomnia and a disbalancing of their day/night cycle. The best drug and alcohol rehabs in Florida and around the country, including our facility in Panama City, treat patients struggling with Insomnia at different points in recovery from alcoholism, and alcoholism has been linked to serious day/night cycle problems.
Alcohol and Insomnia
Alcohol is a depressant. As with other depressants, people who begin to rely on alcohol to help them sleep can eventually experience problems with sleep from the alcohol itself. The problems do not end with just those patients who use alcohol to help them sleep, however. According to this study from the International Journal of Environmental Research and Public Health,
“The results of our research show a higher propensity of night workers to consume alcoholic beverages than those who work during daytime hours, often in binge-drinking mode. In addition, an increase in the amount of alcohol consumed was found to be related to insomnia disorder, especially in night workers. This study provides further awareness of the importance of the negative impact of alcohol consumption on sleep quality in night workers.”
Not only can alcohol effect a person’s ability to sleep in a number of ways, but working a night-shift can cause serious sleep problems as well, based on this research. People who work a night shift and drink alcohol to excess are at risk for the most serious effects from insomnia. The surveys done as part of this study seem to indicate that some night-shift employees may begin to use alcohol as a crutch in dealing with this upset to their day/night cycle. Leaning on alcohol, or even other drugs for that matter, can eventually lead to even bigger problems with things like sleep. As I mentioned above, it is not only those people in active drinking who deal with insomnia problems. The best drug and alcohol rehabs deal with these problems in their own patients, and patients in rehab are not actively drinking alcohol or using drugs. Therefore, we can surmise that, as with other drugs, the effects of withdrawal and early recovery in general can bring sleep problems. Part of treating people for alcoholism and drug addiction is helping people deal with any sleep problems they may experience in early recovery. Experts in alcohol and drug abuse treatment will already know that patients who are experiencing upsetting side effects in early recovery have a much greater chance of returning to drinking or using drugs, if only to rid themselves of these problematic side effects from quitting.
Insomnia and Withdrawal
According to Bower et al., “More than 70% of those with alcohol dependence experience further sleep difficulties during subsequent abstinence.” It is fair to say, based on this data and other research, that insomnia from alcohol use and alcohol withdrawal is likely a huge factor in recovery from problem drinking. It may be appropriate for all the best drug and alcohol rehab centers to focus even more on the problems with sleep that many patients are having. At Florida Springs in Panama City, patients can participate in activities like Yoga, which have been shown to help with the sleep cycle, as most exercise does. This effect may need to be more of a focus for all alcohol and drug treatment centers in Florida and around the country. As I postulated, Foster et al. comments that,
“Disturbed sleep post‐alcohol withdrawal is an important predictor of relapse, however, inconsistencies exist in the literature in relation to the specific components of sleep that are associated with relapse (Foster, Marshall, & Peters, page 17). These facets have not thoroughly been investigated…”
According to Bastien et al. “The Insomnia Severity Index (ISI) has been found to be a reliable and validated method of determining insomnia severity.” I would encourage all the best drug and alcohol rehabs to take these types of findings very seriously and focus on the quality of sleep that is being experienced by patients in drug and alcohol treatment. More focus on the serious sleep problems being experienced by patients will make patients feel more listened to and more cared for, which is always a factor in a patient completing inpatient treatment. As I experienced recently, and my friend experienced before me, poor sleep is strongly associated with psychological distress. We know that psychological distress is a huge part of substance use disorder and recovery from addiction, so more focus on the issue of insomnia seems warranted by those of us trying to treat this deadly illness.
By T.A. Cannon
HODGES, C. J.; OGEIL, R. P.; LUBMAN, D. I. The effects of acute alcohol withdrawal on sleep. Human Psychopharmacology: Clinical & Experimental, [s. l.], v. 33, n. 3, p. 1, 2018. DOI 10.1002/hup.2657. Disponível em: https://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=pbh&AN=129934863&site=eds-live&scope=site. Acesso em: 12 jan. 2022.
PLESCIA, F. et al. Alcohol Abuse and Insomnia Disorder: Focus on a Group of Night and Day Workers. International journal of environmental research and public health, [s. l.], v. 18, n. 24, 2021. DOI 10.3390/ijerph182413196. Disponível em: https://search.ebscohost.com/login.aspx?direct=true&AuthType=sso&db=mnh&AN=34948807&site=eds-live&scope=site. Acesso em: 12 jan. 2022.