Are racing thoughts making it difficult to fall asleep? Do you tend to toss and turn throughout the night, or wake up suddenly from disturbing dreams? Or, on the flip side, do you feel like all you want to do is sleep? Dealing with insomnia or a disturbed sleep pattern in early recovery from a substance abuse disorder (SUD) is very common — and it may even increase your risk for relapse, according to a study in the Journal of Addiction Medicine that found the incidence of insomnia five times higher in people in recovery than in the general population. While studies about recovery and sleep mostly focus on people with a SUD, anyone can suffer from sleep issues, including those with behavioral addictions to gambling, video gaming or sex, among others.
For some, sleep problems may be occasional and just a minor annoyance, while others lie awake night after restless night, ending up exhausted — emotionally and physically — the next day. Sleep issues can be short-lived (only during withdrawal from a drug, for instance) or long lasting: Recovering alcoholics, for instance, have been found to have insomnia or sleep-disordered breathing (such as sleep apnea) for weeks, months or sometimes years after becoming sober.
There are a number of reasons why addiction and sleep problems are often unpleasant bedfellows. For one, you’ve likely become accustomed to using your addiction as a sleep aid; for instance, maybe you turned to a nightcap, joint or masturbation to lull you to sleep. Addiction is also known to disrupt your body’s circadian rhythms, again making it difficult to fall (or stay) asleep without preferred drug or behavior. You may be practicing what sleep experts call “poor sleep hygiene,” or unhealthy habits like smoking (nicotine is a stimulant; even one pack a day can lead to 24 minutes of lost sleep each night) or drinking caffeine late in the day (a caffeine buzz can take up to 14 hours to wear off completely). Yet another contributing factor may be that you’re feeling anxious, stressed or depressed, all of which are known to interfere with solid slumber.
Whatever the reasons, getting to the root of your restlessness is crucial for maintaining sobriety. When your body doesn’t get adequate, restorative sleep, it can not only lead to daytime sleepiness, but also more “fuzzy” thinking (this is common in early recovery), depressed mood and anxiety and poor control of your emotions and thoughts. Simply put, a good night’s sleep restores and heals you — and gives you a clear head so you can continue to make sound decisions that favor your ongoing recovery.
If you have persistent sleep problems, talk to your health care provider, who may recommend starting a sleep diary so you can see patterns that make shut-eye more restful and those that interfere with sleep. Your doctor will most likely advise against taking any type of prescription or over-the-counter sleep aid. For starters, medications like benzodiazepines (Ativan or Klonopin, for example) pose an addiction risk themselves. In addition, changes in the liver caused by abusing substances, particularly alcohol, can make it challenging to properly dose these medications. Melatonin, a hormone that enhances the body’s natural sleep-wake cycles, may be recommended; that said, don’t take this supplement without talking to your addiction specialist or physician. If you’re seeing a primary care physician for sleep issues it’s essential to let him or her know that you’re in recovery so potentially addictive medications are not prescribed for you.
Cognitive behavioral therapy (CBT) can also be a useful, drug-free way to treat insomnia by helping you to understand the reasons why you’re sleeping poorly — including anxiety and depression, as well as habits like too much caffeine or pre-bedtime activities such as looking at a bright computer screen, or having difficult or upsetting conversations with your spouse. CBT can also help you to examine attitudes you may have about sleep; for example, you might think you can get by on six hours per night, though your body needs much more. A therapist may also introduce relaxation techniques, like mindfulness meditation and progressive muscle relaxation, to help calm your mind and body as you wind down to bedtime. Another crucial part of a sound-sleep plan during recovery involves learning (or re-learning) healthy sleep habits. The National Sleep Foundation recommends the following tips for getting to sleep and snoozing soundly all night:
- Stick to a regular sleep schedule and get up at the same time each morning (even on the weekends).
- Create a ritual for bedtime. Use the 30 minutes before you go to bed to do something that relaxes you, such as taking a warm bath, practicing meditation, listening to calming music or reading a good book.
- Watch what you eat or drink in the hours before bedtime. If you’re hungry or too full, it will disrupt your sleep. As mentioned, both nicotine and caffeine later in the day can also interfere with sleeping.
- Get some exercise every day. By committing to a regular exercise regimen — this can be as simple as a brisk daily walk — you’re likely to get to sleep faster and sleep more soundly. Avoid vigorous exercise just before bedtime, though, as you might end up feeling too energized. However, relaxing exercise like gentle yoga poses before bed can help initiate a more restful night.
- Eliminate light and sound as much as possible. Outside traffic can be distracting, as can the ticking of a clock, appliance noises, alerts of email or text messages on your phone and more. Turn off computers and laptops and don’t have your cell phone in the bedroom, even if it’s charging. Consider using blackout curtains, eyeshades, earplugs, “white noise” machines, humidifiers, fans and other devices that create a dark, quiet space that’s ideal for sound sleeping.
Once you’ve pulled up the covers and switched off the light, spend a few minutes thinking about things from the day for which you’re grateful. Whether it’s your family, job, sponsor or just the fact that you’ve made it through another day sober, counting your blessings will work even better than counting sheep.