Does a nightcap help with sleep? Is this a good strategy or a road to trouble?

alcohol and sleepIt’s very common for me to see people who use alcohol to help with sleep, and 28% of insomniacs have used alcohol to help with their sleep. I enjoy a glass of red wine in the evening myself. But, even though initially people may find it helps with getting off to sleep, in the longer run this effect wears off and people can find themselves drinking more and more to maintain the effect.

What effect does alcohol have on sleep?

Whilst alcohol can have a sedative effect, as alcohol is broken down in the body quite rapidly, leading to a withdrawal effect in the second half of the night. This means that in the early part of the night alcohol can put people off to sleep via the early sedative effect but by the second half of the night, will cause restlessness, frequent awakening and poor-quality sleep.  In addition, alcohol can add to tiredness and lowered mood the next day.  I will often see people attributing this tiredness to poor sleep and managing it by further increasing the dose of alcohol, as they feel that if they only drank more they would be more heavily sedated and sleep during the second half of the night would be of better quality.

Alcohol also has effects on underlying sleep architecture.  Even during the first part of the night when people feel that alcohol is putting them to sleep and making them unaware of the environment around them, under the surface the natural progression of sleep is disturbed.  Alcohol reduces the amount of rapid eye movement (REM) sleep and increases alpha or fast wave activity during sleep.  Whilst it can increase slow-wave sleep, which is usually restorative, the increase in alpha activity that occurs at the same time leads to alpha delta sleep, which isn’t restorative. This is the type of sleep that is seen in other conditions where sleep not restorative such as pain or chronic illness.

It’s not just the alcohol

Whilst the alcohol itself has a significant impact on sleep, there are some additional chemicals in alcoholic drinks that can have further impacts on sleep.

Red wine in particular and some varieties of white and sparkling wine contain high levels of salicylates.  In people susceptible to salicylates, who are also susceptible often to food additives such as MSG, they can get an allergic reaction to wine with hives, itching or nasal obstruction.  Salicylates can also cause vivid dreams, restlessness during sleep and insomnia.

Using alcohol for sleep: A pathway to alcoholism

Alcohol and sleepWhilst having a nightcap occasionally won’t really have negative effects on sleep. Over time, if people are having trouble with sleep and using alcohol to manage sleep night after night, over time the amount of alcohol that is needed to get people to sleep increases. I this way, using alcohol to help with sleep is a common pathway to alcoholism, particularly for young adults. I also commonly see people taking a combination of large amounts of alcohol together with medications, or illicit substances such as marijuana to get to sleep, feeling like things are getting out of control, and coming to see me in desperation. It’s not uncommon for people to be using stimulants like caffeine or other illicit substances as well, such as speed or ice to deal with the tiredness they have during the day from the combination of poor sleep and hangover from alcohol and other medications.

What can be done?

alcohol and sleepIf people are not sleeping well, it is important for them to seek help this and discuss it with their health professional.  There are many things that can be done to help with sleep such as changing behaviour and thinking around sleep and modifying other lifestyle factors.  Implementing these strategies, together with more advanced strategies such as cognitive behavioural  therapy, takes away the need for relying on alcohol as a sleep aid.

For people who find they are already reliant on alcohol to help with sleep there is good research showing that working with health professionals experienced in the management of alcoholism and sleep and using strategies such as cognitive behavioural therapy, can successfully get people off alcohol and sleeping better.

In Australia, the National Health and Medical Research Council (NHMRC) has published guidelines on safe drinking levels for adults. The recommendations are that for healthy men and women, drinking no more than 4 standard drinks on a single occasion reduces the risk of alcohol-related injury arising from that occasion. The NHMRC also recommends no more than 2 standard drinks per day to reduce the lifetime risk of harm from alcohol-related disease or injury. A standard drink is defined as 10 grams of alcohol, which is 200ml of standard strength beer (5% alcohol), 80ml of wine (12% alcohol) or 25ml of spirits (40% alcohol).

If you or someone you know needs help with alcoholism there are good services such as the ones listed below:

Related posts & links:

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