Why Poor Sleep Is a Risk Factor for Alcohol and Cannabis Use

by Martin Reed Patient Advocate

A study published in 2012 found that 68 percent of individuals admitted for drug and detoxification treatment reported sleep problems prior to their admission.

Although there appears to be an association between poor sleep and substance use, the connection is still not fully understood.

A comprehensive review published in April 2016 in Addiction Science & Clinical Practice set out to explore this connection and identify the risks associated with poor sleep when it comes to drug and alcohol use.** The link between poor sleep and alcohol use**

The review identified studies that found between 35 and 70 percent of alcohol users suffered from clinical insomnia. In contrast, prevalence rates for insomnia in the general population tend to be between around 15 percent and 30 percent.

Individuals who are suffering from temporary sleep issues may turn to alcohol in a bid to improve their sleep since it's mistakenly perceived to be an effective sleep aid.

In reality, although the drug can help when it comes to falling asleep, alcohol has a significant negative effect on sleep quality. Furthermore, as pointed out and suggested by the authors of the review, chronic alcohol use leads to:

  • Fragmented sleep

  • Reduced sleep duration

  • Increased sleep latency (taking longer to fall asleep)

  • Less time spent in slow wave sleep (important for memory consolidation)

  • Less REM sleep (important for learning)

How to improve sleep if you're dependent on alcoholThe review found that gabapentin, may improve sleep and aid abstinence in those with alcohol-use disorders. Gabapeptin is a nerve medication and type of anticonvulsant that can help to treat seizures and relieve pain from shingles. It also identified studies that found decreased melatonin levels in alcoholics. The melatonin receptor agonists (chemicals that bind to and activate receptors)ramelteon and agomelatine were found to reduce insomnia severity and improve sleep quality.

The authors of the review found that trazodone (often prescribed as a sleep aid to those with addictions) did not have a clinical improvement on sleep in those with alcohol use disorders and that the drug was associated with reduced alcohol abstinence during treatment.

Benzodiazepines, a certain class of psychoactive drugs, are not recommended for those with alcohol use disorders due to their addictive potential and the risk of toxicity when combined with alcohol.

The link between poor sleep and cannabis use

The review found that cannabis can improve sleep, particularly over short periods of time. This may explain why those who experience sleep disturbances such as insomnia may use the drug.

However, when cannabis use becomes chronic, sleep quality can actually decrease — especially during withdrawal. Common withdrawal symptoms include insomnia and strange dreams. The review found that negative effects on sleep can last as long as 45 days after withdrawal.

How to improve sleep when quitting cannabis

If you're struggling with sleep issues due to cannabis withdrawal, the review identified the following treatment options:

  • Oral administration of THC

  • Synthetic alternatives to THC such as Nabilone

  • Drugs such as zolpidem, mirtazapine, gabapentin and quetiapine

The additional risk to our children

A study published in Drug and Alcohol Dependence found that sleep duration and quality as early as the age of 11 was associated with the use of alcohol and cannabis.

Specifically, researchers found that:

  • Less sleep was associated with earlier use, intoxication and repeated use of both alcohol and cannabis.

  • Lower sleep quality was associated with earlier alcohol use, intoxication and repeated use of both alcohol and cannabis.

These findings should be particularly concerning since a 1998 study found that early substance abuse is associated with a shortened time to dependence.

A better alternative to alcohol and cannabis

Although alcohol can help you fall asleep, it harms the quality of your sleep. Although cannabis can improve sleep in the short term, it can harm sleep over the long term.

Alcohol withdrawal and cannabis withdrawal can both have a negative impact on sleep.

With this in mind, it's a good idea to avoid using alcohol or cannabis in a bid to improve your sleep. Instead, you should seek to identify the cause of your sleep problems (the most common causes include physical, mental, and behavioral issues).

The next step is to seek help and be prepared to answer common questions asked by sleep experts.

Your doctor may refer you to a sleep clinic for a sleep study to get to the bottom of your sleep issues. Treatment options may include CPAP for sleep apnea, sleeping pills for short term use or cognitive behavioral therapy.

Martin is the creator of Insomnia Land’s free insomnia sleep training for adults. His online course uses CBT techniques to teach participants how to fall asleep without relying on sleeping pills. More than 4,000 insomniacs have completed his course and 97 percent of graduates say they would recommend it to a friend.

Martin Reed
Meet Our Writer
Martin Reed

Martin is the creator of Insomnia Coach, an eight-week course that combines online sleep education with individual sleep coaching. His course helps clients improve their sleep so they can enjoy a better life with more energy and start each day feeling happy, healthy, rested, and refreshed. Martin also runs a free sleep training course that has helped over 5,000 insomniacs. He holds a master’s degree in health and wellness education and studied clinical sleep health at the University of Delaware.