Using booze won't help you snooze
Ask some friends about how to cure insomnia and you're likely to get this advice:
Drink some alcohol right before bedtime.
Not so long ago, doctors used to suggest the same thing. But today no informed person recommends alcohol as a sleep aid. In fact, research confirms that alcohol interferes with a good night's sleep, disrupting the sequence and duration of sleep states.
Understanding why calls for reviewing some facts about the nature of sleep. Sleep takes place in two major phases that alternate throughout the night:
- Slow wave sleep (SWS) produces the fewest brain waves. This phase offers the deepest and most restful sleep.
- Rapid eye movement (REM) sleep is associated with increased brain waves, dreaming, lighter sleep, and nighttime awakening.
One factor that controls how much time we sleep in each phase is brain chemistry. For example, serotonin is a neurotransmitter that's associated with falling asleep and SWS. In contrast, norepinephrine is present in REM sleep and helps us wake up.
Alcohol disrupts the action of serotonin, norepinephrine, and other chemical messengers that regulate sleep phases. People who drink alcohol within an hour before bedtime often spend more time in REM sleep.
Aging is another factor in sleep quality. As we get older, we spend more of our time in REM sleep. After age 65, we may wake up 20 or more times during the night.
Because they experience less restful sleep than younger people, older adults may be especially tempted to use alcohol as a sleep aid. Unfortunately this strategy is self-defeating, since alcohol often accentuates the sleep-related effects of aging.
Alcohol use can also increase the risk of sleep disorders. About three percent of Americans live with sleep apnea, a condition that narrows an air passage at the back of the mouth, interrupts breathing, and disrupts sleep. Alcoholics are more likely to develop sleep apnea and related problems.
Because of alcohol's sedating effect, many people with insomnia consume alcohol to promote sleep. However, alcohol consumed within an hour of bedtime appears to disrupt the second half of the sleep period, according to Alcohol and Sleep, an Alcohol Alert research report by the National Institute on Alcohol Abuse and Alcoholism. The subject may sleep fitfully during the second half of sleep, awakening from dreams and returning to sleep with difficulty. With continued consumption just before bedtime, alcohol's sleep-inducing effect may decrease, while its disruptive effects continue or increase.
Finally, using alcohol to induce sleep also creates the risk of alcoholism. "Many alcoholics have said that they started drinking regularly to try to get to sleep at night," write Peter Hauri and Shirley Linde, authors of No More Sleepless Nights.
Hauri, director of the Mayo Clinic Insomnia Program in Rochester, Minn., notes that some alcohol abusers quit drinking for a while only to find that they experience insomnia and nightmares. If these people resume drinking to promote sleep, they can slide from alcohol abuse into alcohol dependence.
Fortunately there's much you can do to promote better sleep without using alcohol or other drugs. Try the following suggestions from Mayo's Insomnia Program:
- Keep a regular sleep schedule. Don't sleep late on weekends.
- Eat a light dinner and avoid drinking any fluids close to bedtime. Steer clear of midnight snacks.
- When you're tired, go to bed and turn out the lights. Don't read or try to do paperwork in bed. If you stay awake for more than 15 minutes, get up for a while and return to bed later.
- Avoid stimulants, including nicotine and caffeine.
- Exercise more, preferably in the afternoon.
- Keep your bedroom cool.
- Limit naps to one a day, 20 minutes maximum.
- Take a hot shower or bath just before going to bed.
- Take sleeping pills only with a prescription. And never combine alcohol with sleeping pills. These drugs can interact to produce side effects that are serious -- even fatal.
If these self-care measures fail, then see your doctor for help. Getting professional advice increases your odds of beating insomnia far more than medicating yourself with alcohol.