Restful Sleep Without Drugs
Sleep is an important aspect of well-being and sleep disturbances are common among individuals in recovery from a substance use disorder. Sober sleeping tips can be helpful for ensuring a successful recovery.
The Sleep Cycle
There are two main types of sleep during the sleep cycle: rapid eye movement (REM) sleep and non REM sleep. All stages of the sleep cycle occur several times per night with the REM sleep occurring deeper and for longer periods later on in the cycle.
Non-REM Sleep has three stages:
First Stage: N1
N1 is the first stage of non REM sleep, where the body begins to slip into sleep. This stage lasts only a few minutes. During this stage your heartbeat, breathing and eye movements slow and muscles may twitch as they relax.
Second Stage: N2
N2 is the second stage of non REM sleep and typically lasts 10 to 25 minutes. During this stage the brain displays short burst of electrical activity, your body temperature drops and eye movements stop.
Third Stage: N3
The third stage of non REM sleep is N3 and generally lasts 20 to 40 minutes. Also called “delta”,“slow-wave”, or “deep” sleep, this is the period where heartbeat and breathing slow to their lowest levels. Brain waves become slower and it becomes more difficult to wake up.
Rapid Eye Movement (REM) Sleep
Called rapid eye movement (REM) sleep due to the rapid eye movement that occurs behind closed lids during this stage, most dreaming happens during REM sleep. This typically begins about 90 minutes after falling asleep. Arms and legs become temporarily immobile to prevent you from acting out dreams.
N1 – only lasts a few minutes
N2 – lasts 10 to 15 minutes
N3 – lasts 20 to 40 minutes
On Quality Sleep
You spend approximately one-third of your life sleeping. Quality sleep is as important to good health as a healthy diet, clean water or regular exercise.
The average adult needs about 7-9 hours of sleep per night, however there is no “magic amount” of sleep. The amount of sleep needed changes throughout life, with babies needing up to 18 hours per day. The amount and quality of sleep typically diminishes as you get older, esspecally after age 60.
Although sleep is needed, its biological purposes remain a bit of a mystery. It’s understood that the development of memories likely requires both non REM and REM sleep. Recent research shows that during sleep the body clears out toxins in the brain that build up during times of wakefulness.
Chronic lack of sleep can
increase the risk of:
- Cardiovascular disease
- High blood pressure
- Loss of concentration resulting in accidents
- Low sex drive
- Memory issues
- Weight gain
- Weakened immune system
Quality sleep is as important to good health as a healthy diet, clean water, and regular exercise.
Video: Why Do We Sleep?
The Connection Between Substance Abuse and Sleep Troubles
In a 2012 report in Sleep Medicine Reviews, scientists from the University of Michigan, University of Pittsburgh Medical Center, and the University of Arizona reviewed the results of the research concerned with the relationship between substance abuse and sleep. They reported that studies have shown that substance abuse not only causes disrupted sleep; sleep problems can also increase the risk of relapse to drug use. The authors additionally reported that studies have shown that substance use can produce circadian rhythm disturbances, which can result in irregular sleep patterns. 1
Given the relationship between substance abuse and sleep disturbances, individuals in treatment for substance use disorders may experience insomnia during the recovery process. Fortunately, there are ways to achieve healthy sleep while maintaining sobriety from drugs, alcohol, and potentially addictive prescription sleep aids. These sober sleeping tips can provide a guideline for ensuring restorative sleep during recovery.
Misconceptions about Sleep
Alcohol and Sleep
When discussing sober sleeping tips, it is important to address misconceptions about sleep. One such misconception is that alcohol is a sleep aid. In a research report in a 2007 publication of the Journal of Addictive Diseases, scientists affiliated with the University of Michigan advised that individuals with sleep problems commonly use alcohol to self-medicate and improve their sleep, making them more susceptible to developing an addiction to alcohol. Studies show that although alcohol may help individuals to fall asleep more quickly, it reduces rapid eye movement (REM) sleep and overall is disruptive to sleep.
To make matters worse, sleep disturbances are also common during recovery from alcohol abuse, according to the University of Michigan researchers. 2 For some, it may seem that alcohol is necessary for falling asleep, but there are ways to ensure healthy sleep habits without drinking.
Cigarettes and Sleep
Another misconception is that cigarettes relax the body and help with sleep, when, in fact, the research suggests otherwise. In a 2006 study in the American Journal of Epidemiology, a team from Johns Hopkins University assessed the sleep quality of smokers and compared it to that of non-smokers.
Study results showed that the smokers tended to take more time to fall asleep, and they spent less total time sleeping when compared to individuals who had never smoked. In addition, smokers tended to spend less time, on average, in deep sleep. Interestingly, former smokers and never smokers demonstrated no differences in sleep quality, suggesting that giving up smoking can promote restful sleep. 3
Finally, beyond misconceptions surrounding alcohol and cigarette use for promoting sleep, a common belief is that skimping on sleep isn’t anything to be concerned about, but the reality is that the effects of sleep deprivation can be harmful. A 2003 study in the journal Sleep found that restricting sleep to 4 or 6 hours per night for two weeks impaired mental performance and was just as damaging as two nights with no sleep. 4
Based upon the findings of this study, missing just a few hours of sleep per night can significantly weaken cognitive functioning, which could increase the chances of relapse. Therefore, prioritizing quality sleep is an important part of the recovery process.
Types of Sleep Disorders
An estimated 27 percent of people struggle to get quality sleep regularly. There are a few sleep disturbances that appear most frequently. Here are a few of the most common sleep disorders:
Insomnia is a problem getting to sleep or staying asleep and is the most frequent sleep disorder. Approximately 50 percent of adults experience insomnia occasionally, and 1 in 10 suffers from chronic insomnia. Symptoms of insomnia include:
- Difficulty falling asleep
- Frequently waking up throughout the night
- trouble falling back asleep after waking
- Waking too early in the morning
- Feeling unrefreshed after a nights sleep
- Having a daytime issue due to lack of sleep,i.e. problems with mood, concentration, accidents at work or while driving
Sleep Apnea is a potentially dangerous sleep disorder that is the result of interrupted breathing patterns during sleep. People with sleep apnea will frequently stop breathing in their sleep. Some potential signs or symptoms of sleep apnea include:
- Waking up with a dry or sore throat
- Loud snoring
- Occasional waking up with choking or gasping
- Restless sleep
- Forgetfulness, mood changes, lack or energy
- Frequently waking up with a headache
People with an increase risk for sleep apnea include people who:
- Have high-blood pressure
- Are overweight or obese
Narcolepsy is a neurological disorder which interferes with the controls of sleeping and wakefulness. Signs and symptoms of narcolepsy include:
- Excessive daytime sleepiness
- Sleep paralysis
- Disturbed nighttime sleep
- Memory Issues
- Sudden loss in muscle tone
Restless Leg Syndrome
This condition causes an uncontrollable urge for you to move your legs, typically due to an uncomfortable sensation. Symptoms of Restless Leg Syndrome include:
- Uncomfortable itching, tingling, or crawling feeling in the legs and/or arms
- Desire to move limbs to calm those feelings
- Restlessness, pacing or tossing and turning in bed
- Uncontrollable leg twitching
REM Sleep Behavior Disorder
This disorder is characterized by acting out dreams that are vivid, intense or violent. This occurs during a period of REM sleep where sleep paralysis typically keeps the body in a stationary position.
Symptoms of REM Sleep Behavior Disorder include:
- Movement during sleep such as kicking, punching, flailing or jumping from bed in response to intense or action filled dreams like being chased or defending yourself
- Making sounds, such as talking, laughing, shouting, crying out or even swearing
- Not being able to recall the dream if awoken
Putting Sleeping Tips into Action
There are plenty of misconceptions about healthy sleep but putting sober sleeping tips into place can promote restful sleep during the recovery process. The authors of the 2007 report in the Journal of Addictive Diseases have discussed non-pharmacological treatments for sleep disturbances among patients addicted to alcohol. They advised that some research has shown that cognitive behavioral therapy can improve sleep disturbances during recovery. 2 Treatment programs that contain cognitive behavioral therapy components can therefore assist not only with recovery from addiction but also with sleep disruptions.
Therapies for Improved Sleep
The report in the Journal of Addictive Diseases also described the benefits of relaxation therapy techniques, such as thought stopping and progressive muscle relaxation, for the treatment of insomnia during recovery from addiction. 2 Clients who have ongoing sleep disturbances may benefit from incorporating such techniques into their treatment plans
Sleep Hygiene Helps
The report also addressed interventions that contain education regarding sleep hygiene. Such interventions can complement the other components of treatment to improve sleep, and they teach about the importance of exercise, and a healthy diet for healthy sleep. 2 Incorporating sober sleeping tips from sleep hygiene programs can promote restful sleep. Some sleep hygiene tips include:
Find a sleep schedule, going to bed and getting up at about the same time each day prepares the body for bed through a regular schedule. Also give yourself time for your body to wind down a couple hours before bed.
Create a sleep routine, before bedtime prepare the body by washing the face and changing into pajamas. Find a quiet calming activity, such as knitting, reading, coloring, puzzles, bathing or other activity away from bright screens to wind down the brain.
Set the environment, and create a cool, dark, comfortable sleep environment. The human body has been shown to sleep best between 60-67 degrees fahrenheit. If you tend to watch the clock- face it away from the bed.
Only stay awake in bed for 15-20 minutes, if you find your mind racing or unable to relax- go to another room and find a relaxing activity(away from bright screens) until you feel ready to return to bed.
Lifestyle Factors Contributing to Healthy Sleep
Researchers have discovered the benefits of specific lifestyle factors for promoting healthy sleep. Certain lifestyle habits, such as creating a consistent sleep schedule and following a routine that includes regular exercise, can promote optimal sleep.
Physical activity can be especially useful for achieving restful sleep without drugs or alcohol. Authors from Boston University reviewed the results of 66 studies concerned with the relationship between physical activity and sleep, and they published their findings in the Journal of Behavioral Medicine. They concluded, based upon the results of the reviewed studies, that regular exercise is beneficial for increasing sleep time and reducing the time it takes to fall asleep; exercise has also demonstrated benefits for sleep quality. 5 Regular exercise is a drug-free method for falling into a slumber and achieving restorative sleep throughout the night.
Scientists have also found consistent sleep schedules to be beneficial. In a 1996 study in the journal Sleep, scientists working for the University of Arizona found that when study participants maintained a regular sleep schedule, their daytime sleepiness reduced, and alertness increased. They also experienced greater sleep efficiency when compared to participants who didn’t maintain a regular sleep schedule, meaning that they spent a greater portion of their time in bed actually asleep. 6 Creating a sleep schedule that involves going to bed around the same time and waking up at the same time each day can therefore promote restful sleep during recovery.
Therapy Used to Improve Sleep
Lifestyle alterations, such as creating a consistent sleep schedule and incorporating regular exercise are two strategies for achieving healthy, restful sleep without drugs, alcohol, or cigarettes. Other interventions, such as cognitive behavioral therapy or relaxation therapy can also be beneficial for people who do not respond to general sleep hygiene techniques or lifestyle changes.
Therapies to Improve Sleep
Although many encounter a sleep difficulty throughout their life, several therapies have been found to improve sleep.
Cognitive Behavioral Therapy
Cognitive behavioral therapy(CBT) teaches how to recognize and change behaviors that affect your ability to sleep. CBT techniques that improve sleep include:
Addressing Lifestyle Impacts
Activity throughout the day impacts quality sleep at night. Excessive smoking or drinking can result in poor sleep. Drinking caffeine later in the day, diet, and not getting enough exercise can also impact quality sleep.
Stimulus Control Therapy
This practice involves preparing the mind for sleep. This includes going to bed and waking up at a consistent time and avoiding naps. Using the bed strictly for bedtime activities is also recommended along with getting up when you can’t sleep and only returning to bed when sleepy.
This method is typically taught by a therapist at first and helps you calm your mind and body. Sessions may include medication, imagery, muscle relaxation or others.
Keeping your bedroom a quiet, dark and cool place helps the body understand it is a place for sleeping. It’s recommended that you keep a TV out of your bedroom and turn away the clock if you tend to watch the clock.
This is a type of therapy that requires attachment to a machine that tracks brainwaves. Typically administered in the beginning with a therapist, a machine may come home with you to recognize brain patterns in sleep.
Sleep medication can be an effective short-term solution for some people, however it’s not typically recommended that sleep medications be taken for an extended period of time. The most effective treatments combine medication and therapy.
Napping Vs. Sleeping
When considering the benefits of a “power nap” there are several factors to consider. When napping, it’s important to choose a time that is not too close to your regular bedtime. The best time for a nap is typically around 2pm or 3pm in the afternoon.
It’s also vital to set an alarm for 20-30 minutes. This is to prevent oversleeping which can result in grogginess, fatigue, and void the benefits of a nap. The 20-30 minute limit is important because it allows the body to cycle through the first two stages of the sleep cycle. A full sleep cycle takes 90 to 120 minutes. Its best to wake between stages of the cycle than in the middle.
allows the body to cycle through the first two stages of the sleep cycle
Improved Sleep for Improved Health
Sleep disturbances are relatively common among people who suffer from addiction to drugs and alcohol, and they can make abstinence more complicated. Despite common misconceptions, abstaining from sleeping pills, alcohol, drugs, and cigarettes can actually improve sleep and increase one’s chances of success during the recovery process. Developing healthy sleep habits not only promotes restful sleep; it can also prevent sleep disturbances or insomnia from serving as a roadblock to lasting sobriety. By implementing sober sleeping tips, anyone can overcome the sleep challenges that commonly occur during recovery.