Alcohol and Sleep from Alcohol Explained 2

I recently did an instagram post on alcohol and sleep. Although I mention sleep in Alcohol Explained, I go into a lot more detail about it in Alcohol Explained 2.

I thought it would be worhthwile putting the chapter here as a blog post. I hope it is useful.

When we are looking at how alcohol affects sleep we need to understand three things; how our brain works, how alcohol affects it and sleep.

The first two parts have been dealt with in the preceding Chapter so now let’s now consider sleep.

As with our understanding of the human brain, our understanding of ‘sleep’ is in its infancy. There is much that we as human beings do not understand about sleep, but again fortunately to understand how alcohol affects sleep we only need to understand the basics which are this; we sleep in different cycles and one of the main differentiating factors of these cycles is how deeply asleep we are. One of the cycles of sleep is REM (Rapid Eye Movement) sleep. REM sleep is categorised by rapid movement of the eyes, increased heart rate and parts of the brain show activity similar to if you were awake. It is closely associated with dreaming. Essentially it is a period of sleep in which you are raised up from deep sleep into a state that is very close to being awake. No one actually knows what the purpose of REM sleep is, but what we do know is that it is essential. In tests, rats that have been deprived of REM sleep die within 4 to 6 weeks.

So now we’ve got the basics in place; how our brains work, how alcohol affects us, and sleep. So what happens when we put them all together?

When you drink and then go to sleep the depressant effects of the alcohol holds sway. You can’t get into REM sleep because that arena of sleep requires you to be very close to waking; your brain needs to raise you up to just below the level of full consciousness. Being drugged on alcohol your brain struggles to raise you to this level, so for the first 4 or 5 hours your brain finds it extremely difficult to put you into the REM sleep cycle. You either have no REM sleep, or far less (and far worse quality) than you ought to have.

After this 4 or 5 hour period the alcohol has usually worn off to such an extent that the residual stimulants now outweigh the depressants and the effect of this is that it is generally impossible to get to sleep at all. This is why so many people find that after drinking they wake in the middle of the night completely unable to get back to sleep. Even if they do manage to sleep it is usually fitful and spasmodic. They can be absolutely exhausted, their bodies crying out for sleep, but they will be unable to sleep because the effect of the residual simulants leaves them totally unable to sleep. It’s like trying to sleep after 8 or 9 mugs of very strong coffee.

Imagine you need 8 hours sleep a night to be at your best. Imagine if you decided to set an alarm to wake yourself up after 4 hours and when this alarm went off you got up and drank 8 mugs of strong black coffee and then lay there, tossing and turning and fidgeting and twitching for all the rest of the night. This is exactly what you do when you drink alcohol. Imagine doing that night after night, for days and weeks and months and years. Imagine what it would do to you, imagine the effect on your physical and mental health. Sleep deprivation is used as torture, and it is a highly effective one. There is a lot that we as human beings don’t know about sleep but what is abundantly clear is that sleep is when your body and brain repairs itself and recuperates. Have you ever been mulling over a problem then woken up one day and just known what to do about it? When you sleep your body continues to digest food, to break it down into manageable pieces so it can be properly dealt with. Your mind does exactly the same with all the information and experiences that it absorbs during the day. Sleep is key to our mental and physical wellbeing. Alcohol robs us of that.

This is why, after drinking, you can be in bed for 8, 10 or 12 hours and still end up starting the day tired and drained. It is also worth bearing in mind that even just one or two drinks is enough to upset the delicate chemical balance of the brain and will lead to disturbed sleep.

For many people, myself included, getting decent quality sleep and waking up refreshed and raring to go is one of the great benefits of not drinking. It makes the entire exercise of giving up drinking worthwhile on its own, to say nothing of all the other related benefits. For this reason it can be very frustrating for people who give up alcohol but still find they are still sleeping badly. There are a few things to say on this topic.

Firstly of course you do not give up drinking on day one, and wake up on day 2 feeling refreshed and ready to face the world. It does take a small amount of time to get back into a normal sleeping pattern after you give up drinking. In fact there are four stages that you need to go through before you wake up feeling well rested and ready to face the day:

1. The Alcohol.

The first and most obvious one is the alcohol needs to leave your system. On average it takes one hour for your liver to process one unit of alcohol (one unit being 25ml / 0.85oz of spirits, 76ml / 2.5oz of wine, or 250ml / 8.5oz of beer). So if you’ve drunk 3 bottles of spirits it could take around three and a half days for that alcohol to be processed. Most people probably won’t be drinking to that level, but many people don’t really keep track of what they drink. A good rule of thumb is that the average person will need about 24 hours to rid themselves of all the alcohol.

2. Excess Stimulants.

For most drinkers their problems really start to kick in after the alcohol has left their system because this is when the stimulants are in full sway. One of the key parts of how our brain reacts to the depressive effects of the alcohol is that over time the human brain become more effective at countering the alcohol and one of the ways in which it does this is to create and secrete more and more of the stimulants it uses to counter the ever increasing amounts of alcohol that we drink (this is how we can drink more and more as the years go by). How long these stimulants will take to leave your body will depend on both the individual (long term heavier drinkers will have more of these than lighter drinkers) and the amount drunk in the previous session. For this reason it is not possible to put a firm time frame on it but the majority of people will be through this stage within 24 hours, the worst case being around 72 hours (so 1 to 3 days).

3. The Final Balancing.

The above 2 stages will be the end of the process for intermittent, binge drinkers. However for people who drink regularly (i.e. every day or most days) there is a final stage to go through. As you can see from the graphs in the previous chapter (and in particular the final two), those who drink every day are simply yo-yoing between the ‘excess stimulant’ phase and the drinking phase. They never actually rid themselves of the stimulants (they are drinking and causing the brain to secrete more stimulants before the last lot has been processed). So after 2 to six days of not drinking, the stimulants are finally processed and are not replaced. Because the individual will have become used to having these excess stimulants inside of them for virtually all the time, and because these excess stimulants are now gone, they will feel very tired and lethargic. It is much the same process as if they were drinking 8 or 9 cups of strong coffee every day and suddenly cut it out. This is a period of tiredness, lethargy and feeling like you just want to sleep all the time and have no energy to do anything. It can take anything from 5 days to 3 weeks for the brain to acclimatise to this.

4. Sleep.

Whether you are going through the first two phases only or all three of them there is one final stage you also need to go through before you go back to feeling positive and confident again. This is to get a good night’s sleep. We acclimatise to a sleeping pattern. If you set an alarm for 2am for a few nights, and get up at that time and go to toilet and maybe get a drink of water then you will get used to waking up at this time all the time. Equally if you have spent years waking up at 4 am every night, it will take you time to get back into a normal sleeping pattern. And of course when you do get back into a normal sleeping pattern you will need to get a few night’s sleep to start to feel normal again. If you haven’t had a decent night’s sleep for years you won’t catch up on the missed sleep after just one night.

To a large degree there is not much you can do to hurry the process of getting back to a normal sleeping pattern and waking up feeling refreshed and ready to go. Sleeping tablets for example tend to further interrupt your sleeping pattern and most people find it best to simply wait for their body and brain to find its own natural equilibrium. However there are a few things you can do to assist this natural process as far as possible. I list these below:

1. Try to cut down on caffeinated drinks, particularly later in the day. Definitely avoid caffeine in the evenings and, if you can, in the afternoon as well. Bear in mind also that nicotine is also a powerful stimulant and should be avoided as much as possible.

2. Try to do as much exercise / physical activity as you can, and as early in the day as you can manage. The more physical activity you have undertaken during the day the better you will sleep, but vigorous physical activity will increase oxygen flow and adrenaline which makes you feel more awake. So do as much as you can as early as you can.

3. Eating a large meal can make you feel tired as the body diverts significant resources to digestion, but the digestive process involves much internal movement and can generate a lot of heat. This can disturb your sleep. So try to have your main meal at lunchtime, and eat as light as you can in the evening. If you can manage it don’t eat at all after lunch. It may feel strange to begin with but the effect on quality of sleep is dramatic, particularly for those used to eating a lot in the evening.

4. If you are waking up regularly in the night you may be going to bed too early. If you need 8 hours sleep, and you are in bed for 9, then you are going to spend an hour of your time in bed awake, this usually ends up being in the middle of the night. If your routine allows it try to get up at the same time every day (even weekends / non workdays) as this gets you used to waking up at the same time. If you are then waking up in the night a lot you can then put your bedtime back a bit to find the right level. Having said this, if you are not feeling tired during the day then waking up at night isn’t really anything to be too concerned about. If you are not drinking then waking up during the night tends to be a peaceful time. It is only when you are suffering from the post drinking anxiety that waking up in the night is such torture, as you lie there exhausted but unable to sleep, worrying about anything and everything.

5. No matter how tired you are, or how stringently you follow all these instructions, if you go to bed with your head full of things that worry or upset or anger you, you will struggle to sleep. One of the knacks to falling asleep is to get everything negative and upsetting out of your mind and to focus on something comforting and relaxing. As I say this is a knack, it takes time and effort but the more you do it the easier it gets. Meditating is one way of doing this, or losing yourself in a good book, but essentially what it amounts to is filling your mind up with comforting, happy thoughts. You could focus on a particular thing that makes you happy, or indulge in a little night-time fantasy you create for yourself like hiding away somewhere safe and quiet and warm, but the key is to empty your mind of all the worries, stresses and strains of the day.

Having your brain return to its normal balanced state and waking up fully refreshed after a good night’s sleep is one of the great pleasures of quitting alcohol. In fact one of the worst aspects of drinking is that people make so many sacrifices for it. They sacrifice money, slimness, fitness, sleep, life span, peace of mind, confidence, and resilience. And what do they get in return for all this that they sacrifice on the altar of alcohol? They get to anaesthetise, for a precious few hours every day, all the anxiety and exhaustion that’s been caused by the previous drinking, and to return for a few moments to the feeling of peace and confidence that they would have all the time if they just quit for good. I am not saying that life is perfect when you stop drinking. Everyone, drinkers and non-drinkers alike, have good days and bad but the non-drinkers have the mental resilience and confidence to deal with their problems and still enjoy life.

So if life is so much better when you aren’t regularly poisoning yourself with alcohol, why do so many people return to it after quitting? One aspect of this we have touched on already in this book; that we are constantly being bombarded with messages (some subtle, some more overt) that human beings need alcohol to fully enjoy and cope with life. Another aspect of this is Fading Effect Bias that I dealt with in Alcohol Explained. However since publishing Alcohol Explained another element of this has occurred to me. It is one of the basic driving forces of all living things, the drive to improve your lot in life. This driving force is also known as ‘ambition’.