Health

Why does alcohol mess with my sleep?

But even if you thud into dreamland,
there’s a good chance that too much alcohol will mean a fitful night of sleep.
That’s because alcohol disrupts what’s known as your sleep architecture, the
normal phases of deeper and lighter sleep we go through every night. A night of
drinking can “fragment,” or interrupt, these patterns, experts say, and you may
wake up several times as you ricochet through the usual stages of sleep.

“You pay for it in the second half of
the night,” said Dr Jennifer Martin, a psychologist and professor of medicine
at UCLA. Alcohol is “initially sedating, but as it’s metabolised, it’s very
activating.”

Here’s how it breaks down. In the first
half of the night, when fairly high levels of alcohol are still coursing
through your bloodstream, you’ll probably sleep deeply and dreamlessly. One
reason: In the brain, alcohol acts on gamma-aminobutyric acid, or GABA, a
neurotransmitter that inhibits impulses between nerve cells and has a calming
effect. Alcohol can also suppress rapid eye movement, or REM sleep, which is
when most dreaming occurs.

Later in the night, as alcohol levels
drop, your brain kicks into overdrive. You may toss and turn as your body
undergoes a rebound arousal. “As the levels decline, you’re going to get more
issues with the fragmentation,” said Dr R Nisha Aurora, a member of the board
of directors of the American Academy of Sleep Medicine. You’ll also probably
have more vivid or stressful dreams and — because fitful sleep means that
you’re waking up more regularly — you are more likely to remember them.

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Alcohol is also a diuretic, a substance
that increases urine output, which means you may find yourself waking up to go
to the bathroom. “You are going to have to pee more often,” said Dr Bhanu
Prakash Kolla, an associate professor of psychiatry and a consultant at the
Center for Sleep Medicine at the Mayo Clinic in Rochester, Minnesota. “Moderate
amounts of alcohol, especially wine and spirits, have an early diuretic effect,
especially in the elderly,” he added. It’s unclear whether the urge to urinate
wakes you up, or if you’re just more attuned to your body in the second half of
the night because you’re sleeping more fitfully.

People may also snore more after they
drink. Alcohol is a muscle relaxant and relaxes the muscles in your upper airways,
disrupting normal breathing. Drinking can be especially dangerous for people
with obstructive sleep apnea, who wake up many times during the night as their
airways momentarily collapse.

Most experts agree that drinking will
mess with your sleep, no matter your age or gender. And because alcohol
depresses the central nervous system, experts caution against using it with
sleep aids such as Ambien, Tylenol PM, Benadryl or even supplements such as
melatonin.

“Alcohol is a sedative,” said Dr Ilene
Rosen, a sleep medicine doctor and associate professor of medicine at the
Perelman School of Medicine at the University of Pennsylvania. “I would not use
any sedative hypnotic, whether over-the-counter or not, when you’re drinking
alcohol.”

Some people drink closer to bedtime to
help them get to sleep. But that can start a dangerous cycle of more fragmented
sleep, followed by heavier drinking. “I do see a lot of people who
self-medicate for insomnia with alcohol, which is definitely not a good
practice,” said Dr Sabra Abbott, an assistant professor of neurology in sleep
medicine at Northwestern University Feinberg School of Medicine. Sustained
nightly drinking can establish worrying patterns that can persist even after
people have stopped drinking, she and other experts say.

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To help assess how alcohol may be
affecting your sleep, experts recommend an alcohol-free reset period, or what
Martin called “an alcohol holiday,” lasting at least two weeks. “It can be very
eye-opening to appreciate how much alcohol affects your sleep,” she said. A lot
of people who think they have insomnia, she said, may just be drinking too much
or too close to bedtime.

“It turns out that if they don’t drink,
they sleep much better,” said Martin, who is also a spokesperson for the American
Academy of Sleep Medicine. After the “holiday,” she said, “they can just make a
more informed decision about how much — and how often — they consume alcohol.”

Experts also suggest building in a
buffer zone of at least a few hours between drinking and bedtime. A nightcap is
not your friend. “It’s probably OK to have a glass of wine with dinner four
hours before bed,” Abbott said. Or maybe limit your drinking to happy hour or
the appetiser course.

Alcohol can mess with your morning
routine, too. “People may turn to stimulants” such as caffeine, drinking coffee
well into the afternoon, said Dr Armeen Poor, a pulmonary and critical-care
physician at Metropolitan Hospital Center in New York and clinical assistant
professor of medicine at New York Medical College.

“That makes it harder to fall asleep at
night,” he said. “And then you need more of that sedative, and then it just
goes around and around and around.”

© 2022 The New York Times Company

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