How Does Alcohol Worsen Insomnia?

You’re exhausted! You’ve had a long day at work and are more than ready to get a good night’s sleep. You go through your typical bedtime routine: turn on the fan, climb into bed, and shut off the lights. You take a couple of deep breaths, close your eyes, and … can’t fall asleep. You try different meditation techniques, breathing exercises, and maybe you even start counting sheep, but still — 20, 30, 60 minutes later — you’re wide awake. Sadly, this has become your nightly norm.

Insomnia can be relentless, and it takes a toll on our cognitive, emotional, and physical health. When we add alcohol to the mix, it only makes our sleepless nights worse. Below, we’ll explore the effect alcohol has on sleep and insomnia — and how we can get a better night’s rest.

What Exactly Is Insomnia?

Simply put, insomnia is a sleep disorder that can cause difficulty falling asleep or staying asleep; it can make us wake up too early (without being able to fall back asleep); and it can reduce the overall quality of our sleep. It’s a common disorder that affects 10-30% or more of the worldwide population.

Insomnia is a highly subjective experience that manifests itself differently in every person. It’s different from not having time to get enough sleep due to a busy work schedule or staying up late. Insomnia means not getting sleep despite having the time and intention to do so.

These are some of the most common signs and symptoms of insomnia:

• Daytime drowsiness
• Difficulty focusing during the day
• Feeling frustrated or anxious by a perceived difficulty or inability to fall or stay asleep
• Feeling that you’re not getting enough sleep (despite trying to do so)
• Fitful, nonrestorative sleep
• Frequent waking during the night and/or inability to fall back asleep
• Not feeling rested upon waking 
• Waking up too early (and not being able to get back to sleep)

There are two main types of insomnia: acute and chronic. Acute insomnia is short-term, lasting anywhere from a night or two to a few weeks or months. It’s usually brought on by stressful life events — job loss, death of a loved one, health problems, or a traumatic experience. Chronic insomnia is long-term difficulty with sleep, usually defined as having trouble falling or staying asleep for three or more nights per week for three months or more. 

What Causes Insomnia?

Insomnia can be caused by a variety of factors, involving a complex interplay of our mind-body connection, medical history, environmental factors, and outside influences, such as stress. These are some of the more common causes and contributing conditions:

• Chronic pain, which makes it get comfortable and settle down at night
• Depression, anxiety, PTSD, and other mental health conditions
• Dementia
• Emotional issues, such as grief, anger, loneliness, and worry
• Excessive use of electronic devices (especially at night)
• Irregular sleep habits and/or schedule
• Ongoing health problems, including obesity, diabetes, breathing issues (asthma or sleep apnea), and heart disease
• Stress
• Use of alcohol, caffeine, and/or nicotine 

Certain factors can increase our risk for insomnia. For instance, while the condition can happen at any time in our life, it’s more common the older we get. Women are also more likely to have insomnia than men, particularly during pregnancy, while caring for a newborn, and in menopause. Researchers also believe that there may be a genetic component to insomnia, as it tends to run in families. 

How Alcohol Makes Insomnia Worse

So how does alcohol make insomnia worse? It all comes down to how alcohol disrupts our natural sleep-wake cycle, known as the circadian rhythm. This biological rhythm regulates various physiological processes, including sleep. When disrupted, it can lead to a host of sleep problems, including insomnia.

Upon consuming alcohol, it initially acts as a stimulant, increasing dopamine levels in the brain. This surge in dopamine can induce feelings of alertness and wakefulness. As the body metabolizes alcohol, it transitions into a depressant, causing drowsiness and facilitating the onset of sleep.

However, as the body metabolizes alcohol throughout the night, its stimulatory effects can resurface. This phenomenon, known as the "rebound effect," can lead to awakenings during the night and difficulty returning to sleep. Interestingly, between 35 and 70% of people who use alcohol have insomnia. 

Furthermore, alcohol increases levels of adenosine, a key component of the “homeostatic drive,” which keeps our body balanced. It’s also one of the major mechanisms regulating our sleep-wake cycle. The homeostatic drive tells us it’s time to sleep by boosting levels of adenosine when we’ve been awake for too long. 

After a few drinks, increased levels of adenosine send us into a deep sleep. But once our body realizes it’s had too much slow wave sleep, the homeostatic drive compensates by allowing us less deep sleep in the second half of the night. This is why we might find ourselves tossing and turning after a night of drinking. 

But Alcohol Can Help Us Fall Asleep, Right? 

It’s true: alcohol can help us fall asleep more quickly and easily. This is largely because alcohol is a central nervous system depressant: it slows our brain activity. It also acts as a sedative, inducing feelings of relaxation and sleepiness. But even though alcohol can cause us to fall asleep quickly, it often leads to fragmented and non-restorative sleep. And the more we drink, the greater the effect: higher doses of alcohol have been shown to disrupt sleep, particularly during the second half of the night.

While consuming a little alcohol before bed might seem helpful for insomnia, research shows that people rapidly develop tolerance to alcohol’s sedating effects. One study showed that smaller amounts of alcohol did increase total sleep time and deep sleep for people with insomnia. However, these effects evaporated within a week. As the study continued, participants were inclined to increase alcohol consumption up to almost the equivalent of three beers a night. 

How Alcohol Impacts REM Sleep

Alcohol is also known to suppress and reduce the amount of time we spend in rapid eye movement (REM) sleep — one of the most important stages of sleep for physical and mental restoration. 

REM sleep is the fourth stage of a sleep cycle, and it’s vital for cognitive functions, such as memory consolidation, emotional processing, learning, and creativity. Doctors, experts, and researchers have all noted the importance of REM sleep to our overall health and well-being. Without it, our memory, mood, and mental focus suffer. Lack of REM sleep can even weaken our immune system, as the growth of new healthy cells and tissue in the body is blocked.  

Even just a couple of drinks can disrupt our sleep and prevent us from getting REM. One study found that having fewer than two servings of alcohol per day for men or one serving per day for women decreased sleep quality by nearly 10%. The more alcohol we consume, the more our quality of sleep decreases: more than 2 drinks for men and more than 1 for women decreased sleep quality by almost 40%. 

Why Is Sleep So Important? 

Our body depends on high quality sleep for many vital functions, especially for regulating our metabolism, energy levels, mood, and immune function. Research suggests that good sleep patterns can actually add years to our life.

On the other hand, just a single night of sleep deprivation can speed up cellular aging. Over time, lack of sleep contributes to many serious health concerns, including depression, anxiety, stress, high blood pressure, diabetes, stroke, and cardiovascular disease. 

Research also shows that chronic sleep loss promotes negative emotional processing, which can result in aggression, anger, hopelessness, and (in extreme cases) suicidal ideation. Insomnia can also interfere with our daily life, impairing our ability to focus on tasks, make decisions, and perform well at work. It also impedes our executive functions, daytime wakefulness, and stress management. 

What Is the Treatment for Insomnia?

There’s no simple solution for treating insomnia. Because symptoms vary from person to person, treatment usually involves a bit of trial and error. Oftentimes, it requires getting to the root of the issue — whether that’s stress, drug or alcohol use, work schedules, anxiety or depression, chronic pain, or something else entirely. 

A doctor can help us develop an individualized treatment plan based on our own personal situation, medical history, and lifestyle habits. While certain prescription medications can help facilitate sleep, they can cause side effects, dependence, and eventual tolerance. Experts advise against using sleep drugs, since they mask symptoms without treating the underlying cause of insomnia. 

Many people with insomnia have found success through stress management and relaxation techniques, cognitive behavioral therapy, consistent and healthy evening routines, and good sleep hygiene.

Tips for Getting Good Sleep Without Alcohol 

Achieving restful sleep without relying on alcohol may seem daunting, but it is entirely possible with the right strategies. Here are some tips to get started:

• Establish a regular sleep schedule. Consistency is key when it comes to sleep. Getting into bed at night and getting up in the morning at the same times all week (including weekends) have been shown to help establish healthy sleep. Even if we have trouble falling asleep, following the same schedule cues our body that it’s time to sleep and helps it sync with our natural circadian rhythm. 
• Create an optimal sleep environment. To promote relaxation, it’s important to create an environment that is conducive to sleep. Experts recommend keeping our room quiet, dark, and cool (65℉, 18.5℃), as this helps promote sleep. It’s also worth investing in a comfortable mattress and pillows.
• Develop an evening relaxation routine. Developing and sticking to a healthy evening routine can help encourage sleep. This means following the same pattern prior to going to bed each night. For instance, maybe we take a shower or bath, get into our pajamas, have a cup of decaffeinated tea, do some stretches, read a book, journal, meditation, or light a candle. Find and incorporate activities you find calming, centering, and enjoyable.
• Practice relaxation techniques. We typically get better sleep if we can help our mind and body relax. Techniques such as deep breathing, progressive muscle relaxation, mindfulness meditation, or guided meditation can help us relax and prepare our body for sleep. They help activate our parasympathetic nervous system, a network of nerves that relaxes our body after periods of stress or danger.  
• Limit screen time before bed. Research shows that the blue light emitted by screens — TVs, cell phones, and computers — interferes with our body’s production of melatonin, a hormone that regulates sleep. We should try to eliminate technology and turn off screens at least 30 minutes before bed (an hour is ideal).

Finally, if we feel as though we’ve tried everything and nothing is working, a medical professional can provide personalized advice and treatment options. Sadly, research indicates that up to 80% of insomnia cases are undiagnosed. Don’t be afraid to let your doctor know you’re struggling with sleep — you should never have to suffer in silence. 

If you’re relying on alcohol to help you fall asleep, but your overall quality of sleep is suffering, consider trying Reframe. Our research-backed app has helped millions of people cut back on their alcohol consumption and improve their health and well-being — including their sleep.