Sleep Problems in Addiction Recovery

by | 10. June 2015 08:20

Insomnia (difficulty initiating or maintaining sleep) is one of the most common issues tied to BOTH active substance abuse and the recovery process.  Lack of restful, productive sleep creates significant disruptions in day-to day functioning.  When someone is trying to re-establish stability in their job, relationships, health AND abstain from substances of abuse, sleeping problems represent a tremendous hurdle in reaching those goals.  SAMHSA addressed the sleep/insomnia issues in a Fall 2014 brief; they outlined several non-pharmacological interventions and several lifestyle tips for promoting healthy sleep.  These strategies are effective and minimize risk of relapse, the caveat is that they require vigilance, commitment and take time to produce results.  Patience, especially when not sleeping well, can be elusive for people in early recovery.  This process can open the door for relapse when (some) pharmacological remedies are recommended.  The ultimate challenge of recovery is to delay instant gratification & sleep medicines (mainly sedative-hypnotics and benzodiazepines) eliminate that delay.  Compounding that issue, often times, is the far too casual approach towards these medicines by prescribers and people in early recovery.  It can be easy to minimize or dismiss the risks associated with these medicines when they produce immediate results.  They are mistakenly perceived/presented as “low risk” or “not risky at all”.  The seeds for relapse are sewn far in advance of the actual event.  It is a poor decision to start planting these seeds by prescribing someone  with a substance abuse history these medicines that have documented abuse potential (even if they are not the person ‘drug of choice’).  It is equally risky (if you’re a person in recovery or loved one to someone in recovery) to start seeking these medicines for fast relief of insomnia.  A recent article published by NPR talks about the benefits of utilizing therapy to root out the underlying causes of insomnia.  This can help a person safely improve their sleep without the risks some medicines create.  A key statement from the NPR article quoting Dr. David Cunnington, director of the Melbourne Sleep Disorders Centre in Australia, explains the basic difference between lifestyle changes/therapy and sedatives to treat sleep problems: “A medication just puts a blanket over that anxiety and helps people get rest. But cognitive behavioral therapy addresses the core problems, challenging people’s thinking around sleep.  It can actually break the cycle of insomnia”.  SAMHSA, in the brief mentioned earlier in this commentary, cites Harvard Medical School, Division of Sleep Medicine and the National Sleep Foundation in their list of tips for Promoting Sleep Hygiene.  These tips include: 1) Go to bed and get up at the same times each day 2) Use natural light (that comes through a window) to remind yourself of when it’s time to be asleep & awake 3) EXERCISE regularly 4) If you take naps, keep them short and before 5pm 5) Don’t eat or drink too much when it is close to bedtime 6) Avoid caffeine and nicotine for several hours before bedtime 7) Wind down before going to bed (take a warm bath/shower, light reading or practice relaxation techniques). 8) Keep the bedroom a relaxing place – avoid paying bills or doing work from the bed 9) Sleep in a dark, quiet room that isn’t too hot or too cold & 10)Don’t lie in bed awake. If you can’t fall asleep within 20 minutes get up and do something relaxing.  To read more about sleep problems associated with addiction and recovery check out SAMHSA’s In Brief here.  To read more about hoe therapy & counseling can be helpful for sleep problems, check out NPR’s article here

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