Assessing the Risks of Using Alcohol as a Sleep Aid – Clinical Advisor

September 14, 2018Share this content:
Using alcohol as a sleep aid can lead to alcoholism and maintenance insomnia.

Taking a good history of all the medications a patient is using — including illicit drugs and alcohol — is vital as virtually all drugs with a high abuse potential have an effect on sleep.1 Unfortunately, one of the most common substances patients use to aid in sleep induction is alcohol.2 Approximately 30% of people with insomnia report using alcohol to help promote sleep.1,2

Studies have shown that alcohol consumed in low quantities approximately 30 minutes before bed may improve sleep in those with insomnia.1,2 However, alcohol consumed in larger quantities may impair  the second half of sleep. When alcohol is completely metabolized during the night, it causes rebound wakefulness during the last hours of sleep.

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Recently, researchers at the Sleep Disorders and Research Center in Detroit, Michigan, reported the risks of using alcohol as a sleep aid.2 Initially, alcohol appeared to improve sleep efficiency and increase sleep stages 3-4. After the sixth night of alcohol-induced sleep, however, the participants in the study lost any benefit from consuming alcohol. This caused participants to increase their self-administered alcohol quantity. 

This is the major concern for patients who drink alcohol to help promote sleep: Repeated nightly use leads to the development of tolerance.1,2 Once a patient becomes tolerant to a substance, the patient needs more of the substance to achieve the same effect. Alcohol tolerance can lead to a myriad of health issues as well as alcoholism. I have had many patients who later became alcoholics say they started drinking for anxiety issues and to help them sleep.

Unfortunately, if a patient has been drinking for a long time and decides to stop, his or her

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