Sleep

What are some of the sleep problems that people experience in recovery?

When you were using alcohol or other drugs, your sleep pattern may have been disrupted. Now that you are in recovery, post-acute withdrawal from alcohol and other drugs can leave you feeling sleepless and exhausted. Don’t worry. This process is normal, and it happens to most people in recovery. Eventually you will want to establish normal sleep patterns. The average person needs between seven to ten hours of sleep each night.

Sleep is important because it allows your body’s metabolism to slow down enough to repair daily wear and tear. Roughly one-fifth of all slumber time is spent in REM (rapid eye movement) sleep; this is where large amounts of psychological healing work are often accomplished.

What is sleeplessness?

Sleeplessness can take several forms:

• difficulty falling asleep: one to three hours may pass before you can actually fall asleep
• early morning awakenings: you wake early in the morning and are unable to get back to sleep
• frequent nighttime awakenings: you fall asleep easily but wake up many times during the night

Many people worry about their sleep difficulties. This can create a vicious cycle: the more a person worries about being able to fall asleep, the more difficult it actually becomes. Once you get into bed, you may worry about things such as “Will I be able to sleep tonight?” or “Will I be too tired tomorrow to get my work done?” This type of worrying will only increase your level of physical arousal and impair your ability to sleep and relax.

Should you use medications to help you sleep?

Using medications to induce sleep can be unhealthy. Not only are many sleep inducing medications addictive, they can also make sleep problems worse.

Withdrawing from these types of drugs, such as benzodiazepines and barbiturates, actually cause a rebound effect where sleep difficulties temporarily worsen before improving on their own. This can be true even when the medication is not addictive. Many nonaddictive, sedating medications merely delay the process of correcting sleep problems.

Healthy options for improving sleep

There are many effective strategies for dealing with sleeplessness that do not involve using drugs:

• Take a hot bath or shower before bed. Doing so will increase your body’s core temperature and help you relax.
• Exercise four hours before bedtime, usually between 4:00 p.m. and 7:00 p.m. Mild to moderate exercise during these times will promote and induce sleep later in the evening. Exercising too intensely or too late in the evening may make falling asleep more difficult.
• Avoid caffeine. If you insist on daily coffee or sodas, limit your caffeine intake to the early morning. Switch to decaffeinated beverages after 10:00 a.m.
• Avoid using your bed for reading, writing, watching television, talking on the phone, or engaging in other activities that require mental alertness. Using your bed in this manner conditions your brain to react with increased alertness, which can keep you awake when you’re ready to sleep.
• If you are tossing and turning in bed after twenty to thirty minutes, get out of your bed, go to another room, and engage in some type of relaxing activity, like reading, stretching gently, or meditating. Go back to bed only when you feel sleepy.
• Use relaxation strategies. There are many different sleep tools available, including relaxation techniques and CDs or audio downloads. Try different tools until you find the one that works for you.
• Avoid naps during the day. Although a nap feels good when you are tired after a night of sleeplessness, it only makes the problem worse the follow- ing evening.
• Use “white noise.” A fan, relaxing music played very softly, or other background noise can allow the senses to relax rather than be alerted by sudden changes in noise level.
• Eat small amounts of carbohydrates, such as popcorn, toast, or cereal, prior to bedtime. Some carbohydrates contain tryptophan, the amino acid that the body uses to make serotonin, the neurotransmitter that slows down nerve traffic. A high-carbohydrate meal also stimulates the release of insulin, which helps clear from the bloodstream the amino acids that compete with tryptophan, allowing more of this natural sleep-inducing amino acid to enter the brain.
• Develop a relaxing ritual for the fifteen to twenty minutes prior to sleep, such as meditating, listening to relaxing music, and/or practicing relaxation techniques. This will help you relax your mind and body.
• It is important that you practice these techniques on a regular basis because lack of rest can set you up for relapse and an eventual return to use. Change in sleep patterns may not happen “overnight.” But by developing good sleep habits, you will be taking good care of yourself and ad- dressing sleep problems in healthy ways. If your sleep problems persist for more than six months during your recovery, contact your physician for a referral to a sleep clinic for a full evaluation.

Remember, you may experience periods of exhaustion during recovery. This is normal. If your exhaustion exists for an extended period of time, contact your physician to see whether there are any other underlying physical or mental issues that should be addressed.

Recovery Action Step

What are some strategies you could use to handle sleeplessness or exhaustion? Journal about these and create your own plan of action.

What are some typical dreams people experience in recovery?

It is not uncommon for those in recovery, even people who have been in recovery awhile, to have dreams of drinking or using. Not everyone has this experience, but many do. It is a normal part of recovery, and it is harmless. What those dreams mean from a psychoanalytic standpoint is not as important as the fact that they do happen, and they shouldn’t surprise you.

For example, some recovering people dream that they are drunk, but they’re sure that they haven’t taken a drink. Others experience chills, shaking, or jitters when they wake up, as if they had been drinking. Of course this is all a bad dream, but it can be alarming. Being unsettled by these dreams is good because it indicates that you are far enough along in your recovery to realize that sobriety is what you want—that you don’t want to go back to living the nightmare of using.

Here are some general guidelines for what to expect from your dreams during your recovery:

Early recovery

Drug and alcohol use interferes with normal sleeping. When the using stops, many people experience frequent and intense dreams. The dreams seem very real and frightening. Remember, these are a normal part of the recovery process, and you are not responsible for using alcohol or other drugs in a dream. Exercise is a tool that may help you lessen this dream activity.

Middle recovery

Dreams about using typically become less frequent after six months of recovery. When they do occur, they can create powerful feelings that last well into the following day. It is important to be extra careful to avoid relapse on days following powerful dream activity. Often, dreams during this period are about deciding to use or not to use, and they can indicate how you feel about those choices.

Late recovery

During this time, dreaming about alcohol or other drug use can help warn you when you are more vulnerable than usual to relapse and an eventual return to use. When you have dreams about using, review your situation and correct any problems you discover. Listed below are some helpful actions you can take when dreams begin:

• Exercise.
• Go to Twelve Step meetings or to other outside support groups.
• Call a counselor.
• Talk to sober friends.
• Take a break.
• Stay away from alcohol and other drugs.

The great thing about sleep when you are sober is that you can wake up with no hangover and no concerns about what happened the night before. You can wake up feeling hopeful and content—another recovery gift you’ll receive one day at a time.