Sleep And Addiction Recovery: How Good Sleep Habits Can Improve Recovery Outcomes

Consistent, healthy sleep habits promote a deeper slumber, which is essential for good health. Sleep fosters cellular repair, hormone functions, and many other vital bodily processes.

Good sleep habits can also help people manage mental health disorders, including substance use disorders (SUDs), as high-quality sleep can create better recovery outcomes.

Though more research is needed on the connection between sleep and recovery, scientists are exploring ways to include sleep treatment as part of addiction care.

Sleep Cycles In Addiction Recovery

The average adult requires seven to nine hours of sleep per night.

During those hours, sleep occurs in four stages: N1, N2, N3, and rapid eye movement (REM) sleep. We cycle through these stages multiple times throughout the night.

The first three stages are lighter ones. During these stages, a person may be awakened easily.

Though these early stages benefit the brain and body, the most substantial changes occur during REM sleep, when the brain and body heal.

As a result, the REM stage may be the most beneficial for people in addiction recovery, which is a complex process that fosters healing in both the mind and the body.

When people in recovery get enough sleep, they provide some of the fuel that their bodies need for this process.

How Substance Abuse Impacts Sleep

According to research on sleep and addiction, sleep problems may occur during a high, after a high, and during abstinence and withdrawal.

These problems may include difficulty falling asleep, staying asleep, or experiencing deep sleep.

SUDs and sleep difficulties often turn into a vicious feedback loop. An SUD may create sleep difficulties, for example, and sleep difficulties increase a person’s risk of substance abuse.

Sleep And Stimulant Abuse

Stimulants are drugs that speed up the central nervous system (CNS). They boost dopamine, a brain chemical that promotes wakefulness.

These drugs can include prescription stimulant medications and illicit drugs such as cocaine and methamphetamine.

They can disrupt the sleep-wake cycle, especially if consumed at night or late in the day. A person who consumes stimulants may find themselves unable to fall asleep at night.

Some people may continue to abuse stimulants to deal with the fatigue that comes from a lack of sleep, thus prolonging these difficulties.

Sleep And Depressant Abuse

Depressant drugs are substances that slow CNS activity. They provide temporary anxiety relief, and they are sometimes prescribed for sleep issues.

However, some people develop an addiction to sleep medication, which often causes rebound insomnia when they stop taking it.

Not all depressant substances are prescription medications. For example, alcohol is classified as a depressant.

While many people may fall asleep easily after drinking alcohol, this substance blocks high-quality sleep by disrupting the REM cycle.

Sleep And Opioid Abuse

Opioids are drugs that attach to the brain’s opioid receptors. This interaction relieves pain and can cause euphoria.

These drugs include prescription opioids such as morphine and oxycodone, as well as heroin, an unregulated street drug.

Like alcohol, opioids cause relaxation that may initially induce sleep but can also disrupt the crucial REM stage of sleep.

Studies on opioid use and sleep reveal that these drugs disrupt sleep in several ways.

These disruptions include:

• contributing to sleep apnea
• causing shallow breathing
• reducing sleep efficiency
• disrupting slow-wave (N3) sleep

Sleep And Marijuana Abuse

Though marijuana is less addictive than many other substances, marijuana abuse can lead to addiction, as well as withdrawal symptoms when people stop using it.

Marijuana causes euphoria when it binds to cannabinoid receptors.

Because these receptors play a role in sleep and wakefulness, many people who use marijuana experience sleep difficulties when attempting to quit.

How Sleep Promotes Addiction Recovery And Prevents Relapse

While poor sleep and substance abuse contribute to each other, the opposite is also true. Quality sleep and addiction recovery can benefit each other.

The early stages of recovery, including withdrawal, may cause sleep disturbances as the body adjusts to the lack of substances.

However, when a person stops taking substances that have interrupted their rest, the body can re-establish healthy sleep patterns.

Those healthy sleep patterns can, in turn, provide the physical and mental energy the person needs to overcome common relapse triggers and heal from addiction.

Physical Benefits Of Sleep For Addiction Recovery

High-quality sleep improves our ability to perform tasks. When we have slept well, our bodies can complete more tasks, and we can do them more accurately than when we are not rested.

When we have not slept well, these same tasks require more effort and willpower, as we do not have the same access to our energy reserves.

Healing from substance abuse can require a lot of physical energy. However, studies show that people tend to give up on endeavors more quickly when they have less energy.

Furthermore, we make poor choices, including choices that impact our health, when we become sleep deprived. This is one reason why fatigue is a common trigger for SUD relapse.

Consistent, quality sleep, however, can mitigate this risk and provide the energy that people need to continue their recovery.

Emotional Benefits Of Sleep For Addiction Recovery

Adequate sleep promotes many emotional health benefits, including a decreased vulnerability to stress.

Research on sleep and stress shows that people who get at least eight hours of sleep report less stress than those who do not.

For many people in recovery, stress is a potential relapse trigger. When people get enough sleep during recovery, that sleep may equip them to continue their abstinence even during stressful situations.

Additionally, sleep protects the brain from other common emotional relapse triggers, including depressed mood and anxiety.

Though it is still possible to experience negative emotions while rested, we are more reactive to these emotions when we are sleep deprived.

Sleep helps us regulate our emotions, allowing us to cope with emotional difficulties in healthy ways.

Cognitive Benefits Of Sleep For Addiction Recovery

Sleep is essential to brain function. Several processes occur during sleep that allow our brains to perform at their best the next day.

For example, sleep has a big impact on learning and memory, which may help people as they heal from SUDs.

In the early stages of treatment, people learn healthy strategies and coping mechanisms for addiction. Quality sleep can help them to remember these strategies more easily.

Sleep also promotes better focus, attention to detail, reasoning, and problem-solving, all of which can help people remember their treatment goals and motivation and equip them to overcome recovery obstacles.

How Addiction Recovery Promotes Better Sleep

As better sleep promotes addiction recovery, healing from substance abuse can also promote better sleep.

Because drugs and alcohol can disrupt sleep cycles, removing these substances from the body can restore healthy slumber.

Reducing Sleep Disturbances

As stated above, certain drugs promote wakefulness, making it difficult to relax and fall asleep. Other drugs may cause drowsiness, but these drugs often prevent REM sleep.

As people’s bodies adjust to the lack of substances, these disruptions may stop.

Note that it does take time for the body to re-establish normal sleep cycles, and many people experience sleeplessness during withdrawal.

However, long-term recovery promotes better sleep and allows people to sleep more deeply than they did when using drugs.

Sleep Disorder Recovery

Drug use can cause or worsen sleep disorders. For instance, two of the most common sleep disorders are insomnia and sleep apnea.

Insomnia is characterized by difficulty falling asleep and staying asleep. Sleep apnea causes breathing difficulties and persistent snoring, which results in poor sleep quality and fatigue.

When drugs factor into these issues, stopping drug use often reverses any negative effects caused by their use.

Tips For Getting Enough Sleep In Recovery

While we generally understand why we need high-quality sleep, actually getting enough sleep can be challenging, especially while in recovery from addiction.

Factors such as withdrawal symptoms and adjusting to treatment can make a good night’s sleep seem impossible.

If you are currently healing from addiction, allow your body time to adjust. Worrying about a lack of sleep can make the issue worse.

As your brain and body adapt to sobriety, the following tips can help you improve your sleep.

Medical Detox And Medication-Assisted Treatment

For many people, withdrawal is the most difficult stage of addiction recovery.

Symptoms of withdrawal can include sleeplessness, but secondary factors such as physical pain and flu-like symptoms can also impede your ability to relax and to sleep.

Medical detox and medication-assisted treatment (MAT) can mitigate these issues.

During medical detox, doctors can administer prescription and over-the-counter medications that alleviate withdrawal symptoms and help participants fall asleep.

MAT uses medication on a more long-term basis, often allowing participants to taper off of drugs gradually. It is especially common and effective as a treatment for opioid use disorders.

Like medical detox, MAT reduces withdrawal symptoms, including those that can disrupt sleep.

Whole-Person Addiction Care

Whole-person addiction care focuses on healing the physical, emotional, mental, and spiritual aspects of substance abuse. It is sometimes called “holistic” care.

However, the term “holistic” may also refer to a non-medical rehab center that uses alternative treatment methods, such as art therapy or acupuncture.

If you are interested in either type of holistic addiction care, make sure that you clarify which type of program is being offered.

Programs that take the whole-person approach may emphasize the importance of sleep, providing tips and support for a good night’s rest.

These programs may also promote factors that contribute to sleep, such as daytime exercise and adequate nutrition.

Sleep Hygiene

“Sleep hygiene” refers to healthy bedtime habits that promote restfulness. Good sleep hygiene can make it easier to fall asleep and stay asleep throughout the night.

These habits may be especially beneficial to people in recovery, as a bedtime ritual can provide something to occupy the mind and body in the absence of drugs or alcohol.

Minimize Blue Light Exposure

One important aspect of sleep hygiene is to minimize the use of electronics before bed.

The blue light from phone and computer screens mimics daylight and sends wakefulness signals to the brain.

However, because abstaining from drugs requires a lot of mental energy, you may find it difficult to abstain from screen time as well, especially if you find this habit familiar and comforting.

If you struggle to eliminate screen time altogether, you might take a harm-reduction approach instead.

Your devices may have a “dark mode” setting or a setting that uses yellow light instead of blue light during the evening hours.

Try using these settings while reducing your screen time by just a few minutes. Over time, you might try reducing screen time in small increments until you have stopped completely.

Other Sleep Hygiene Habits

In addition to reducing blue light exposure, you can implement other bedtime habits that promote sleep.

Some proven sleep hygiene habits include:

• going to bed at the same time every night
• waking up at the same time every morning
• making sure that your bedroom is as dark as possible
• keeping your bedroom cool and comfortable
• avoiding large meals and caffeine too close to bedtime

Seeking Care For Sleep Disorders

If you have a sleep disorder that is not caused by drugs or alcohol, seek care from a doctor if possible.

A doctor may provide treatment that can help you sleep better, such as a continuous positive airway pressure (CPAP) machine for people with sleep apnea. Your doctor can also refer you to a sleep specialist.

For some, a sleep disorder may be an underlying cause of chemical dependency, as being unable to sleep or sleep well may cause people to use substances for relief.

For these people, addressing this root cause of addiction can aid the recovery process.

When you seek treatment, tell your doctor about your history of substance use. You will not be penalized for this information, but your doctor will keep it in mind while prescribing medication.

For example, they may provide a medication with a low risk of dependency or a low risk of interaction with substances you have used.

Seeking Care For Co-Occurring Disorders

Many people who experience addiction also have a co-occurring disorder.

A co-occurring disorder, or dual diagnosis, is any mental health condition that a person experiences along with an SUD.

Like addiction, many of these conditions disrupt sleep. Depression, for example, can cause excessive sleepiness during the day and difficulty falling asleep at night.

Post-traumatic stress disorder (PTSD) can cause hypervigilance, preventing people from relaxing enough to fall asleep, as well as nightmares and other sleep disturbances.

If you do have sleep issues related to a co-occurring condition, consider seeking dual diagnosis care.

Dual diagnosis care addresses both the SUD and the accompanying mental health condition. Treating the co-occurring condition may help you get to the root of your sleep difficulties.

Timing, Exercise, And Breakfast

Many factors impact how much and how well we sleep at night.

One study from the University of California, Berkeley recommends a three-part strategy to improve slumber: adjusting your wake-up time, exercising during the day, and eating the right breakfast.

The study notes that people who slept later than their usual wake-up times felt more energized throughout the day than those who did not.

The study also indicates that exercise during the day promotes wakefulness, as does a breakfast that includes complex carbohydrates.

To implement these recommendations, you might try some of the following tips:

• Adjust your morning routine to allow for a later wake-up time. For example, you could shower at night instead of the mornings, or you could choose your outfit the night before.
• If your morning routine has no room for adjustments, try going to bed a few minutes earlier instead.
• Add fruits or whole grains to your breakfast.
• Take walks or add other simple physical activities to your day.

The HALT Relapse Prevention Strategy

Addiction treatment programs often teach relapse prevention strategies that participants can use after graduating.

One of these strategies is the HALT method, which addresses common addiction triggers.

HALT is an acronym that stands for:

• hungry
• angry
• lonely
• tired

This strategy asks people to halt, or pause, when confronted with a possible relapse and ask themselves if they are experiencing any of the above feelings.

If so, they can remedy that feeling to the best of their ability, which can prevent them from using drugs or alcohol to cope.

If this strategy works for you, pay close attention to the “tired” trigger because it can magnify the other three.

If you do feel tired, you might take a short nap or give yourself permission to accomplish fewer tasks.

Finding Addiction Treatment

Because sleep and recovery overlap so much, it can be difficult to address both concerns at once. If you haven’t started addiction treatment yet, consider a drug rehab center.

The structure and resources at a rehab center can help you adjust your sleep patterns as you receive addiction care.

Resources For Improving Sleep Quality During Addiction Recovery

Addiction recovery is often a complex process, and sleep issues can complicate it even further. However, resources are available for both SUD healing and sleep.

Here you’ll find some resources that can help you get started.

The following resources can help people with SUDs find addiction treatment and support, which may also improve sleep disturbances:

• FindTreatment.gov — This Substance Abuse And Mental Health Services Administration (SAMHSA) website can help you find addiction treatment and other mental health services in your area.
• Opioid Treatment Program Directory — SAMHSA also provides this tool for locating opioid addiction treatment, including MAT programs.
• SMART Recovery — This nonprofit organization provides an alternative to 12-step groups.
• Sober Apps: New Tools To Help Those In Recovery — Get Smart About Drugs, a U.S. Drug Enforcement Administration (DEA) resource, provides this list of apps that people can use during their recovery journey.
• Start Your Recovery — This organization provides information for people with addictions as well as their loved ones.

These resources may help people in recovery to improve their sleep outcomes:

• Bedtime Calculator — This tool from the American Academy of Sleep Medicine (AASM) helps people choose the best time to go to bed based on age and wake time.
• Epworth Sleepiness Scale — This tool from Harvard University measures daytime sleepiness and helps people determine whether they are getting enough sleep at night.
• National Sleep Foundation — The NSF is a nonprofit organization that provides research, education, and other resources to promote quality sleep.
• Sleep Diary — This printable resource from AASM allows people to track habits that impact sleep quality.

Here you’ll find resources for people who suspect they have a sleep disorder:

• American Sleep Apnea Association — The ASAA provides education and resources for people who experience sleep apnea.
• AASM Search Tool — People can use this tool to find sleep disorder specialists in their area.
• Narcolepsy Network — This organization offers information and resources for people who experience narcolepsy, a disorder that causes excessive sleepiness.

Written by the Addiction Resource Editorial Staff