Insomnia and Addiction

According to research findings, roughly 10% of the global population displays symptoms of insomnia, suggesting a medical condition. Interestingly, individuals involved in substance use experience higher rates of sleep disturbances. Reports show that approximately 70–74% of those undergoing treatment for alcohol or other drug issues express distress related to their sleep.

We take a closer look at insomnia and why it’s so prevalent among those suffering from addiction. We also provide help with information about treatment options, tips for better sleep hygiene and the next steps for finding treatment.

What is insomnia?

Insomnia is a sleep disorder characterised by persistent difficulty falling asleep, staying asleep, or achieving restorative sleep, despite having the opportunity to do so. There are, in fact, different types of insomnia, shown below:

  • Onset insomnia: This refers to difficulty falling asleep at the beginning of the night. Individuals experiencing onset insomnia may find it challenging to initiate the sleep process when they initially go to bed.
  • Maintenance insomnia: This involves difficulty staying asleep throughout the night. People with maintenance insomnia may awaken during the night and struggle to return to sleep, leading to fragmented and disrupted sleep patterns.
  • Behavioural insomnia of childhood: This is a sleep disorder commonly observed in children. It is characterised by difficulties in falling asleep or maintaining sleep and is often associated with behavioural factors such as resistance to bedtime routines.
  • What causes insomnia?

    To identify the causes of insomnia, we must initially examine the two distinct types of severity: chronic insomnia and acute insomnia.

    Chronic insomnia

    Chronic insomnia is diagnosed when sleep difficulties persist for an extended period, typically at least three nights per week for three months or more. Healthcare professionals may use the following criteria to diagnose chronic insomnia:

    Signs of insomnia
    Difficulty falling asleep, staying asleep, or experiencing non-restorative sleep occurs at least three nights per week.
    Duration of symptoms
    Symptoms persist for three months or longer.
    Impact on functioning
    Insomnia significantly impairs daytime functioning, leading to issues such as fatigue, mood disturbances, difficulty concentrating, and decreased performance at work or in daily activities.
    Chronic insomnia can be caused by various factors, including:

    • Psychological factors: Anxiety, depression, stress, and other mental health conditions.
    • Medical conditions: Chronic pain, arthritis, gastrointestinal problems, respiratory disorders, and hormonal imbalances.
    • Sleep disorders: Conditions like sleep apnea, restless legs syndrome, and periodic limb movement disorder.
    • Lifestyle factors: Poor sleep hygiene, irregular sleep schedule, excessive caffeine or alcohol intake, and lack of physical activity.
    • Environmental factors: Uncomfortable sleep environment, noise, or disruptions.

    Acute Insomnia

    Signs of insomnia
    Symptoms persist for a shorter duration than chronic insomnia, often ranging from a few days to a few weeks.
    Acute insomnia is often linked to a specific triggering event, such as stress, significant life changes, illness, or environmental factors.
    Acute insomnia is commonly associated with identifiable triggers, including:

    • Stressful events: Work-related stress, financial difficulties, relationship issues, or major life changes like moving or loss of a loved one.
    • Illness: Physical discomfort due to illness or recovery from surgery.
    • Environmental factors: Changes in sleep environment, excessive noise, or disruptions.
    • Jet lag: Disruption of the circadian rhythm due to rapid travel across time zones.
    • Medications: Some medications may cause temporary sleep disturbances as a side effect.

    What is a dual diagnosis of insomnia and addiction?

    A dual diagnosis of insomnia and addiction refers to the coexistence of both a substance use disorder (addiction) and a sleep disorder (insomnia) in an individual. This means that a person is simultaneously struggling with issues related to substance abuse or dependence and experiencing difficulties with sleep.

    Why does addiction co-occur with insomnia so often?

    The relationship between addiction and insomnia is complex and multifaceted, and several factors contribute to their co-occurrence. It’s worth noting that the relationship between insomnia and addiction can be bi-directional. This means that those with substance addictions could develop insomnia, and those with insomnia could develop a substance addiction.

    It’s also important to note that not everyone with addiction experiences insomnia, and not everyone with insomnia develops an addiction. However, there are some common mechanisms and factors that can explain the frequent association between the two:

  • Withdrawal symptoms: When individuals addicted to substances attempt to quit or reduce their use, they often experience withdrawal symptoms. Insomnia is a common withdrawal symptom for many substances, making it challenging for individuals to maintain regular sleep patterns during recovery. A study found that 66.5% of those receiving treatment in a detox centre for Substance Use Disorder experienced insomnia, with sleep-maintenance insomnia being the most frequent type reported.
  • Psychological factors: Both addiction and insomnia can be influenced by psychological factors such as stress, anxiety, and depression. Substance abuse may be a way for individuals to cope with these issues, and the resulting mental health challenges can contribute to insomnia.
  • Disruption of circadian rhythms: Substance abuse can disrupt the body’s natural circadian rhythms, which regulate sleep-wake cycles. This disruption can lead to difficulties falling asleep or staying asleep, contributing to insomnia. Conversely, poor circadian rhythms have also been correlated with substance abuse, with a greater chance of developing addiction.
  • Lifestyle factors: Individuals with a drug addiction may adopt irregular or chaotic lifestyles, with inconsistent sleep schedules and poor sleep hygiene. Unhealthy lifestyle choices can exacerbate sleep problems.
  • Co-occurrence of mental health disorders: Both addiction and insomnia often co-occur with other mental health disorders. For example, a study suggests that someone with a history of trauma or post-traumatic stress disorder (PTSD) may be at a higher risk for both addiction and insomnia.
  • Treatment options for insomnia and addiction

    Addressing both insomnia and addiction disorders concurrently presents unique challenges, but they are certainly beatable. UKAT possesses extensive expertise in effectively treating individuals dealing with dual-diagnosis conditions.

    Initiating the recovery process begins with a medically assisted detox which entails a careful reduction and elimination of the addictive substance from the body. Nonetheless, it’s essential to note that detox can potentially worsen insomnia symptoms, underscoring the importance of simultaneously managing sleep disturbances.

    Therapies proven effective for addiction, such as cognitive behavioural therapy for insomnia (CBT-i), can also be beneficial for individuals dealing with insomnia. CBT-i yields outcomes comparable to those of sleep medication but without any side effects, fewer instances of relapse, and a propensity for sustained sleep improvement well beyond the conclusion of the treatment. The enduring enhancements appear to stem from the patient acquiring skills to support and enhance the body’s innate sleep mechanisms.

    Adopting a holistic approach is crucial in addressing insomnia by considering the person as a whole- mind, body, and spirit. Holistic therapies, also known as alternative treatments, include yoga, meditation, aromatherapy and more. These treatments prove valuable in enhancing relaxation and reducing stress, thereby facilitating better sleep.

    Post-treatment care, or aftercare, is a crucial element of the recovery journey as it aids in maintaining the progress achieved during treatment. This encompasses group therapy sessions, offering ongoing support and reinforcing healthy habits.

    Will rehab cure my insomnia?

    While the rehab treatment we provide isn’t directly aimed at treating insomnia, many of the therapies and techniques we use to assist drug addiction will have a positive effect on your sleeping hygiene. Once you have completed rehab, keeping your sleep hygiene levels at the highest is crucial. You can do this by:

    Keeping to a consistent sleep schedule
    Maintain a consistent sleep routine by retiring and rising at consistent times daily, including weekends. This practice assists in aligning your body’s internal rhythm, facilitating easier and more natural transitions into slumber and wakefulness.

    Creating a relaxing bedtime routine
    Establish a calming pre-sleep routine to signal to your body that it’s time to wind down. This might include reading a book, taking a warm bath, practising relaxation exercises, or gentle stretching. Avoid stimulating activities and bright screens at least an hour before bedtime.
    Optimise your sleep environment
    Transform your bedroom into a serene and conducive space for sleep. Ensure it remains dark, tranquil, and at a comfortable temperature. Prioritise a supportive mattress and plush pillows for optimal rest. Ponder incorporating blackout curtains, earplugs, or a white noise machine to shield against external disruptions.
    Limit stimulants and electronic devices
    Avoid stimulants like caffeine and nicotine in the hours leading up to bedtime. These substances can interfere with your ability to fall asleep. Additionally, reduce your screen time before bedtime, as the blue light emitted from electronic devices can disrupt your circadian rhythm. Consider using blue light filters on your devices or wearing blue light-blocking glasses in the evening.
    Regular exercise
    Participate in consistent physical activity, ensuring you complete your exercise regimen several hours before you plan to sleep. While exercise generally enhances sleep quality, engaging in strenuous activities too close to bedtime might hinder it. Strive to strike a suitable balance, and contemplate incorporating relaxing activities such as yoga or light stretching into your evening routine.

    The next steps

    If you or someone you care about is grappling with both insomnia and addiction, taking the essential step of seeking professional assistance is paramount. At UKAT, we offer a nurturing and understanding setting for addiction recovery. Simultaneously, we address and manage insomnia symptoms effectively. Contact us today to explore our treatment solutions and begin your path to recovery.

    Call us now for help

    (Click here to see works cited)

    • Grau-López L, Grau-López L, Daigre C, Palma-Álvarez RF, Martínez-Luna N, Ros-Cucurull E, Ramos-Quiroga JA, Roncero C. Insomnia Symptoms in Patients With Substance Use Disorders During Detoxification and Associated Clinical Features. Front Psychiatry. 2020 Nov 17;11:540022. doi: 10.3389/fpsyt.2020.540022. PMID: 33312131; PMCID: PMC7704430.
    • Hasler BP, Smith LJ, Cousins JC, Bootzin RR. Circadian rhythms, sleep, and substance abuse. Sleep Med Rev. 2012 Feb;16, 1:67-81. doi: 10.1016/j.smrv.2011.03.004. Epub 2011 May 26. PMID: 21620743; PMCID: PMC3177010.
    • Colvonen PJ, Straus LD, Drummond SPA, Angkaw AC, Norman SB. Examining sleep over time in a randomised control trial comparing two integrated PTSD and alcohol use disorder treatments. Drug Alcohol Depend. 2020 Apr 1;209:107905. doi: 10.1016/j.drugalcdep.2020.107905. Epub 2020 Feb 11. PMID: 32065939; PMCID: PMC8515903.
    • Rossman J. Cognitive-Behavioral Therapy for Insomnia: An Effective and Underutilised Treatment for Insomnia. Am J Lifestyle Med. 2019 Aug 12;13, 6:544-547. doi: 10.1177/1559827619867677. PMID: 31662718; PMCID: PMC6796223.