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Alcohol Use and Sleep

Problems initiating or maintaining sleep are commonplace, and disruption of sleep may be caused by many factors. Sleep difficulties prompt some people to use alcohol as an antidote to insomnia. However, alcohol use itself produces aberrant sleep patterns. The study of the effect of alcohol and other drug use on sleep is an ongoing research focus. A brief review of normal sleep is necessary to understand the research study discussed in this review. For the normal person, sleep occurs in four stages. Two brief stages of sleep (1 and 2) typically precede stage 3, slow wave sleep (SWS), the deepest sleep. Twenty-five percent of sleep time is spent in SWS. In the normal sleeper, after a period of SWS, every 90 minutes or so for about 5-30 minutes, stage 4 follows, which is a period of sleep characterized by rapid eye movement (REM). Periods of lighter sleep occur at intervals during the night. In clinical studies, persons who are deprived of REM sleep by researchers who waken them at the onset of REM sleep attain REM sleep much more quickly and frequently when they are permitted to sleep again. REM sleep is associated with dreaming. People deprived of REM sleep do not seem to be adversely affected, at least in clinical situations of short duration. In clinical studies, people deprived of SWS are affected by feeling less rested and having more daytime sleepiness. REM and SWS are thought to have very different functions. One hypothesis poses that the brain recognizes REM sleep as a type of wakefulness. A person deprived of REM sleep (at least for a short while) would not necessarily feel sleep deprived because the brain recognizes this form of sleep as a type of activity associated with consciousness (Dement, 1999). The International Classijkation of Sleep Disorders, Diagnostic and Coding Manual describes 78 sleep dyssomnias in three categories: intrinsic sleep disorders, extrinsic sleep disorders, and circadian rhythm disorders. AlcoholDependent Sleep Disorder is listed under extrinsic sleep disorders and is diagnosed when an individual has used alcohol to initiate and maintain sleep for at least 30 days. Included in the category Sleep Disorders Associated with Medical Disorders is found Alcoholism, which is characterized by fragmented sleep during a drinking episode and during abstinence. This fragmented sleep is often characterized by nightmares and other anxious dreams. The relationship of drug or alcohol use to sleep is complex. This relationship is explored in the following study by Drummond et al.