Written by Katie Harris, Content Writer
Beginning treatment is a brave step on the road to recovery. If you searched for this article when you’d rather be asleep, you already know that sadly, this isn’t a process you will likely be able to sleep through, both figuratively and literally.
But try not to let that get you down, there is hope for those who are addicted and their families. The fact that you’re here and not self-medicating is a good sign, so give yourself a pat on the back. Recovering from addiction is one of the hardest things a human being could ever do, and look at you! You’re doing it.
You’re not alone, that’s why we did the research to help you learn what to expect with sleep and drug addiction recovery. The relationship between sleep and addiction isn’t simple, and there are often complications that could affect recovery or even predict relapse behavior. To learn how you can make the best of a difficult situation, read our guide on how respecting your rest can help you heal.
What’s the Link Between Sleep and Addiction?
According to the American Psychological Association, more than 40 million Americans suffer from nicotine, alcohol or drug addiction.
The hard truth is that during recovery, you are five to ten times more likely to experience sleep disorders, according to a study conducted at the University Hospital of Ohio.1
Depending on which addiction you’re kicking, these withdrawals can cause anything from extreme alertness to nausea, depression, and other issues that could make it hard to rest.
It’s important to realize that when you’re looking for a cure for insomnia, you’re at a higher risk for relapse. You know yourself best, so when you recognize the signs of insomnia, we recommend reaching out to those who can help before you reach a crisis. You don’t want to develop a new addiction while trying to kick another.
Some science suggests there is even a connection between the circadian rhythm (internal time-keeping) and substance abuse, meaning those with genetic sleep disorders may be predisposed to addictive behavior.2
If you fall into that category, you may be in for a rough spell, but we encourage you not to give up. You got this! You’re even learning how to help yourself succeed, and for that we applaud you.
Before we dive into our guide too deeply, know there are options available for those in crisis, and if you feel you are on the verge of a relapse, we would encourage you to contact your sponsor if you have one or reach out to someone you trust who can help.
How Do Different Addictions Affect Sleep?
Not every addiction is the same, and while they may all interfere with sleep, some withdrawals will cause hyper arousal, and others may make you feel downright exhausted or depressed. Whatever you’re experiencing, we know it isn’t comfortable. That’s why we want to help you understand your symptoms, so you can catch those sweet Z’s as soon as possible, and if it helps to know that you aren’t the only one struggling, that’s great too.
Alcohol
Alcohol can cause insomnia whether you’re actively drinking or in recovery. This could be because many people with alcoholism began using the drug as a way to help them fall asleep. Alcohol is a depressant, so it may make you tired initially, but unfortunately these effects are short-lived, unlike addiction, and often end up causing early waking and shorter REM cycles.
As the body gains tolerance and becomes more dependent on alcohol, however, it will take longer and longer to fall asleep, and you’ll probably start waking up earlier. According to a report by the Substance Abuse and Mental Health Services Administration, when sleep disruptions continue into addiction detox, (particularly with alcohol), subjects become much more likely to relapse.3 If you are worried about relapsing, let us help with this bit of advice: alcohol won’t help you sleep.
When patients relapse into Alcoholism, they tend to experience a short-lived improvement (think twenty-four hours) with sleep that quickly gets worse again and could even reduce the chances of ever resting easily again. So you may ask yourself, is one night of sleep worth a lifetime of restlessness?
Sedatives
Like alcohol addiction, in many cases, sedative addictions can stem from sleep disorders that cause patients to seek a way to rest. When you go into recovery, the withdrawals may worsen the original effects of insomnia or other problems with rest in a hard-to-break cycle. As the sedative decreases in the bloodstream during withdrawal, Psychology Today reports symptoms could include insomnia, racing thoughts, anxiety, and in some cases, seizures.4
While cannabis or CBD in small amounts may help some people sleep, for those who are trying to quit, the effects may be different. Sleep problems can arise within the first few days of withdrawal and could last for weeks. For those in recovery, SAMHSA reports sleep problems may predict a relapse within two days of attempted abstinence.
Stimulants
Concerning stimulant recovery, while patients might expect to rest more easily as the accelerant wears off, the results tend to be a mixed bag. SAMHSA reports that patients experience a wide variety of results, with some experiencing worse quality of rest that they perceive to be better, and others noting the worsened rest. For those who are recovering from Cocaine, while they may sleep longer during recovery, REM and long wave cycles are significantly affected, decreasing the restful benefits of sleep, according to a UCLA study.5
| Addiction | Effects in Addiction | Effects in Abstinence/Recovery |
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| Alcohol |
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| Sedatives |
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| Stimulants |
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| Opioids |
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| Hallucinogens |
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Opioids
Many opioid addictions stem from an original injury that caused an unbearable amount of pain. As users become addicted to the medications that help them recover from an injury, sleep becomes less restful and stress levels often increase. According to the National Institutes of Health, opioid users often experience insufficient sleep duration, poor sleep quality, and irregular sleep schedules.6
If you’re recovering from opioids, you may feel that the sleep you do get doesn’t really help as much as you want it to. The Journal of Clinical Sleep Medicine says this is because opioid users struggle from reduced REM periods as well, which normally aids in emotional processing, stress management, and many other essential functions.7 During recovery, you may feel more stressed and anxious because of this, which could be misinterpreted as cravings, when really you just aren’t able to process emotions.
According to a university study in India mentioned in the same journal, this could put patients at risk for Restless Leg Syndrome.7 If you’re struggling with any of these symptoms, talk therapy may help you as processing your emotions could be the relief you need to combat cravings.
You should also know that many drugs used to treat opioid addiction can cause issues sleep walking.
Hallucinogens
Psychedelic drugs or hallucinogens can have an overall negative effect on rest despite creating a dream-like experience for users. Common side effects include poor sleep quality, insomnia, and in some cases, a lack of REM periods.
Drugs that affect serotonin levels are especially harmful to rest as they disrupt the circadian rhythm and make it difficult for the body to self-regulate sleep cycles. After a while, those who abuse the drug may end up only being able to dream when they are under the influence.
As these drugs are so addictive, doctors usually recommend recovery in a treatment center where professionals can help you navigate the process of withdrawals that often involves suicidal feelings, depression, and anxiety.8 However, there is hope in recovery. After a rough period of withdrawals, in many cases the body will be able to learn how to create positive emotions again organically, meaning happiness can return, you just have to stick it out.
Common Sleep Disorders During Recovery
While insomnia is one of the most common troubles with sleep, it is certainly not the only sleep disorder, nor is it the most difficult to treat. Drug abuse can make it take longer to fall asleep, cause frequent waking, and waking up early. After a while this might make it difficult to think clearly, focus, stay awake, or fight off infections. This is why taking care of yourself and seeking health care is so important during recovery.
Insomnia
Insomnia is the most commonly diagnosed sleep disorder among those with substance abuse disorders. You’ll recognize the symptoms of hyperalertness, anxiety, depression, and the obvious: the fact that you’re awake when you want to be asleep. However, did you know that taking longer to fall asleep, waking up early, and waking frequently are also insomnia?
When these symptoms occur at least three nights per week for more than a few months, doctors will generally issue a diagnosis. If you notice these symptoms, know you’re at risk for relapse. Don’t let all your hard work go to waste. Recovery should be applauded, and getting help when you need it is something you owe yourself.
It’s important to note that these symptoms have to occur in a situation that is otherwise conducive to rest. If you decide to stay up every night willingly playing video games or watching movies, we recommend turning off the lights and the music and trying to sleep on your own. If you still aren’t sleeping, talk to your doctor about your options.
Treatment for this disorder varies greatly depending on the circumstances and other contributing factors, but be aware that some doctors may prescribe sleeping pills or depressants if they are unaware of your circumstances which could result in addiction.
Learn More: Best Mattresses for Insomnia
Sleep Apnea
Outside of addiction recovery, there are two main causes for sleep apnea, one stemming from an actual blockage in air passages during sleep, and the other resulting from a brain problem that struggles to remind the body to breathe during sleep.
For those experiencing withdrawal symptoms from alcohol or opioids, there is an increased risk for sleep apnea, which could result in serious injury or death. This is because depressants can cause muscles in the upper air passageway to relax, causing snoring or the inability to breathe. This effect may cause patients to wake frequently, disrupting REM cycles and reducing the quality of rest, according to the New York Office of Alcoholism and Substance Abuse Services.
If you notice that you wake up from snoring, gasping, or you just don’t feel rested after sleeping all night, talk to your doctor about sleep apnea. They should be able to find the root of the problem.
Learn More: Exercises for Sleep Apnea and Best Mattress for Sleep Apnea
Restless Leg Syndrome
Restless Leg Syndrome is a disorder that causes discomfort in the legs and feet, which is somewhat alleviated by tapping or shaking the limbs. Those experiencing withdrawals from opioids and depressants may be put at a higher risk for developing RLS related to hyperactivity or anxiety.
“Most individuals with diagnosed substance use disorders have numerous potential risk factors that can contribute to the development of their issues … individuals with medical conditions that result in significant pain, stress, and problems with functioning who also have RLS/WED symptoms would be at an increased risk for substance abuse.” – American Addiction Centers9
Taking stimulants may make the issue worse, and withdrawals that increase restlessness may trigger the difficulty to fall asleep.
Related: Best Mattress for Restless Leg Syndrome
Side Effects from Methadone (Often Used to Help People Detox from Opioids)
Compared to substance abuse withdrawals, the side effects of Methadone seem relatively manageable, however, this doesn’t mean the drug should be taken lightly. When used to combat opioid withdrawals, methadone is more effective in mitigating problems with rest according to a study conducted in Iran, but it doesn’t mean it will eradicate them.10
One study found that taking a maximum or above maximum dosage of Methadone is significantly associated with a new onset of sleep problems, so in many cases, less in more.11 If this is the course your doctor has taken with you, be aware there have been known instances of sleep walking and sometimes vomiting associated.
Insomnia and the Likelihood of Relapse
We’re going to say it again, just so it’s clear. Sleep deprivation is closely tied to relapses in addictive behavior, especially with substance abuse. According to a study conducted in Cleveland, Ohio, this is because many controlled substances are widely used to help people rest.1
During recovery, when patients can’t find another way to get rest, it can be extra difficult to resist using drugs that aid in rest.
We aren’t trying to scare you–well–maybe we are. If you’re having a hard time with sleep during recovery (and the fact that you’re reading this means you probably are) you are going to need some help to get through this, but the good news is that you can get through this. Recovery and rehab can work for many people, and if you have been there before, sometimes it takes a few tries to really stick. Remember that setbacks aren’t failures, they are a part of the journey.
Getting back to the risks of relapse, remember that many studies show that the sleep-inducing effects of most drugs wear off over time. The Psychiatric Times reports that drinking up to six hours before you sleep can effectively ruin the second half of the sleep cycle.12 When you drink right before bed, you might not be able to fall asleep at all before too long.
The study goes on to say that periods of insomnia often occur when addicts enter a period of abstinence or attempted recovery. In heavy drinkers, these symptoms are somewhat alleviated when they relapse, but the cycle stops quickly when the sleep problems return because the alcohol no longer helps you sleep.
Part of the reason for the connection between sleep disorders and relapse could be that patients struggle to find adequate treatment for sleeping problems. In these cases, what begins as therapy-seeking could easily turn into drug-seeking. While drug-seeking usually revolves around the euphoric effect of controlled substances according to the Wayne State Study, these can become closely intertwined when the effects are coupled with sleep quality.
If doctors fail to identify which behavior a patient is exhibiting, he could aid in drug abuse or fail to help a patient in need of therapy. If this is happening to you, we are sorry your doctors and others have let you down, but it’s not too late to seek help. We recommend finding a doctor or friend you can be completely honest with. This way, they can help you avoid potential obstacles or temptations for relapse.
Questions for Your Doctor
Are sleeping pills addictive?
This is a great question for your doctor because it communicates your need for sleep, and your desire to avoid relapse. Hopefully, this will help them guide you in the right direction for relief. Not all sleeping pills are controlled substances, so there may be an option that is right for you. If not, your doctor should know to give you other options to help you rest.
Melatonin is widely described as a supplement or vitamin, but it’s classified as a drug. It isn’t right for everyone, but it shouldn’t be addictive or cause serious problems in most cases.
Sleeping pills that fall into the category of depressants or opioids, however, could easily become addictive. While your doctor should be able to properly screen for drugs that could cause you issues, we’ve done some research to point you in the right direction.
It’s important to recognize that most doctors only prescribe sleeping pills for short-term use, and try to find more natural or sustainable ways to help you rest. Doctors will probably only prescribe the heavy-duty suppressants for severe cases of insomnia on an as-needed schedule, according to Addiction Center.13
When these pills are used as a way to combat anxiety or are used in a way other than what the doctor prescribed, it’s considered substance abuse. The longer one takes these drugs, the more of them they may need to create the same feel-good effect, and addiction or dependency could develop. If you think you are at risk for this behavior, be honest with your doctor, they can help.
Can I use sleeping pills during detox?
Some doctors may prescribe sleeping pills during recovery or detox, but most will probably look for alternative methods to treat insomnia or other sleep disorders.14 If you are prescribed an addictive sedative, ask your doctor about your risk for drug abuse. Higher dosage sleeping pills are easily addictive and often abused, there are even treatment centers specifically for sleeping pill addiction.
Keep in mind that the less powerful or more natural pills such as melatonin or other over the counter medications might not be effective or fix the underlying problems for everyone.
Is exercise safe for me during addiction recovery?
Exercise is a great way to help improve sleep, and it might even become one of the best tools in your recovery arsenal. However, you should always ask your doctor before making your own treatment decisions. Exercise could be dangerous in early abstinence, especially for those experiencing alcohol withdrawals.15
The benefits of exercise could come from the natural exhaustive effect, or because of the way exercise affects the body chemically, facilitating the release of feel-good hormones and increasing quality of rest.
Quitalcohol.com recommends exercise for recovering alcoholics because of its ability to increase mental clarity, decrease anxiety and depression, and help patients cope with mood swings.16 While exercise may seem like a good idea, it’s important to check with your doctor to make sure you are healthy enough to attempt this type of treatment and learn which exercises would be most effective for you.
Keep in mind that if you struggle with opioid addiction due to underlying pain, you may opt for lower impact activities like swimming or biking to avoid exacerbating a condition.
What diet do you suggest to promote sleep?
While there is relatively little research focused on diets that help recovering addicts rest, there are a few foods that doctors recommend for treating insomnia and other sleep disorders, including complex carbs, nuts, cottage cheese, warm milk, chamomile tea, and some types of fruits. Each of these foods contains building blocks for better rest when consumed in the right portions at the right time, according scientists.17
Some specialized diets could help combat depression or other disorders that often follow sobriety or abstinence and may indirectly affect sleep. You doctor should be able to point you in the right direction and will likely be thrilled that you want to make the most of your likelihood for recovery.
Get More Info: Chamomile Tea and Sleep
Could my medications be keeping me awake?
While some sedatives are used to help induce sleep, some interfere with the amount of REM periods you experience, which is a key indicator that could predict relapse. During recovery, some doctors prescribe antidepressants or anxiety medications to quell some of the effects of withdrawals. If your sleep problems began shortly after starting a new medication, it could be possible that it is interfering with your rest and therefore your recovery.
If you want to read about specific effects on sleep from common medications, Harvard Medical School curated a list that you could bring to your doctor.
Natural Sleep Tips
Talk to Your Sponsor
If you’re a part of a recovery program with an individual sponsor, remember that you aren’t alone. A sponsor could be able to share with you specific practices that helped them through their detox process. While one method may not work the same for both of you, it’s never a bad idea to gain some insight and reach out to someone who can help, especially if that person is great at withholding judgement.
If you don’t have a sponsor, find someone you can be honest with who will listen to you. Having a support group can make a big difference in recovery. While it may be scary, you’re already reading this article so you’re probably on the right track. Keep going!
Exercise
In many cases, exercise can be a great tool to help improve rest after the first few days of detox. Exercise naturally increases the levels of endorphins or happy hormones in the body that can help you manage anxiety and depression. Additionally, exercise increases the length of slow-wave periods of rest, meaning more time for your body to spend in rejuvenation.
Harvard Medical School even reported that exercise can help reduce the likelihood of relapse by helping recovering addicts form new interpersonal connections and help manage cravings.18
Now you have an excuse to chat people up in the gym. Personal trainers could also be a great resource for keeping you accountable.
However, it may not be safe to exercise in every stage of rehabilitation. Talk to your doctor to learn which type of exercise is best for your circumstances. While some may benefit from weight lifting, others may do better with cardio exercise. Your doctor should be able to help you stay within your limits.
Sleep Routine/Hygiene
Creating a space specifically for rest is vital in combating all sleep disorders. If you associate your bed with work, anxiety, restlessness, or other activities, it can be difficult for your body to know when it’s time to rest.
During addiction withdrawals, the body may be missing other cues for sleep, such as drug use. When you can retrain your body to recognize other cues, such as brushing your teeth, meditating, or reading, your body may be able to adjust to the new schedule more easily.19 The National Institutes of Health recommends reserving the bed for rest and intimacy only, and assigning all other activities to other areas of your home.20
If you don’t know where to start, a good book could help you drift off, bonus points if you’re reading about sleep.
Light/Noise Therapies
As some substances create problems with internal timekeeping, light therapy could help to signal your brain when it’s time to be awake, and when it’s time for you to sleep. Using special box lights throughout the day may be a helpful factor in triggering patterns of wakefulness and drowsiness.
Plus, using a lightbox at your desk may be the conversation starter you need to make new friends and expand your support group. In other cases, certain sounds could help lull your brain to sleep naturally. Some research suggests that white noise may be effective in masking disruptive environmental noises, we’re looking at you, cat that has no respect for the sanctity of sleep.21
Cognitive Behavior Therapy
One of the most highly recommended treatments for those in addiction recovery programs is cognitive behavioral therapy or CBT for short.22 This form of talk therapy is about getting to the root of the problem and finding behavioral changes to fix the outcome.
According to Addiction Center, revisiting painful memories in therapy could help lessen some of the negative emotions that result, helping those struggling with addiction to find new ways to process their emotions with more positive outcomes. When this process is applied to sleep, it could combat some of the emotional factors that tend to keep us awake. In other words, there’s no need to stay up replaying sad or shameful memories when you’ve already gotten that out of the way earlier, and learned how to manage it.
“When an addicted person understands why they feel or act a certain way — and how those feelings and actions lead to substance use — they are better equipped to overcome their addiction.” – Addiction Center
Counseling
Like CBT, counseling could help recovering addicts process their emotions in healthier ways. This could contribute to more purposeful thought patterns, coping mechanisms for addictive tendencies, and in some cases training for how to recognize and manage stress triggers. In many cases, feelings of shame tend to make it hard to break the cycle of addiction. When you can find forgiveness for yourself and real healing, there will probably be less of a need to dull or escape from pain.
We know what you may be thinking, so let us beat you to the punch: you do deserve healing, and it is possible. We may not know you personally, but if serial killers on death row find it in themselves to make peace with their past–and they do–who are we to say you can’t?
The American Psychological Association reports that talk therapy can be especially effective when focusing on motivational interviewing and consistency management.23 As recovering addicts receive support and encouragement, they are often better able to avoid relapse.
Conclusion
If you are in the process of addiction recovery, you are not alone and there are many resources that may help improve your situation. Remember, you are doing a good thing in seeking out help. We hope our article helps to point you in the right direction, but we stand by the statement that doctors and treatment centers are ultimately the best places to go for long term care and treatment.
Though sleep may not seem like an uphill battle that won’t back down, there is a light at the end of the tunnel. Most recovered addicts find that after a painful period of withdrawals, rest tends to improve over time. The road to recovery is rarely short or without bumps, but the better you rest, the more likely you are to succeed. We wish you luck, along with a little pat on the back for your determination to succeed.
Katie Harris
Content Writer
About Author
Katie writes content at Sleep Advisor, where she has finally found people who appreciate her true passion for sleep. Based in Austin, Texas, she graduated with a degree in Communications and enjoys combining creativity with research to improve the world’s sleep, starting with her sleepwalking husband.
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- Watson, Robert., et al. “Cocaine Use and Withdrawal: The Effect on Sleep and Mood”. The American Journal of Drug and Alcohol Abuse. 1992.
- “Sleep Dysfunction as a Core Feature of Opioid Use Disorder and Recovery”. National Institutes of Health. Last modified January 18, 2024.
- Rosen MD, Ilene M., et al. “Chronic Opioid Therapy and Sleep: An American Academy of Sleep Medicine Position Statement”. Journal of Clinical Sleep Medicine. 2019.
- “Ecstasy Withdrawal and Detox”. Addiction Center. Last modified April 18, 2024.
- “Is Restless Legs Syndrome a Cause for Substance Abuse?”. American Addiction Centers. Last modified May 21, 2024.
- Khazaie MD, Habibolah., et al. “Sleep Disorders in Methadone Maintenance Treatment Volunteers and Opium-dependent Patients”. Addiction & Health. 2016.
- Li, D.J., et al. “Predictors of sleep disturbance in heroin users receiving methadone maintenance therapy: a naturalistic study in Taiwan”. Dove Press. 2018.
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- “Sleeping Pill Addiction And Abuse”. Addiction Center. Last modified June 6, 2024.
- Arnedt Ph.D, J. Todd., et al. “TREATMENT OPTIONS FOR SLEEP DISTURBANCES DURING ALCOHOL RECOVERY”. National Library of Medicine. 2007.
- “Alcoholics Should Avoid Excessive Physical And Psychological Stress During Early Abstinence”. Alcoholism: Clinical & Experimental Research. 2007.
- “The Importance of Exercise During Recovery”. Quit Alcohol. Webpage accessed July 10, 2024.
- Doherty, Rónán., et al. “Sleep and Nutrition Interactions: Implications for Athletes”. Nutrients. 2019.
- Twark MD, Claire. “Can exercise help conquer addiction?”. Harvard Health Publishing. 2018.
- “How to improve your sleep while in addiction recovery”. SMART Recovery. 2017.
- “A Good Night’s Sleep”. National Institute on Aging. Last modified November 3, 2020.
- Farokhnezhad Afshar, Pouya., et al. “Effect of White Noise on Sleep in Patients Admitted to a Coronary Care”. Journal of Caring Sciences. 2016.
- “Cognitive Behavioral Therapy”. Addiction Center. Last modified June 12, 2024.
- Winerman, Lea. “Breaking free from addiction”. American Psychological Association. 2013.