Alcohol is Really Bad for Sleep Quality

The second variable that I will be manipulating across a two week period to examine its impact on sleep is alcohol.

I will discuss what my data shows, how easy or difficult I found this strategy to implement, and what previous research says. These three factors will be combined for an overall score and grade on how effective avoiding alcohol is at helping people to improve their sleep.

quentin-dr-125010

If you look at my sleep diaries from the first four weeks of 2017 in the benefits of tracking your sleep and caffeine and sleep articles, I consumed alcohol on 5 out of the 28 nights, or 1.25 nights per week. If I were to continue at this frequency, it is unlikely that it would significantly disrupt my sleep, but there were two nights where I had more than two standard drinks, which isn’t recommended on a long-term basis.

Self-Assessment

If you are unsure if you are drinking at hazardous levels or not, please take a few seconds to fill out the following questionnaire. Known as the AUDIT (alcohol use disorders identification test), there are ten questions which contribute to your overall score:

  1. How often do you have a drink containing alcohol?
    • Never (0 points) – skip to question 9
    • Monthly or less (1 point)
    • Two to four times a month (2 points)
    • Two to three times a week (3 points)
    •  Four or more times a week (4 points)
  2. How many drinks containing alcohol do you have on a typical day when you are drinking?
    • one or two (0 points)
    • three or four (1 point)
    • five or six (2 points)
    • seven to nine (3 points)
    • ten or more (4 points)
  3. How often do you have six or more drinks on one occasion?
    • never (o points)
    • Less than monthly (1 point)
    • Monthly (2 points)
    • Weekly (3 points)
    • Daily or almost daily (4 points)
    • (if total score for questions 2 and 3 is 0, skip to question 9)
  4. How often during the last year have you found that you were not able to stop drinking once you had started?
    • never (o points)
    • Less than monthly (1 point)
    • Monthly (2 points)
    • Weekly (3 points)
    • Daily or almost daily (4 points)
  5. How often during the last year have you failed to do what is normally expected from you because of drinking?
    • never (o points)
    • Less than monthly (1 point)
    • Monthly (2 points)
    • Weekly (3 points)
    • Daily or almost daily (4 points)
  6.  How often during the last year have you needed a first drink in the morning to get yourself going after a heavy drinking session?
    • never (o points)
    • Less than monthly (1 point)
    • Monthly (2 points)
    • Weekly (3 points)
    • Daily or almost daily (4 points)
  7. How often during the last year have you had a feeling of guilt or remorse after drinking?
    • never (o points)
    • Less than monthly (1 point)
    • Monthly (2 points)
    • Weekly (3 points)
    • Daily or almost daily (4 points)
  8. How often during the last year have you been unable to remember what happened the night before because you had been drinking?
    • never (o points)
    • Less than monthly (1 point)
    • Monthly (2 points)
    • Weekly (3 points)
    • Daily or almost daily (4 points)
  9. Have you or someone else been injured as a result of your drinking?
    • no (0 points)
    • yes, but not in the last year (2 points)
    • yes, during the last year (4 points)
  10. Has a relative or friend or a doctor or another health worker been concerned about your drinking or suggested you cut down?
    • no (0 points)
    • yes, but not in the last year (2 points)
    • yes, during the last year (4 points)

If your score is 8 or over, this is an indication that you are using alcohol at a hazardous and harmful level. Please seek out further information on how to cut down your drinking to safe levels, and if possible set some goals for your self in relation to your drinking so that it is less dangerous and you are able to keep track of it.

If your score is over 15, it may be difficult to cut down by yourself, and a referral to a drug or alcohol service for further assessment, counselling and monitoring may be preferable to ensure that you can make the right changes for your long-term health.

My score was 5, as I did injure myself a few times when younger and occasionally have more drinks in a single night out than I should. As long as I don’t go on too many more poker cruises that include 4 hours of free drinking I should be okay, but it is probably something that I need to keep an eye on if it ever does become more frequent or heavy in the future.

eaters-collective-109606

The Experiment

In order to explore exactly why I shouldn’t increase my alcohol consumption, I decided to once again be a little bit more extreme than I normally am.

For one week only, I had:

  • One standard drink on the Monday
  • Two standard drinks on the Tuesday
  • Three standard drinks on the Wednesday
  • Four standard drinks on the Thursday
  • Five standard drinks on the Friday
  • Six standard drinks on the Saturday
  • Three standard drinks on the Sunday

On the other week, I had absolutely no alcohol that I was aware of (apart from Listerine mouthwash).

WARNING: If you are trying to improve your sleep at home, I DO NOT RECOMMEND experimenting with any more alcohol than you normally have, and no more than two standard drinks on any given night if possible. If you are pregnant, not drinking any alcohol is the safest recommendation. If you are under 18, delaying when you first begin drinking for as long as possible is the best thing you can do. The prefrontal cortex is still developing and growing until at least the age of 25, and alcohol can disrupt this growth process. Being smarter and healthier in the long run seems like a pretty good payoff for not beginning to drink until after your brain has properly developed.

The Outcome

sleep-and-alcohol

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Objectively, Jan 30 (29/1/17 on the sleep diary) was the worst night of sleep for no alcohol, but I think that may have been that I was doing work on my computer until too late. Even then, there was more restful than light sleep. Feb 07 (6/2/17 on the sleep diary) was the best night of objective sleep so far, with a restful:light sleep ratio of 2.98:1.

Comparison 2: No alcohol vs alcohol

With the alcohol week, I woke up 1.57 times on average, 1.43 more times than without alcohol. I did manage to spend 28 more minutes in bed and get to bed 35 minutes earlier each night, but only obtained an extra 15 minutes per night of sleep. Despite getting the recommended 7-8 hours of sleep per night (7hours and 14 minutes) my sleep quality was the worst it had been all year (3.57/5) and I felt much more tired, unmotivated and unproductive during the day. It took me longer to fall asleep, I spent more time in bed awake each night, and my sleep efficiency was 95.8%, also the lowest it had been all year.

Objectively, my worst night was Feb 01 (31/1/17 on the sleep diary), which took place after only two standard drinks. The night after six standard drinks wasn’t as bad as I thought it would be objectively, with a restful:light sleep ratio of 1.15:1. It seems that with alcohol, the longer I spend in bed, the less restful my sleep becomes.guillermo-nolasco-134842

Is Avoiding Alcohol a Good Sleep Strategy?

EFFECTIVENESS

For me, yes. It gave me the best sleep quality and sleep efficiency for the year so far. My total sleep time and the time that I went to bed wasn’t ideal for this week, but otherwise it seemed all positive. I give the effectiveness of this strategy a 21/25.

APPLICABILITY

For me, it wasn’t too difficult to not drink for a week, especially seeing that my partner doesn’t drink at all either. It is one of the main complaints that I do hear from many client’s that abstain from alcohol though, and that is that their social lives do take a hit once they stop drinking. Many functions and social events are at bars or involve the consumption of alcohol, and if they have been previously heavy drinkers then sometimes it can be hard to not just go with the flow and join in with others. Previous drinking buddies also may not understand or be as supportive as hoped, especially if that is what they used to enjoy doing with you. Given the potential social implications, I’ll give this strategy an applicability score of 14/25, with minimising alcohol being easier to apply than abstaining from alcohol altogether.

SCIENCE

This excellent handout from Elsevier gives all of the science you need to know about alcohol and sleep:

alcohol-and-sleep-disruption

I therefore give the science of this strategy a 40/50.

Overall, avoiding alcohol as a way to sleep better gets a score of 21/25 + 14/25 + 40/50 =

75/100: Distinction

The alcohol impaired my sleep quality and sleep efficiency, which are two things that I find more important than sleep quantity or duration. I also felt generally more tired, apathetic, anxious and irritable during the week that I was drinking every day.

As I tend to struggle from fatigue at times, cutting out alcohol as much as possible seems to be a good way to go for me, as it led to the best sleep quality and sleep efficiency that I had experienced all year. Now I just need to bring my delayed circadian rhythm forward a bit so that I can feel sleepy earlier, get to sleep earlier and potentially increase my total sleep time.

What I Recommend

I know that alcohol consumption is almost normalised in Australia because of how many people drink and how it is a part of so many social events, but it does cause serious harm and costs to individuals, relationships, families and society if it is consistently used at high risk levels.

According to the World Health Organisation, high risk drinking increases the risk of:

  • medical and psychological problems
    • alcohol dependence
    • memory loss
    • depression
    • anxiety
    • premature aging
    • drinker’s nose
    • vitamin deficiency
    • bleeding
    • inflammation of the stomach and pancreas
    • liver damage
    • ulcers
    • vomiting
    • diarrhea
    • malnutrition
    • impaired sexual performance
    • deformities during pregnancy or low birth weight babies
    • numbness
    • painful nerves
    • tingling toes and fingers
    • trembling hands
    • impaired sensation
    • falls
    • weakness of heart muscle
    • heart failure
    • anemia
    • impaired blood clotting
    • cancer of throat, mouth and breast
    • frequent colds
    • pneumonia
    • reduced resistance to infection
  • social, domestic, legal and occupational problems
    • aggressive behaviour
    • irrational behaviour
    • impaired judgment and decision making capacity
    • frequent arguments
    • frequent violence
    • accidents and death from drunk driving
    • losing jobs due to inconsistent performance and attendance

Therefore minimise your alcohol consumption where you can, keep it under 2 standard drinks per day, and give yourself some alcohol free days throughout the week (and alcohol free weeks throughout the month or alcohol free months throughout the year).

I kn0w that some studies say that a glass of red wine a night is good for cardiovascular health and stress, but there are other, potentially healthier ways to consume antioxidants, socialise with others and reduce your stress levels.

Conclusion

If you can maximise the benefits of not drinking (including better sleep, greater productivity, better health etc.), minimise your positive expectations of what a drink can do for you, and build up your drink-refusal self-efficacy (capacity to say no to others who offer you a drink), you are at a much lower risk of hazardous alcohol consumption going forward. The less alcohol that you drink, the healthier that your brain and body should feel, especially in the long run.

If you are wanting to reduce your consumption of alcohol but need extra support, please check out the following link and contact the appropriate services or make an appointment to see a medical professional now. It’s unlikely to resolve itself without any action being taken.

Thanks for reading! My next episode exploring the effects of watching TV in the last two hours before sleep is now up. If you are wanting some individualised feedback on how to improve your sleep, please check out my CBT-I and personalised sleep reports services.  

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