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Brandon Peters, M.D.

30 Days to Better Sleep: Avoid Alcohol Near Bedtime

By January 10, 2013

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With few sleeping pill options historically, difficulty falling asleep has been helped with home remedies, including a shot of alcohol. These "nightcaps" seem to make it easier to fall asleep, but with a better understanding of the effects, they are now discouraged. It seems to be a contradiction: alcohol makes you feel sleepy, but it worsens your sleep. Why should you avoid alcohol near bedtime?

Alcohol comes in myriad forms: beer, wine, and spirits or hard liquors such as rum, vodka, whiskey, tequila, brandy, and so forth. No matter its form, it all works the same. Alcohol acts as a depressant of the central nervous system, specifically the brain. It can affect behavior, concentration, and attention. At higher blood alcohol levels, increasing sleepiness and even depressed levels of consciousness can occur. Someone who is highly intoxicated may "pass out," becoming unresponsive to the environment and appearing to be asleep.

In light of these experiences, it would seem to be logical to use alcohol to increase sleepiness and aid the transition to sleep. For people who suffer from insomnia, often characterized by difficulty falling or staying asleep, it is a readily available fix. However, it is unfortunately one to avoid. Why is this so?

The effects of alcohol are short-lived. Though it may make you feel sleepy, it is rapidly cleared out of the body by the liver. As the blood alcohol levels drop, its depressant effects on the brain quickly abate. Your brain acutely rebounds from its depressed state, and this will lead to awakenings or arousals from sleep. Therefore, your sleep becomes more fragmented as the alcohol wears off. This can lead to worsened insomnia during the night.

Moreover, alcohol can have specific effects on the muscles of the airway. It is a muscle relaxant and when the muscles lining the nose, mouth, and throat relax, the airway collapses. This can lead to signs and symptoms of obstructive sleep apnea. As the airway collapses, the brain recognizes this and wakes the affected person to restore breathing, furthering the fragmentation of sleep.

When should you stop drinking alcohol to reduce its effects on sleep? It is recommended that alcohol not be consumed in the 4-6 hours preceding sleep. This may seem rather strict as it basically eliminates the consumption of alcohol in the evening, when most people drink. As an alternative rule of thumb, you should allow 1 hour of time to pass before going to bed for every alcoholic beverage you consume, starting from your last drink. If you have one drink at 9 PM, you can go to bed at 10 PM. For people with sleep apnea, especially if it is untreated, it may be advisable to avoid alcohol entirely as it may worsen the degree of sleep apnea.

So, contrary to custom, you should avoid alcohol before going to bed. Though it may cause transient sleepiness, it ultimately fragments your sleep and could contribute to sleep-disordered breathing such as sleep apnea. If you are serious about sleeping better, avoiding alcohol before bedtime is one small change you can make that might make a big difference.

Check out the entire series, "How to Sleep Better in 30 Days."

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Comments
January 12, 2014 at 11:49 pm
(1) ZolliStar says:

I wish it were not true that alcohol disrupts sleep.

I have sleep apnea and have learned that, alas, I can’t enjoy even a glass of wine within two to three hours before sleep otherwise I suffer from disturbed sleep all night long.

In addition, I sleep much better if I eat early — at least four hours before bedtime — and get off the computer for at least 90 minutes before bedtime.

While I’m jealous of people who don’t have these problems, I am also grateful to — finally! — know why I was always so tired. My sleep apnea was not diagnosed for some 20 years. It was an exhausting two (and counting!) decades: mine is a severe case of SA.

If I do everything I’m supposed to do — no alcohol in the evening; eat three hours or more before bedtime; no computer near bedtime — if I observe all the guidelines all then slip on my mask and turn on my CPAP machine at bedtime, I have a pretty good night of sleep.

It’s worth it!

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