Wednesday December 12th 2018

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Sleep Deprivation in Addiction Treatment, It’s Like Being Drunk!

By Robert Wright, Jr., Ph.D., COFT
The Stress Relief Doctor

ARTICLE SUMMARY: This article reviews the effects of missing sleep and how it can impact your addiction recovery. Sleep deprivation has been connected with increased relapse, adverse health effects, and suicidal thinking. More here, with a section at the end for your questions.


ESTIMATED READING TIME: 10-15 minutes.


TABLE OF CONTENTS


Danger Zone

Are you sleeping enough?

Probably not.

Due to the hectic pace of today’s world, you may find it challenging to get enough sleep so that you feel rested the next day and are able to perform at your best. Most likely, you already know that you are not getting enough sleep, but you may not know just how damaging a serious sleep deficit can be including shortening your life expectancy.

So, when you are working to achieve or maintain addiction recovery, not being able to get enough sleep can be disastrous—triggering cravings, relapse or worse.

Whether you are currently coping with addiction or in recovery, a sleep deficit, if you’re not careful, can knock your recovery off track; if you do not address its potentially debilitating effects. For instance, did you know that if a fMRI scan is taken of your sleep deprived brain, it will look like the brain of someone on meth or undergoing chemotherapy?

Thus, it’s critical that you increase your awareness of just how important getting a good night’s sleep is and how sleep deprivation can impede your path to recovery as you work to deal with, heal, and recover from addiction.

We’ll help you do that here. Please continue reading for more. Then, we invite your comments and questions about sleep deprivation at the end. In fact, we try to respond to all legitimate queries personally and promptly.

Why Is Sleep Deprivation So Harmful?

Whether you are undergoing addiction treatment or working to maintain recovery, a mounting sleep deficit can make your task that much harder. Why?

When you don’t get enough sleep, it’s “as if” you’ve automatically created a dual diagnosis situation.

On the one had you may be fighting off a known addiction; on the other hand, sleep deprivation can create a series of compounded bad outcomes, which may feel like “piling on top” of your known addiction. The results of such “piling on” can exasperate your attempts at recovery since they can push you closer to a feeling state of depression or hopelessness.

Sleep Deprivation Studies and Hard Facts

Studies and surveys conducted by the Centers for Disease Control (CDC) recognize that sleep disorders and sleep deprivation are now at crisis levels for all too many Americans. In fact, the CDC concluded that 1/3rd of adults don’t get enough sleep. Even our youth are affected: 2/3rds of teenagers don’t get the full 8 hours of sleep they need per night. Additionally, their surveys found that female teens got even less sleep than their male counterparts.

According to the National Sleep Foundation’s Sleep in America survey, 37% or 103 million Americans admitted to having fallen asleep while driving during the past year. Additionally, 13% or 35 million drivers reported falling asleep at the wheel at least once per month, while another 4% or 11 million drivers admitted having an accident or near accident due to “dozing off” while behind the wheel.

However, driving while drowsy can actually be worse than driving while drunk! According to the National Sleep Foundation, if you drive after being up for 18 hours straight, the effect on your body is similar to a .05 blood alcohol concentration—.08 is a typical DUI standard in the USA. However, if you pull an “all-nighter” (awake for 24 hours) for school, work, due to an emergency, or because you were out partying “until the cows came home,” the effect on your body and brain is “as if” you had a blood alcohol level of .10—legally drunk in every state!

I love this infographic summarizing sleep deprivation facts.

Potential Bad Outcomes

When you do not get enough sleep especially when you are challenged with addiction, you may be setting yourself up for potential disaster. For instance, when you miss just one night’s sleep, blood testing shows a loss of brain tissue and circulation of brain molecules usually found in your blood under conditions of brain damage.

Take a look at the consequences of what a serious sleep deficit can do to the quality of your life:

Can You Die of Sleep Deprivation?

It’s not clear.

The psychological research and popular literatures present a mixed picture of whether a serious sleep debt can actually kill you or cause you to “flip out.” As the Infographic above demonstrates, it’s probably not a good idea to run a large sleep debt unless you are looking for trouble. For example, there have been numerous cases where individuals have died while playing marathon length video tournaments.

Another insidious way a sleep debt can cause death is through overwork. Although many people in our society brag about how many hours they work as well as how they never take vacations, studies show that this is a bad idea with serious consequences including death of the workaholic.

This is exactly what happened to the former celebrated CEO of Chrysler who met an untimely death. Recent examples of workers dying from working too much overtime in Japan, have caused a national outcry as more workers realize the impact lack of sleep can have on longevity and their quality of life. In fact, in Japan, there is even an official term for overwork: Karoshi.

Of course, Japan is not the only country where working huge amounts of overtime are the norm. In fact, here in the USA, due to the so called “Gig” economy which provides no financial safety net to independent contractors, many workers are working 2 or 3 jobs just to stay afloat and pay the rent. The result is many workers have money worries combined with a sleep debt as they live paycheck to paycheck. Unfortunately, “Gig” economy sleep deprivation is a worldwide phenomenon.

Unfortunately, in the context of addiction, some people are using drugs or alcohol to sustain their workaholic behaviors by self-medicating. In worse case scenarios, the resulting sleep deprivation can serve as a double whammy: eventually leading to high levels of anxiety or depression, burnout, incapacitation or an early death.

Suicide and Sleep Deprivation

There are numerous studies that indicate that sleep deprivation can lead to suicide. In fact, severe sleep loss can result in depression, anxiety disorders and nightmares—all of these make addiction and recovery significantly more difficult to treat successfully. You can learn more about how these forms of sleep deprivation can adversely affect recovery here.

Unfortunately, sleep deprived suicide isn’t just a phenomenon seen in adults. Several studies indicate that sleep deprived children who get less than 8 hours sleep per night are 3 times more likely to commit suicide. Additionally, a recent study found that almost 50% of adolescent participants had nightmares which preceded their suicidal ideation and suicide attempts to take their own lives. Studies such as these can serve as warning flags to concerned parents that they need to take an active role to ensure that their young children and teens get adequate sleep and rest.

Parents can use such knowledge as a doorway for opening up new communication channels with their children. This may also mean having to set “house rules” for late night computer, smartphone and videogame use since research conclusively demonstrates that the blue wavelength light from phones, laptops and TV screens simultaneously delay the onset of sleep and interrupt the circadian rhythm. Thus, increasing the risk that your child could build a mounting sleep deficit, adversely affect her academic performance as well as heighten suicide risk.

What Causes Sleep Deprivation?

Sleep deprivation can arise from multiple causes. In fact, there are at least 90 different known sleep disorders that can cause you to lose sleep or rack up a sleep deficit. Most likely you are familiar with some of these known sleep deprivation causes such as anxiety, circadian rhythm disorders, insomnia, nocturia, obstructive sleep apnea, restless leg syndrome, etc., however, what’s important to remember regardless of the cause is that sleep deprivation happens whenever you do not get a healthy amount of sleep; thus resulting in a sleep debt.

Here is a short list of reasons why getting enough sleep can be so hard especially when you are challenged with addiction:

  • Smartphone addiction and distraction
  • Videogame addiction and distraction
  • Non-stop emails, phone calls and texts marked URGENT
  • Falling asleep in bed with your phone
  • Falling asleep with the TV on
  • Late night blue wavelength light interrupts circadian rhythm and melatonin release
  • After hours requests from your boss for work to be completed and ready by the morning
  • Working two or more jobs in excess of 80 hours per week
  • Time lost stuff in traffic and commuting long distances
  • Single parent with children
  • Having an undiagnosed sleep disorder
  • Financial problems or worrying about money
  • Rotating shift work
  • Close and extended family obligations
  • Repeated bathroom use during the night

Here’s a summary of what happens during sleep deprivation, summaries taken from a clinical trial performed in 1976 by Huber-Weidman “Sleep, sleep disturbance, and sleep deprivation”.

How Much Sleep Do You Need?

You may be surprised at just how much sleep you and your loved ones need based upon new statistics provided from the National Sleep Foundation of required sleep durations:

Newborns and Infants: 12-17 hours per day
Toddlers and Preschoolers: 10-14 hours per day
School-aged Children: 9-11 hours per day
Teenagers: 8-10 hours per day
Adults: 7-9 hours per day
Seniors: 7-8 hours per day

Key Points for People in Recovery

There are literally thousands of research studies which show the adverse relationship linkage and outcomes between sleep deprivation and substance abuse disorders. Whether you are working to achieve or maintain recovery, it would be wise to pay attention to just how important getting a healthy amount of sleep is regularly. Many of us underestimate the critical importance of sleep to our healthy well-being.

Below are some key points to remember about sleep deprivation and addiction on your road to recovery:

1. Using alcohol to “unwind” at the end of the day works against you by preventing you from entering deep REM (rapid eye movement) sleep. In fact, alcohol disrupts and interrupts your circadian rhythm so that you only enter the lighter stages of sleep. This means that you never feel fully rested and can often experience fatigue and sleepiness the next day. Seniors who consume alcohol at bedtime are more likely to become unsteady, increasing their risks for falling and being injured should they get up to use the bathroom at night.

2. Insomnia and other forms of sleep disturbance commonly occur among individuals diagnosed with a substance abuse disorder. In fact, sleep problems tend to persist even after withdrawal and detox when there has been chronic use of substances such as amphetamines, cocaine, heroin, marijuana, and methamphetamines.

3. Effective non-pharmacological solutions for sleep deprivation includes Biofeedback, Cognitive Behavioral Therapy, Exercise, Floating, Mindfulness Meditation, Neurofeedback, Open Focus, Progressive Muscle Relaxation, and Yoga.

How to Get the Sleep You Need

Before we get to the “how to”…

NOTE HERE: At any point in your process, you can seek out the services of a sleep psychologist or therapist who specializes in sleep disorders. Also, be sure to discuss your sleep challenges with your doctor or medical practitioner so that you can be checked for an underlying medical disorder such as obstructive sleep apnea or clinical depression.

When you commit to your own self-care in this way by making getting a good night’s sleep a priority, you may be startled to find just how much doing so improves the quality of your life—it’s a smart move you’ll be glad you made!

STEP 1: Admit you have a problem.

Recent research demonstrates that developing good sleep hygiene is the antidote to sleep deprivation. You need to make a commitment to eliminate your sleep deficit especially when you are wrestling with addiction issues. However, you first need to acknowledge that you are not getting enough sleep.

This can sometimes be difficult to do in addiction treatment when you have a sleep deficit because sleep deprivation simultaneously weakens your brain’s prefrontal cortex’s reasoning ability and its ability to control your amygdala’s emotional circuitry. Thus, making it harder for you to make good choices about sleep and addiction treatment or recovery. You must move past “I’ll start someday” to “I’m starting right now.” It’s important to be gentle with yourself so that you don’t judge yourself too harshly. Remember, your sleep debt occurred over a period of time, so cut yourself some slack as you “ease into” your new and consistent sleep routines.

STEP 2: Record your sleep in a sleeping log or journal. Aim to slowly increase sleep.

Keeping an honest sleep log will increase your awareness of just how much sleep you are actually getting. Most likely, you are getting much less sleep than you think especially if you fall asleep with your smartphone in your hand and TV is still on. Once you have the facts in hand, you can set up an intelligent action plan to adjust your sleep behaviors. This includes learning “how” to go to bed at night whenever you feel sleepy!

Once you know that you aren’t getting enough sleep, consider adding 15 minutes of sleep each night for a week, then another 15 minutes the following week until you start to feel better. This allows you to get the added sleep you so desperately need without drastically disrupting your schedule.

STEP 3: Set up your ideal sleep environment.

Consider custom tailoring your bedroom to increase your sleep comfort by putting up black out curtains to keep out light that may be keeping you awake. Cover or remove all LED emitting clocks and devices and be sure to turn off the TV and place your smartphone OUTSIDE of your bedroom. Yes, for some of you, this may be the hardest “get a good night’s sleep” recommendation to implement! True, parting with your phone can be tough at first but remember your goal: to achieve or maintain recovery by getting a good night’s sleep!

Recent studies demonstrate that most people find it easier to fall asleep in a cool room rather than a warm one. The “sweet spot” temperatures ranged between 65-70 degrees. Experiment with varying temperatures until you get good results.

STEP 4: Learn how to relax.

A key way to jumpstart the process of getting the sleep you need every night is learning how to relax by letting go of any excess tension you may be holding in your body. You may not realize it, but at the end of the day, most likely you’ll have a huge build up of tension in your body. You can test this out by doing a “body scan” using your imagination by simply directing your attention to individual body parts starting with your feet.

What happens next may surprise you since once you direct your attention to your left or right ankle or foot, your reaction may be “Hey, I didn’t know I had pain there like that!” As you direct your attention to various parts of your body, you should start to feel better and much more relaxed. Doing so increases your chances of being able to get a good night’s sleep at bedtime. You can also do the body scanning while in bed. I often get excellent tension relief results while in bed, whenever I have had a “rough” day.

STEP 5: Look at and change what you’re eating.

Recent nutrition research tells us that you must also make wise food choices to enhance your chances for recovery as well as for getting a good night’s sleep. First, you must eliminate as many “junk foods” as possible from your diet. Top foods to avoid are sugar, processed foods, white flour, food additives, and caffeine (Uggh!).

Second, you must recast your eating regimen to include whole foods, whole grains, fiber, protein, Omega-3 fatty acids, fruits and vegetables and seafood. Of course, these are just recommendations. The main point is that you should closely examine what you put into your mouth in order not to sabotage your chances for recovery and simultaneously improve your capacity to get a good night’s sleep.

Missing from the list above is water. It is critical that you hydrate yourself adequately daily. Depending on whom you consult, that could mean drinking at least 72 ounces of water per day.

STEP 6: Turn off screens one hour before bedtime.

Studies show that in order to get a good night’s sleep, you should shut down all electronics at least an hour before bedtime. Ouch! I know, for some of you that might seem like an impossible task. But, the good news is that when you turn off your screens at least an hour before bedtime, you short circuit the negative effects of blue wave length light delaying the onset of sleep and interrupting your circadian rhythm. That means you’ll spend less time “counting sheep” or “tossing and turning” in an attempt to fall asleep.

STEP 7: Look into alternative sleep therapies to complement your regime.

Use aromatherapy to your advantage! Multiple studies have demonstrated that the essential oil scents jasmine and lavender promote a good night’s sleep and increase your ability to be alert the following day. The best part is that these scents are quite fragrant and pleasing to smell and they begin to increase your sense of calm immediately, whether you are heading to bed or just merely want to relax.

Or, consider adding music therapy to your “get my sleep groove on” mix. The ancient saying “music soothes the savage beast” tends to be true for most people. I have found the music of Steven Halpern to be particularly helpful and lovely whenever I want to fall asleep right away. Steven has music that lowers your stress and anxiety as it lulls you to sleep effortlessly. His signature work is Spectrum Suite. You can check out Steven’s music here.

Want to Learn More?

If you’d like to learn more about how you can experience the benefits of overcoming sleep deprivation, you can email me at rwright.nyc[at]gmail[DOT]com. Feel free to contact me with your questions or to schedule a training session. www.StressFreeNow.info

About the Author:Dr. Bob, the Stress Relief Doctor, is an Executive Stress Management Wellness Trainer who helps high achieving individuals and groups get ahead of the stress burnout curve by giving you the tools you need to address and dissolve your habitual stress, anxiety, grief and chronic pain. Dr. Bob is the co-host of the popular StressFreeNow podcast series.

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About Dr. Robert Wright Jr., Ph.D., COFT

Dr. Bob, the Stress Relief Doctor, is an Executive Stress Management Wellness Coach who helps individuals and groups get ahead of the stress curve by giving them the tools they need to address and dissolve their habitual stress, anxiety, grief and chronic pain. Dr. Bob is an author, keynote speaker, and the co-host of the popular StressFreeNow podcast series. Let Dr. Bob help you move forward with your life by reducing your stress, anxiety, grief and chronic pain. To learn more or to schedule a Wellness Coaching session, visit his Coaching page or you can email him directly at mailto:Dr.Bob@StressFreeNow.info