Sleep and alcohol use and abuse

Introduction
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By Deirdre A Conroy PhD

Sleep and alcohol use and abuse is also known as or subsumes Sleep disorders associated with alcoholism. -ed.

The author explains the basics of alcohol-related sleep disorders. She discusses the acute and chronic effects of alcohol on sleep as well as the management of sleep disorders during alcohol withdrawal and in recovering alcoholics. Insomnia in abstinent alcoholics is a common clinical problem that can increase the risk of relapse. Unfortunately, this is an area of only limited clinical research, though there are some data for the utility of cognitive-behavioral therapy for the treatment of insomnia in recovering alcoholics. The potential usefulness of ramelteon, gabapentin, and acamprosate for this condition is also discussed. New research has focused on the effects of ethanol on circadian rhythms. Child and adolescent sleep disturbances may predict alcohol abuse.

Key Points

  • Alcohol can have sedating effects on sleep initially, but can become sleep disruptive with chronic use.
  • Objective and subjective sleep disturbances have been observed several years after drinking has stopped in recovering alcoholics.
  • Persistent sleep disturbances are common and are related to relapse.
  • Studies have shown that childhood and adolescent sleep disturbance may play a role in future drinking.
  • Pharmacological and nonpharmacological treatments (eg, cognitive behavioral therapy for insomnia) have been shown to improve sleep in recovering alcoholics.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention and risk factors
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Pregnancy
References cited
Contributors