The Relationship between Substance Abuse, Insomnia, and Suicidal Thoughts

Accruing evidence indicates that insomnia is prevalent and persistent in early recovery from substance use disorders and may predict relapse. As such, insomnia treatment after abstinence represents an important area for intervention and treatment.

According to Dr. Nicholas Rosenlicht of University of San Francisco:

“Treating sleep disturbance in early recovery may have considerable impact on maintenance of sobriety and quality of life.”

Evidence suggests that the incidence of insomnia in early recovery may be five times higher than the general population and may persist for months to years.

Insomnia is linked to a higher risk of alcohol-related problems and relapse. The association may run in the other direction as well, since population studies report people with sleep disturbance are more likely to be at risk of developing addiction.

Compounding the problem, some patients addicted to alcohol use the substance in the evening in an effort to address sleep problems. Alcohol is a well-documented cause of sleep disruption with toxic effects on several neurobiological systems, and may contribute to lasting sleep problems even during abstinence.

Behavioral approaches are widely used to treat patients with insomnia during recovery; in particular, evidence supports the use of cognitive-behavioral therapy (CBT) to address both alcohol abuse and sleep disturbance. This approach along with sleep hygiene practices includes daily sleep diaries and questionnaires to gather information on the patient’s insomnia and progress during treatment.

Another study found that alcohol use was significantly associated with suicide risk among women. However, further analysis revealed that insomnia symptoms explained a significant proportion of the relationship between alcohol and suicide risk. For men, there was a significant indirect effect of alcohol use increasing suicide risk through insomnia symptoms.

Principal investigator Michael Nadorff, PhD, assistant professor at Mississippi State University claims:

“By better understanding this relationship, and the mechanisms associated with increased risk, we can better design interventions to reduce suicide risk.”

Data shows excessive alcohol use leads to about 88,000 deaths in the U.S. each year and shortens the lives of those who die by almost 30 years. In addition, 38,000 deaths each year are by suicide, the 10th leading cause of death. These deaths are preventable. Promoting the importance of proper sleep habits along with teaching about substance abuse in mental health education may help risk prevention.

A good night’s sleep is essential for overall health especially when dealing with the additional stress of achieving sobriety and improving mental health. Please talk to a health care professional for additional information on improving the quality and quantity of your sleep.


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