Why does alcohol interfere with my sleep?

Tips for getting a better night's rest when your nightly plans include drinking.  (Aileen Son for The New York Times)

© Distributed by The New York Times Licensing Group
Tips for getting a better night’s rest when your nightly plans include drinking. (Aileen Son for The New York Times)

A couple of glasses of wine or a few drinks at night may make you fall asleep faster than usual. Who hasn’t left the dirty dishes for the next morning or skipped their skin care routine after dinner or a night out?

But even if you land in dreamland with a bang, too much alcohol will most likely mean a fitful night’s sleep. That’s because the alcohol disrupts what is known as sleep architecture, the normal phases of deeper and lighter sleep that we go through each night. A night of drinking can “chunk” or interrupt these patterns, experts say, and you may find yourself waking up multiple times as you bounce back through the usual stages of dream.

“You pay for it in the second half of the night,” said Jennifer Martin, a psychologist and professor of medicine at the University of California, Los Angeles campus. Alcohol is “initially a sedative, but as it’s metabolized, it’s very activating.”

Here’s what happens: In the first half of the night, when fairly high levels of alcohol are still circulating in your bloodstream, you’re likely to sleep soundly and dreamlessly. This happens for a reason, in the brain, alcohol acts on gamma-aminobutyric acid (GABA) which is a neurotransmitter that inhibits impulses between nerve cells and has a calming effect. Alcohol can also suppress rapid eye movement, or REM sleep, which is when most dreams occur.

Later at night, as alcohol levels drop, your brain speeds up. Your body can go round and round as it experiences bouncing arousal. “As the levels go down, you will have more problems with fragmentation,” explained Nisha Aurora, a member of the board of directors of the American Academy of Sleep Medicine. You’ll probably also have more vivid or stressful dreams, and since irregular sleep means you wake up more often, you’re more likely to remember them.

Alcohol is also a diuretic, a substance that increases urine output, which means you may wake up to go to the bathroom. “You’re going to have to urinate more often,” said Bhanu Prakash Kolla, a physician and associate professor of psychiatry and a consultant at the Mayo Clinic Center for Sleep Medicine in Rochester, Minn. “Moderate amounts of alcohol, especially wine and spirits, have an early diuretic effect, especially in the elderly,” he added. It’s not clear if the urge to urinate wakes you up or if you’re just more in tune with your body in the second half of the night because you sleep fitfully.

People may also snore more after drinking. Alcohol is a muscle relaxant and acts on the muscles of the upper respiratory tract, interrupting the normal process of breathing. Drinking can be particularly dangerous for people with Sleep apnea, who wake up many times during the night due to their airways collapsing at times.

Most experts agree that drinking will affect your sleep, regardless of your age or gender. And because alcohol depresses the central nervous system, experts warn against using it with sleep aids like Ambien, Tylenol PM, Benadryl, or even supplements like melatonin.

“Alcohol is a sedative,” said Ilene M. Rosen, Ph.D., sleep medicine and associate professor of medicine at the University of Pennsylvania Perelman School of Medicine. “I would not use any sedative hypnotic, over-the-counter or not, when drinking alcohol.”

Some people drink closer to bedtime to help them fall asleep. But that can start a dangerous cycle of more fragmented sleep, followed by more intense alcohol intake. “I see a lot of people self-medicate with alcohol for insomnia, which is definitely not good practice,” said Sabra Abbott, MD, an assistant professor of Neurology in Sleep Medicine at Northwestern University Feinberg School of Medicine. Sustained drinking at night can set worrying patterns that can persist even after people have stopped drinking, according to Abbott and other experts.

To help assess how alcohol may be affecting your sleep, experts recommend an alcohol-free reset period, or what Martin called an “alcohol vacation,” lasting at least two weeks. “It can be very revealing to see how much alcohol affects sleep,” he said. Many people who think they have insomnia, he said, may be drinking too much or too close to bedtime.

“It turns out that if they don’t drink, they sleep much better,” said Martin, who is also a spokeswoman for the American Academy of Sleep Medicine. After the “holidays,” he said, “they can make a more informed decision about how much and how often they drink alcohol.”

Experts also suggest creating a buffer zone of at least a few hours between drinking and going to bed. A nightcap doesn’t do you any good. “It’s probably okay to have a glass of wine with dinner four hours before bed,” Abbott said. Or maybe you should limit your drinking to happy hour or appetizer plate time.

Alcohol can also disrupt your morning routine. “People sometimes turn to stimulants” such as caffeine and drinking coffee late into the afternoon, said Armeen Poor, a pulmonary and critical care physician at Metropolitan Hospital Center in New York and a clinical assistant professor of medicine at New York Medical. College.

“That makes it more difficult to fall asleep at night,” he explained. “And then you need more of that sedative and then it just goes on and on and on and on.”

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