Awake and Addicted: Insomnia Impedes Recovery

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Insomnia is a persistent problem for many people in recovery from addiction and may lead to an increased risk of relapse, a new study by researchers from Stanford University and the University of San Francisco finds.

For recovering addicts and alcoholics, passing out in a drug- or alcohol-related stupor was probably quite common when they were drinking or using. But paradoxically, once they find sobriety, a good night’s sleep may suddenly be all but impossible. When substance abusers quit abusing, it can take them a while to find a new physical, mental and emotional equilibrium, and that process can play havoc with their ability to fall asleep at night in a consistent and timely fashion.

In an article appearing in the November/December edition of the Journal of Addiction Medicine, researchers from Stanford and UC San Francisco discuss the relationship between chemical dependency and insomnia. Based on the plethora of studies they analyzed, the researchers estimate that those in the early stages of recovery from addiction are five times more likely than a member of the general public to suffer from chronic sleeplessness. Furthermore, these bouts of insomnia may persist for months or years.

And while precise studies on the question have been scarce, the data collected so far shows a real connection between insomnia and relapse into addiction. The stress and discomfort associated with chronic sleeplessness could be enough to push even the most patient soul over the edge, and in the case of the chemically dependent, that could mean turning back to drugs or alcohol if they believe it will bring their insomnia to an end. Complicating the situation even further, cause-and-effect with insomnia and addiction can at times be difficult to determine since evidence indicates that insomniacs have an elevated risk of developing a substance abuse problem.

To Treat or Not to Treat, and How?

Some studies suggest sleep-inducing medication can decrease the likelihood of relapse for substance abusers suffering from insomnia. Treating the symptom in this instance is virtually the same as treating the underlying illness, as the removal of this one risk factor for relapse is enough to keep the recovering addict on a course toward lasting sobriety.

But many addiction specialists disagree on principle with the idea of giving sleep medication to recovering addicts. These substances are often addictive in their own right, possibly making them a bad bet for those already dealing with a substance abuse issue. One chemical dependency could be substituted for another, it is feared, and that is why most treatment experts believe non-medicinal therapies for insomnia are more appropriate and sensible when the insomniac suffers from a pre-existing addiction.

While controlled studies are lacking, cognitive-behavioral therapy (CBT) seems to work well for recovering addicts with insomnia. Strategies with CBT revolve around the elimination of specific triggers and the alteration of any patterns of behavior that might be contributing to the development of bad sleeping habits. CBT requires a very detailed approach to the problem, allowing for the discovery of subtle factors that might worsen the recovering addict’s struggle with sleeplessness.

Naturally, any treatment given for insomnia must be coordinated with treatment for addiction, so each healing regime will complement and reinforce the other. Addicts and alcoholics attempting to complete a comeback from substance abuse must never neglect any aspect of their mental, physical and emotional health, and insomnia is a condition that should be treated aggressively and proactively whenever it appears to disrupt a recovering addict’s life.

Strange Status of Insomnia in Addiction

Says Dr. Nicholas Rosenlicht, one of the academics responsible for the study: “Treating sleep disturbance in early recovery may have considerable impact on maintenance of sobriety and quality of life.” Recovering addicts are in such a sensitive state of mind that just about anything negative or troubling could conceivably act as a trigger for relapse. Sleeplessness causes stress, unhappiness and significant life disruption, and that makes it a true enemy and a force to be reckoned with during the addiction recovery process.

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