Sleep Disorders: Drug- and Alcohol-Related Sleep Disorders

Sleep disturbances have been associated with drug use, drug abuse, and withdrawal from drug abuse. Sleep disturbances also have been linked to the use of alcohol and to chronic alcoholism.

Drugs and Sleep

Many prescription and nonprescription medications can cause sleep problems. The severity of sleep problems caused by a medication will vary from person to person.

Prescription drugs that may cause sleep problems include:

• High blood pressure medications
• Hormones such as oral contraceptives
• Steroids including prednisone
• Respiratory medications
• Diet pills
• Attention deficit/hyperactivity disorder medications
• Some antidepressants

The following nonprescription medicines can cause sleep problems:

• Pseudoephedrine, including the brand Sudafed
• Medications with caffeine. These include the brands Anacin, Excedrin, and No-Doz as well as cough and cold medications.
• Illegal drugs such as cocaine, amphetamines, and methamphetamines.
• Nicotine, which can disrupt sleep and reduce total sleep time. Smokers report more daytime sleepiness and minor accidents than do nonsmokers, especially in younger age groups.

Alcohol and Sleep

Alcohol often is thought of as a sedative or calming drug. While alcohol may induce sleep, the quality of sleep is often fragmented during the second half of the sleep period. Alcohol increases the number of times you awaken in the later half of the night when the alcohol's relaxing effect wears off. Alcohol prevents you from getting the deep sleep and REM sleep you need because alcohol keeps you in the lighter stages of sleep.

With continued consumption just before bedtime, alcohol's sleep-inducing effect may decrease as its disruptive effects continue or increase. The sleep disruption resulting from alcohol use may lead to daytime fatigue and sleepiness. The elderly are at particular risk for alcohol-related sleep disorders because they achieve higher levels of alcohol in the blood and brain than do younger adults after consuming an equivalent dose. Bedtime alcohol consumption among older adults may lead to unsteadiness if walking is attempted during the night, with increased risk of falls and injuries.

Reviewed by The Sleep Medicine Center at The Cleveland Clinic.

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Edited by Michael J. Breus, PhD, WebMD, September 2004.

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Last Editorial Review: 6/20/2005