Because a recovering addict has become accustomed to the constant intake of drugs and alcohol that have chemically altered their brain, body, and nervous systems, the sudden deprivation of illicit substances will cause them to experience post-acute-withdrawal syndrome (PAWS), a withdrawal period that can last between a few weeks to two years. During this time, one of the symptoms faced is insomnia.
Insomnia puts a recovering addict at risk for relapse since they once relied on the sedative properties of drugs and alcohol to function, and can be tempted to use those same substances to aid their aggravating lack of sleep. In order to prevent the possibility of a relapse, recovering addicts can turn to non-pharmaceutical options to combat both their addiction and insomnia.
These are the strategies proven to improve sleep quality during addiction recovery.
1. Cognitive behavioral therapy
The psychological intervention of cognitive behavioral therapy (CBT) tackles both the mental and physical obstacles of insomnia, such as stress sources and the reactions that occur because of them. CBT focuses on rewiring how the brain perceives sleep in order to identify and understand the factors that impact sleep and change an individual’s behaviors towards those factors mentioned above.
CBT has several alleviating strategies:
Controlling external elements and the environment of a bedroom
The bedroom should only be limited to two things: sleep and sex. Anything else will cause the body to associate a bedroom with stressful stimuli, such as completing work, which is one of the last things one need when they are trying to fall asleep. Therefore, a recovering addict should focus on controlling the most influential external elements in a bedroom: exposure to light, temperature, and noise.
If light exposure—whether that’s in the form of fluorescent light or technology’s blue and white light—is not limited one to two hours before sleep, the body will suppress the production of melatonin, the “sleep hormone”. Additionally, the room should be kept at a cool temperature, between 60°F to 67°F (roughly between 15°C to 19°C). Insomnia prevents one’s body temperature from cooling down in the evening which hinders their ability to fall or stay asleep. Furthermore, the body is prone to cultivate even more heat due to this stress.
Lastly, outside noise should be minimized as much as possible. It has the ability to increase adrenaline as one is falling asleep or suddenly disrupt a sleep pattern in the middle of the night. While traffic, cars, and honking cars cannot be controlled, a person can settle for playing white noise in the bedrooms background or using earbuds to cancel out sound altogether.
Sleep restriction is a technique where the individual establishes a strict schedule of time allowed to spend in bed and a regular awakening time. The time needed to stay awake each day is calculated by adding the allowed bedtime to the awakening time. For example, if the allowed bedtime is 6 hours and the awakening time is 6 am, the individual must stay awake from 6 am until midnight. As sleep improves, the time in bed can be advanced in 15-minute increments until a healthy sleep/wake cycle of refreshing sleep is reestablished. It is important to get at least 30 minutes of bright light exposure upon awakening either via direct sunlight or a light box and to avoid napping. The goal of this behavioral therapy is to consolidate sleep time by restricting the amount of time spent in bed. By doing that, it is hoped that the individual will eventually acclimatize to specific times of day when they are active and alert and others allowed to sleep.
Another important factor to consider is to avoid using weekends as an excuse to “catch-up” on sleep by sleeping in. Contrary to popular belief, no one can ever compensate for the lack of sleep they have experienced throughout a week. In fact, setting aside even two days that do not adhere to a weekday sleep schedule can throw off one’s desired sleep schedule all-together.
Follow a nightly ritual
A nightly ritual should include practicing good sleep hygiene, such as avoiding naps that last for hours during the day and avoiding stimulating elements, such as technology, sugar, and caffeine, before bed. This is also an excuse to indulge in a series of relaxing activities, such as a taking a warm bath, doing yoga, and taking time to meditate. The body will eventually turn the nightly ritual into an everyday and necessary sleeping habit.
Implement the use of biofeedback
Under the instruction of a doctor, one can track and recognize the physiological and physical responses that prevent them from adequately sleeping. The main elements that are observed in bio-feedback are heart and muscle tension. Biofeedback utilizes electrodes (sensors) which record the biological signals that occur before and during sleep (i.e., an accelerating heartbeat or tightening muscles). Upon becoming aware of their physical symptoms and reactions during insomnia, an individual can then find ways to combat them, especially with relaxation therapy.
2. Paying mind to diet and exercise
Instead of turning to addicting sleeping pills, an individual can simply be meticulous about their daily meals. Maintaining a healthy diet will always be a valuable contribution to improving sleep, in addition to keeping the mind and body functioning at their optimum levels. This is especially significant considering that some foods naturally produce melatonin, the “sleeping hormone” that automatically kick-starts the body to rise or drift off to sleep.
High-intensity and low-intensity exercise, in conjunction with a healthy diet, also increases serotonin production which maintains the chemical levels necessary for a proper sleep-wake cycle. Additionally, vigorous physical activity always leads to the body undergoing a necessary recovery period where it significantly drops in temperature that encourages a state of rest.
3. Natural forms of relaxation
The use of herbs is a safe, non-addictive remedy. They have naturally sedating properties that affect brain receptors directly connected to the central nervous system to induce relaxation and drowsiness. The most popular herbs include chamomile, passion flower, and lavender, which are recommended to be consumed either as a tea, a supplement, or used in aromatherapy. However, an individual should first consult with their doctor about herbal remedies to find what herbs work best for them to determine a proper and measured intake that accommodates to their sleep needs.
Tune out the world with music
Playing soft music relaxes the central nervous system by diminishing the presence of stress and anxiety. According to a study, music was found to improve sleep quality by inducing its listener in a deep REM sleep, the most vital part of sleep that encourages the restoration of the body’s psychological well-being. It is necessary for the body to recover during sleep because, without that restorative process, one will suffer fatigue, possible depression, anxiety symptoms, and poor memory function.
Massage therapy not only reduces anxiety and promotes relaxation, but it also helps the body produce more serotonin. Without a proper influx of serotonin levels, an individual is more likely at risk for not only triggering insomnia but depression and fatigue as well. Fortunately, the technical movements of massage therapy stimulate the production of dopamine and endorphins, which increases blood flow, diminishes inflammation, and reduces muscle tension. Some examples of massage therapy techniques that provide the benefits mentioned above are kneading, the pull-and-squeeze motion of muscle tissue, and myofascial release, which is the gradual pressure on fascias (the fibrous tissue that encloses muscles and other organs) that had previously restricted blood flow.
A unique method that impacts the quality of sleep is acupuncture. Since acupuncture’s purpose is to stimulate nerves and muscles in the autonomic nervous system—which controls the involuntary bodily functions such as digestion, the beating of the heart, and breathing—the technique regulates the cortisol “stress” hormone imbalance that commonly occurs in insomnia. Too much stress is also associated with increased levels of epinephrine (adrenaline) that can keep a person wide awake at night.
On a final note, all efforts taken in addiction recovery are valuable steps forward
By following the strategies above, a recovering addict can overcome the inevitable insomnia stage during their journey to sobriety, and be assured that they are not restricted to medication to help them sleep and can instead use non-pharmaceutical options that will work just as well, and sometimes, even better.