Alcohol Abuse and Sleep

Room to discuss issues related to Alcohol Abuse.

self medicating is a natural result of untreated sleep deprivation.

I am glad I saved this important article written a few years ago by a well known and respected sleep doctor.

While the focus is on sleep apnea and snoring, I believe it is most relevant to this thread and so, I share it with you

Sleeping Under the Influence
James C. O’Brien MD, FCCP, D’ABSM

Sleep is an amazing and essential activity that is required for both maintaining and maximizing ones personal health and well-being.

The activity of “sleep” comprises almost one-third of our lives and by the time we are 45 years old, we have spent almost 15 years of our life asleep!

If we have any untreated sleep disorders, such as obstructive sleep apnea (OSA), then the time we devote to obtaining sleep is to some degree wasted, given the lack of deep and restorative sleep that untreated OSA causes.

For those diagnosed with OSA, CPAP use is essential for their health and well-being every night.

Most snorers can recall how their snoring was reportedly worse whenever they consumed more alcohol than was usual for them. Others, who have no history of snoring, will report that bed partners indicate that they are snoring on occasion after they have been drinking.

It is clear that alcohol ingestion can “relax” the upper airway and contribute to the “noise pollution” of simple
snoring and the potential serious consequences if one has severe obstructive sleep apnea and is without treatment. In addition, many medications including narcotic pain relievers and muscle relaxants can adversely affect ones breathing during sleep and cause more sleep-related breathing disturbances than should be happening during a given night’s sleep.

Besides the upper airway narrowing from the social use of alcohol and medicinal use of pain killers and muscle relaxants, the presence of severe nasal congestion from allergies or upper respiratory infection and colds can cause increased difficulty breathing, which for some can result in snoring and the inability to sleep well or feel rested despite sleeping their “usual” number of hours.

Lastly, ones ability to breathe through their nose can be compromised by sleeping on their back and for others aggravated during dream sleep which can comprise up to 25% of our sleep each night. When this occurs, patients can
sometimes remember that they are continually awakening and on their back, as well as having a recollection of increased dreaming at night- arising from the increased awakenings during REM stage sleep. Why this occurs is likely related to the presence of paralysis during REM stage sleep that normally affects all of our muscles except our eyes, heart and diaphragm. These experiences can occur in both OSA patients on CPAP therapy as well as individuals with a previous reputation for simple snoring and without any sleep-related breathing disorder.

Sleeping under the influence of alcohol, pain killers, muscle relaxants as well as colds and severe nasal allergies can all compromise our best use of CPAP therapy. Since CPAP is usually a single positive airway pressure, the
additional upper airway resistance and nasal resistance can potentially reduce the benefits usually derived from ones CPAP therapy.

What does all this mean?

Well consider sleeping on your side if you are snoring despite using your CPAP treatment, since this will lessen the number and severity of events that may be causing your snoring. Going without CPAP because of the presence of snoring is not a good idea since without CPAP you will likely snore more and have more sleep disruption, assuming your CPAP device is working as usual for you. One cannot “turn off” REM stage sleep and there isn’t any medication or method to lessen this essential sleep stage for obtaining the best overall sleep possibility.

Nasal congestion is another story and can be temporarily improved by the use of over the counter (OTC) nasal sprays that could be used for up to 3 days to relieve nasal congestion assuming it is from a simple cold. If nasal congestion
is from allergies, then OTC non-sedating antihistamines or topical nasal steroids requiring a prescription would be useful to permit the best effect from your CPAP device.

Lastly, it might make sense for those who experience variations in upper airway resistance associated with, seasonal allergic rhinitis, episodic nasal congestion from colds or consume alcohol socially on weekends to look into the potential benefit of an AUTO CPAP device, which can vary the pressure necessary to maintain nasal patency and provide easy nasal breathing during deep sleep, regardless of any common circumstances that can influence upper airway resistance.

Although, most insurances can present barriers or auto CPAP use their versatility is not to be ignored for those with lifestyles and other medical conditions that can have an impact on their necessary treatment of obstructive sleep apnea.

Let’s also not forget that treated patients with sleep apnea often lose weight and their fixed CPAP pressure over time may feel “too strong” compared to when they first started their CPAP treatment. Another reason to consider a flexible CPAP pressure capability for those impacted with large changes in weight after initiating CPAP treatment for their OSA.

Sleep well