User:Beastlyvaulter

'''Alcohol use and sleep

Alcohol is a highly abused substance that greatly exacerbates sleep problems. During abstinence, residual disruptions in sleep maintenance and sleep architecture are the greatest predictors of relapse [1]

Moderate alcohol consumption and sleep disruptions

Moderate alcohol consumption 30-60 minutes before bedtime catalyzes disruptions in sleep maintenance and sleep architecture that are mediated by blood alcohol levels [2]. Disruptions in sleep maintenance are most marked once alcohol has been completely metabolized from the body. Under conditions of moderate alcohol consumption where blood alcohol levels average 0.06-0.08 percent and decrease 0.01-0.02 percent per hour, an alcohol clearance rate of 4-5 hours would coincide with disruptions in sleep maintenance in the second half of an 8 hr sleep episode [2]. In terms of sleep architecture, moderate doses of alcohol facilitate "rebounds" in rapid eye movement (REM) and stage 1 sleep; following suppression in REM and stage 1 sleep in the first half of an 8 hr sleep episode, REM and stage 1 sleep increase well beyond baseline in the second half. Moderate doses of alcohol also increase slow wave sleep (SWS) in the first half of an 8 hr sleep episode [2]. Enhancements in REM sleep and SWS following moderate alcohol consumption are mediated by reductions in glutamatergic activity by adenosine in the central nervous system [2]. In addition, tolerance to changes in sleep maintenance and sleep architecture develops within 3 days of alcohol consumption before bedtime [2].

Alcohol consumption and sleep improvements

Low doses of alcohol (one 12 oz. beer) are sleep promoting by increasing total sleep time and reducing awakenings during the night. The sleep promoting benefits of alcohol dissipate at moderate and higher doses of alcohol (two 12 oz beers and three 12 oz. beers, respectively) [3]. Previous experience with alcohol also determines whether or not alcohol is a "sleep promoter" or "sleep disrupter." Under free-choice conditions, in which subjects chose between drinking alcohol or water, inexperienced drinkers were sedated while experienced drinkers were stimulated following alcohol consumption [4]. In insomniacs, moderate doses of alcohol improve sleep maintenance [5].

Alcohol consumption and fatigue

Sleepiness influences the severity of alcohol consumption. Conditions of sleep deprivation encourage more episodes of alcohol consumption [2]. Increased alcohol consumption during the winter months for Northern climate residents is attributed to escalations in fatigue [6].

Alcohol abstinence and sleep disruptions

Sleep and hormonal disruptions following withdrawal from chronic alcohol consumption are the greatest predictors of relapse [1]. During abstinence, recovering alcoholics have attenuated melatonin secretion in the beginning of a sleep episode, resulting in prolonged sleep latencies [7]. Escalations in cortisol and core body temperatures during the sleep period contribute to poor sleep maintenance [7,8].

References

1. Feige, B., Scaal, S., Hornyak, M., Gann, H., Riemann, D. Sleep electroencephalographic spectral power after withdrawal from alcohol in alcohol-dependent patients. ALcoholism: Clinical and Experimental Research. 2007 Jan ; 31 (1): 19-27. 2. Roehrs, T., and Roth, T. Sleep, sleepiness, and alcohol use. Alcohol Research & Health. 2001; 25(2):101-109. 3. Stone, B. Sleep and low doses of alcohol. Electroencephalography and Clinical Neurophysiology. 1980; 48: 706-709. 4. Schuckit, M.A. Low level of response to alcohol as a predictor of future alcoholism. Am J Psychiatry. 1994 Feb;151(2):184-189. 5. Rohers, T., Papineau, B.A., Rosenthal, L., Roth, T. Ethanol as a hypnotic in insomniacs: self administration and effects on sleep and mood. Neuropsychopharmacology. 1999 Mar; 20(3):279-86. 6. Levine, M.E., Duffy, L.K., Bowyer, R.T. Fatigue, sleep, and seasonal hormone levels: implications for drinking behavior in Northern climates. Drugs & Society. 1994; 8(2): 61-70. 7. Kühlwein, E., Hauger, R.L., Irwin, M.R. Abnormal nocturnal melatonin secretion and disordered sleep in abstinent alcoholics. Biol Psychiatry. 2003; 54: 1437-1443. 8. Danel, T., Libersa, C., Touitou, Y. The effect of alcohol consumption on the circadian control of human core body temperature is time dependent. Am J Physiol Regulatory Integrative Comp Physiol. 2001; 281: R52-R55.