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Dealing with insomnia during withdrawal from substances

05-10 | By CSAA Team

Dealing with insomnia during withdrawal from substances

One of the most common symptoms affecting individuals in recovery or withdrawal from substance abuse is insomnia. During this period, individuals may find it difficult to maintain regular sleep cycles for several weeks, months or even years. In particular, the initial period of withdrawal can be extremely stressful and irregular sleep patterns worsen the suffering. Besides making the recovery process more unbearable, insomnia causes fatigue, weakens the body’s immunity, and increases the vulnerability to illnesses and stress levels.

Regular use of substances or addiction results in the brain producing lower levels of dopamine, a chemical that controls reward and pleasure centers in the brain. A regular intake of addictive substances provides sufficiently high levels of dopamine which compensate for the brain’s normal production.

During withdrawal, the brain takes time to stabilize, usually four to six weeks, to produce sufficient levels of dopamine again. This has the effect of increasing stress levels and inducing a state of panic till the time dopamine levels normalize. The stress experienced during these four to six weeks is usually sustained for much longer periods and at higher intensity levels.

Insomnia during early withdrawal impedes recovery and contributes to relapse

An older study, published online in the Journal of Addiction Medicine, shows that the chances of suffering from insomnia during the early stages of recovery could be five times higher than the general population. Findings from past research also show that insomnia during the early stages of withdrawal threatens recovery and may be a significant factor in relapse:

  • Instances of disturbed sleep cycles are fairly common in early recovery from alcohol addiction or immediately after detox, which may last for several months in spite of complete sobriety. In all such cases, insomnia has been found to be a significant predictor of relapse during recovery from alcohol dependence. Relapse can occur anywhere between a few weeks and a few months during recovery.
  • Long-term cocaine abuse is associated with lower sleep time and a longer time to fall asleep. The study also found that cocaine abusers do not perceive that they are suffering from a sleep-related problem, possibly due to the fact that cocaine inhibits the brain’s assessment of sleep requirement. The study also refers to past research which has established that sleep deficit during the first two weeks of recovery is a sufficient predictor of relapse.
  • Insomnia during opioid withdrawal may start anywhere between 12 and 30 hours since the drugs were last used. Although light marijuana users do not experience severe symptoms during withdrawal, insomnia is a common complaint during withdrawal among users who have had high marijuana dependency.

Behavioral therapies are most effective in treating insomnia during withdrawal

Although short-term medication can be prescribed for curing insomnia during withdrawal, there are chances of misuse and can be counterproductive to ongoing treatments targeting sobriety. Often, clinicians specializing in addiction medicine express their reluctance in prescribing any medication to patients who are suffering from insomnia due to side effects.

Risks associated with anti-insomnia medicines have led to the increasing use of behavioral therapies in treating insomnia during recovery. Cognitive behavioral therapy (CBT) is especially useful and one of the most widely advocated therapies. The treatment methodology includes use of a daily sleep record and individual assessments to collect information on insomnia and improvement in the condition during treatment. CBT increases awareness on the causes of insomnia during withdrawal and promotes good habits that are conducive to better sleep.

Treatment of insomnia during withdrawal should be an essential component of any recovery plan. Self-medication or use of substances to cure insomnia should be avoided completely. If you or someone you know is battling substance abuse, the Colorado Substance Abuse Advisors can assist with information on customized substance abuse treatment programs in Colorado. Call our 24/7 helpline number 866-300-5857 or chat online with our advisors for information on the best substance abuse treatment centers in Colorado.


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