Did you know that the most common sleep diagnosis associated with substance addiction is insomnia? Or, that most mental health disorders, including substance use disorders, are linked to troubled sleep patterns? The problem is twofold: On one end, lack of sleep can trigger emotional and physical issues in people, and lead them to cope with drugs and alcohol. Conversely, substance abuse can lead to insomnia, due to its negative effects on the body and brain.

If your loved one is struggling to sleep at night, and/or is facing a substance abuse problem, he or she may be at risk for this dual diagnosis. Insomnia and substance addiction often co-occur, and can cause lasting, detrimental effects on a person’s physical and emotional well-being. Below, we explore what insomnia and addiction might look like in an individual, and what you can do to help.

What is Insomnia?

Insomnia is a common sleep disorder that affects an estimated 30 to 40 percent of Americans each year. Those suffering have extreme difficulty falling asleep or staying asleep for a sufficient period of time. Insomnia drastically affects a person’s mood and psychological state. It disrupts their ability to complete normal routine tasks, to be successful at work or school, and to maintain healthy relationships. 

There are two types of insomnia: acute and chronic. Acute insomnia is more common and generally less severe, as it is usually caused by stressful life circumstances and lasts a few nights at a time. Chronic insomnia, on the other hand, lasts for a prolonged period of time. It is usually caused by other medical and psychiatric issues. According to clinical resources like the ICSD3 and DSM-5, chronic insomnia is present when:

• An individual as difficulty initiating, maintaining, and/or awakening early in the morning three or more nights per week, and 
• This endures for three months or more, and
• It causes significant impairment in daytime functioning, and
• The sleep disturbance is present, despite an adequate opportunity to sleep.

Common causes of insomnia include psychological issues (such as a mental health disorder), medical conditions (such as chronic pain or sleep apnea), and other factors like hormone changes or disruptions to one’s circadian rhythm. 

When a person is suffering from insomnia, he or she is also at risk for other issues, including a greater vulnerability to accidents, depression, and other mental health disorders. Under the umbrella of mental health disorders is addiction, formally known as a substance use disorder.

The Link Between Insomnia and Addiction

Those experiencing chronic insomnia are at a heightened risk for addiction. Research shows that people who suffer from sleep disorders like insomnia are 5 to 10 times more likely to be diagnosed with a substance use disorder. As noted above, there are two ways in which these disorders interconnect.

Drug Addiction Leads to Insomnia

When a person repeatedly uses drugs, he or she increases the risk for insomnia. This is because continued substance abuse affects the neurochemical functioning of the brain. It disrupts the brain’s sleep-regulatory systems and, in turn, disturbs the latency, duration, and quality of sleep for the user. 

How, exactly? Drugs and alcohol are chemicals that impact the brain functioning over time. For example, drug abuse stimulates the neurochemical dopamine, which produces pleasure in an individual. Dopamine also helps regulate alertness and is a component of a person’s sleep-wake cycle. When drugs are repeatedly used, this can lead to increased alertness and severe sleep deprivation. Sleep deprivation then downregulates dopamine receptors, making a person more apt to keep using drugs. 

Certain drugs disrupt other chemicals involved in the sleep cycle, too. Marijuana, for instance, affects the endocannabinoid system that also helps regulate the sleep-wake cycle. Thus, marijuana abuse can cause troubled sleep patterns over time. In fact, over 40 percent of those trying to quit marijuana say that sleep difficulty is the most distressing symptom in recovery. Recovering users can suffer from insomnia for days or even weeks. If the insomnia is severe, it can lead a person to relapse.

It is not uncommon for those in early recovery to experience sleep problems. Drug withdrawal – which occurs after an addicted person stops using drugs – is actually a leading cause of insomnia. And the symptoms of insomnia can in turn lead a person back to drug abuse. According to the study cited above, one in every 10 individuals who relapsed after marijuana treatment said the cause was sleep difficulty.

Insomnia Leads to Substance Abuse

Insomnia causes difficult symptoms such as irritability, anxiety, mood swings, and general fatigue. Over time, these can take a great toll. A person may try everything possible to cope with the detrimental effects of insomnia, which includes misusing substances. When a person uses drugs and alcohol to cope with a mental health condition like insomnia, it is called self-medication.

According to the Centers for Disease Control and Prevention (CDC), about half of the people that suffer from sleep disorders and regularly abuse alcohol and/or drugs, do so in efforts to improve sleep.

Because drugs and alcohol have temporary, pleasurable, and often mind-numbing or relaxing effects, many people will use them to try and medicate their insomnia. However, the more they do this, the more likely they are to develop a substance use disorder. 

Similarly, people with insomnia may get a prescription for sleep medications, such as Ambien, to overcome their nightly struggles. They may become reliant on these drugs to get to sleep, and may start to use larger or more frequent doses to feel the drugs’ effects. This can also lead to substance addiction.

Insomnia and Addiction Treatment for Teens & Young Adults

When substance addiction and insomnia co-occur, professional intervention and treatment is necessary. The treatment must be immediate and integrated, meaning it treats both the substance use disorder and the insomnia disorder at once. 

If your loved one is misusing substances, is reliant on substances, and faces issues with sleep, do not hesitate to seek proper help. As overwhelmed as you may feel in this moment, it’s important to recognize that co-occurring insomnia and addictive disorders are very treatable. A multi-disciplinary, dual diagnosis approach is recommended for people who are battling substance abuse and a co-occurring mental health disorder. 

Turnbridge is an integrated, evidence-based, dual diagnosis treatment center for teens and young adults battling co-occurring substance use and mental health disorders. We have worked with many clients suffering from insomnia, and can help your loved one back on a healthy path. To learn about our programs, please do not hesitate to call 877-581-1793 today.