Like drugs and flip-flops, drugs and sleep don’t mix very well. Stimulants can take hours to leave the body, keeping you up late into the night. Even the drugs that don’t actively block sleep can totally ruin a good night’s rest. Here's a quick guide to how substances can shake up your sleep.
Who doesn’t like a drink before bed every once in awhile? Alcohol brings on sleep quickly and causes deep sleep earlier than normal, so a drunk snooze initially appears to be quite restful. However, alcohol keeps the sympathetic nervous system from powering down, and as the night goes on boozy sleepers will wake up for a few seconds at a time without realizing it, disrupting the phases of their sleep cycle. When all the alcohol is metabolized, the depressant effect disappears and the body becomes super-sensitive to stimuli. You know how you wake up at the crack of dawn after a night out and can’t get back to sleep? That's why. In fact, many of the symptoms of a hangover can be chalked up to simple sleep deprivation.
America’s second most popular sedative isn’t all it’s cracked up to be. The leafy green has won a place on nightstands for its drowsy powers, but marijuana actually inhibits good sleep. Although it doesn’t impact total sleep time, marijuana decreases REM sleep, the critical phase of the sleep cycle that produces dreams. Those who start using cannabis as a teenger are more likely to have sleep problems later in life, and marijuana users are twice as likely to suffer from insomnia compared to non-users. Heavy smokers often have a hard time falling asleep after they quit, and REM sleep can return with a vengeance, causing vivid, potentially anxiety-inducing dreams. But don’t despair, bedtime tokers, it’s not all bad news: a 2013 study found that cannabis might be an effective tool against sleep apnea.
Hallucinogens like LSD, DMT, and psilocybin (magic mushrooms) mimic serotonin in the brain. The brain uses serotonin to process sensory inputs and emotions, so elevated levels cause wild perceptions of one’s environment and overwhelming feelings– not a particularly sleepy state of mind. Normally, serotonin diminishes in the evening and plays a role in triggering drowsiness, so a psychedelic trip can push back the onset of the sleep cycle by several hours.
MDMA works much the same way as other psychedelics, by dramatically increasing the level of serotonin in the brain. Frequent use can damage the brain’s ability to create serotonin on its own, leading to terrifying cases of sleep paralysis. It’s also an amphetamine, with a strong stimulant effect designed to keep users up all night.
Such drugs as morphine, oxycodone, and heroin are powerful sedatives, but there’s a big difference between sedation and quality sleep. In a study of chronic pain patients, researchers found that those who were taking opioids suffered reduced REM and non-REM sleep with more disruptions. Opioids can also cause sleep apnea, as well as muscle cramps and tremors that make it difficult to fall asleep.
Cocaine floods the brain with dopamine, increasing wakefulness long after the drug’s euphoric effects wear off. It also suppresses REM sleep. Persistent cocaine use can alter genes in the brain that control the circadian rhythm, fundamentally altering the natural sleep cycle. A study of former drug addicts found that they had serious difficulty falling asleep a year after quitting. Interestingly, the same group reported that they slept better than they did before they began using cocaine, reflecting the delusional confidence commonly associated with the drug.
Nicotine is a stimulant, and smokers have a hard time falling asleep and sleeping deeply in the first part of the night. As morning approaches, withdrawal symptoms kick in and cause frequent sleep disturbances. Like cocaine, heavy nicotine use suppresses the expression of genes that drive the circadian clock, making it difficult to sleep at normal hours.
Caffeine, of course, isn’t great for sleeping. It takes a long time to fully break down in the body, and many people’s daily routines involve more coffee than they can metabolize in a single day. Sleep doctors have long recommended a 2PM cut-off for caffeine consumption. Even a little caffeine after that point can have serious effects. In one study, subjects given an 8 oz. cup of coffee six hours before bedtime suffered up to a full hour of lost sleep.
Special thanks to Dr. Damon Raskin of Cliffside Malibu, who contributed to this article.