Dr Neil Stanley Independent Sleep Expert
BACK It is slightly odd for Ekirch to suggest that people in earlier times were unaware of the effects of alcohol on sleep, Pliny the Elder in his Natural History, 14.142 was certainly aware of the effects of alcohol on sleep ‘Even if all should turn out for the best, drunkards never see the rising sun, and so shorten their lives. Tippling brings a pale face and hanging  cheeks, sore eyes, shaky hands that spill the contents of vessels when they are full, and the condign punishment of haunted sleep and restless nights, and the crowning reward of drunkenness, monstrous licentiousness and delight at iniquity. Shneerson, Sleep Medicine, 96–7. Effects on sleep Acute effects Alcohol is an anxiolytic and a weak hypnotic. It increases the total sleep time, reduces sleep latency, reduces the latency before stages 3 and 4 NREM sleep and increases their duration as well as suppressing REM sleep. It is short-acting so that as the blood alcohol level falls during the night REM sleep rebound occurs, often with vivid dreams, loss of NREM sleep and frequent awakenings. After a large intake of alcohol these withdrawal features are seen on the next night. High doses may also reduce the duration of stages 3 and 4 NREM sleep and its diuretic effect causes awakenings from sleep. It also induces obstructive sleep apnoeas which lead to sleep fragmentation. Chronic effects Chronic alcohol ingestion disrupts the sleep–wake cycle, possibly through disturbing the pattern of melatonin secretion. Alcohol is often taken initially in order to promote sleep, but tolerance to its hypnotic effect leads to the quantity being increased and often other hypnotics are taken as well. The pharmacological effects of alcohol are combined with episodes of partial withdrawal and dehydration which lead to difficulty in maintaining sleep. Waking with dreams and headaches is common, especially in older subjects in whom the homeostatic drive to sleep is weaker. The sleep architecture disintegrates with the duration of both stages 3 and 4 NREM and REM sleep being reduced and low-amplitude K-complexes. Frequent sleep stage shifts and arousals lead to both insomnia and excessive daytime sleepiness. Periodic limb movements in sleep are common. BACK
© Dr. Neil Stanley 2013-2018