During recovery, your teen’s body will go through many adjustments—the initial detox, unforeseen weight gain—as it attempts to heal itself. One struggle they may encounter is returning to a normal, healthy sleep cycle. Sleep is key to recovery but, due to the effect of substances on sleep patterns, your teen may have a hard time when bedtime rolls around.
Substances and Sleep
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In a chapter regarding the effects of drugs on sleep, Dr. Heather Ashton presents a summary of how substance abuse affects sleep patterns. When sedatives are abused, for instance, light sleep or stage 2 sleep is prolonged (which accounts for the longer sleeping time) while REM and slow wave sleep (SWS) are diminished. SWS is thought by some to play an important role in cerebral restoration and recovery, while REM sleep, especially in early life, is associated with brain maturation and development.
Alcohol consumption reduces REM sleep and increases SWS. However, in the middle of the night when the body metabolizes the alcohol, the user may wake up more often and experience vivid dreams or nightmares because REM sleep also increases as alcohol is metabolized.
Amphetamines and related substances (MDMA, ecstasy, cocaine) decrease sleep time, increase sleep latency (the time it takes to fall asleep) and increase sleep fragmentation. Ashton also found that most antidepressants decrease REM sleep; while REM sleep is often increased in depressed patients, the suppression of REM sleep is not necessarily associated with improved mood.
Sleep, Substance Abuse and Circadian Rhythms
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Substance use can indirectly affect the body’s circadian rhythms as it can interfere with timing of light exposure, meals, exercise and social activities. Still, these factors may be re-regulated once the substance is removed from your teen’s life. Talk to you child’s doctor about circadian rhythms and keep an eye on your child’s natural tendencies as they go through the recovery process.
Withdrawal and Recovery
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When the initial decision is made to stop using substances, your child’s sleep cycle is affected almost immediately. Acute withdrawal tends to be linked to sleep disturbance; your teen will most likely experience extended SOL, decreased slow wave sleep and decreased sleep time as their body attempts to normalize. However, as your child continues to abstain from drugs, their sleep patterns should return to a ‘baseline’, that is, their body’s standard sleep pattern.
Sometimes, the normalizing process can take quite a long time—your teen may experience disturbed sleep well into their recovery. This is a difficult obstacle as disturbed sleep can often trigger substance abuse relapses. Encourage healthy sleeping habits in your teen to help them manage this difficult time. Routine bedtimes and wake-up times can help re-establish a normal sleep cycle. It may also be helpful to establish pre-bedtime relaxing rituals such as going for a long walk, reading a chapter from a beloved book or listening to soothing music.
Across the board, it is clear that substances interfere aggressively with the body’s natural sleep patterns. In fact, chronic use of most substances results in similar sleep patterns: extended sleep onset latency (SOL), reduced total sleep time (TST), more nighttime awakenings and decreased slow-wave sleep (SWS) and rapid eye movement (REM) sleep.
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