Wednesday, December 22, 2010

Get Some Sleep: Go Easy On The Alcohol

During the holiday season, a few things always happen: I spend too much, eat too much and drink too much. From Thanksgiving to New Year’s, we run around town going to office parties and open houses. The food is plentiful and the drink abounds. We all know how awful we feel the day after we overindulge in our favorite alcoholic beverage, but I don’t think everyone understands how it whacks our sleep, and that it has more than one negative effect. First, as everyone knows, alcohol is a sedative, but as that sedating effect wears off, usually after three to four hours, then many people wake up and are wide awake, some for hours.

So alcohol can cause maintenance insomnia, that is, the inability to maintain sleep for the desired seven to eight hours that most people need. This is why we discourage people from trying to use alcohol as a sleeping aid if they are having trouble getting to sleep. It might help with their initiation insomnia - the inability to fall asleep - but then they will most likely have maintenance insomnia. Even if alcohol doesn’t lead to insomnia, we know that it disturbs people’s sleep stages. Moderate to heavy alcohol consumption within two hours of sleeping, usually decreases the amount of slow wave sleep, which is the deepest sleep. And it causes brief arousals that a person is unlikely to remember but that all add up to make a person feel tired and unrefreshed the next day.

Also, it is well-documented that alcohol can not only cause a significant worsening of sleep apnea, but that it can cause a collapse of the airways and a lowering of oxygen levels in people who otherwise do not have obstructive sleep apnea. It does so by making the throat muscles even more relaxed than normal during sleep and sedating the brain so that it does not react as quickly to the changes in oxygen and carbon dioxide and therefore the oxygen levels can drop lower than they would normally. Alcohol also can make the blood vessels in the nose become engorged, much in the same way that it leads to facial flushing in some people, and this can in turn cause nasal congestion, which can worsen sleep apnea. There is also research showing that alcohol works directly on the part of the brain that acts as the central pacemaker for our internal clock that sets the 24-hour rhythm for all of our biologic processes. Therefore, alcohol can disrupt our circadian rhythm and thereby disturb the many physiological processes that are controlled by this 24-hour internal clock.

Most importantly, alcohol impairs our ability to metabolize glucose. Short or disrupted sleep also makes it difficult for the body to handle glucose and insulin properly. And because alcohol disturbs sleep in all the ways I have just elaborated, then alcohol is a double whammy on glucose regulation. Given the obesity epidemic and the rise in type 2 diabetes, it is important for people to understand that not only is alcohol full of calories from carbohydrates, but that alcohol makes it hard for us to clear the blood of the sugars that are the breakdown products of alcohol. So as you’re enjoying a little holiday cheer, keep in mind that the Christmas punch could be setting you up for a bad night of sleep. But if you drink in moderation, stop at least two hours before bedtime, and keep yourself well hydrated, then you can probably get a decent night’s sleep. And have lots of energy to get up and do it all over again.

Lisa Shives, M.D., is the founder of Northshore Sleep Medicine in Evanston, Illinois. She’ll blog on Tuesdays on The Chart. Read more from her at Dr. Lisa Shives’ Sleep Better Blog.

Source: Lisa Shives M.D. - sleep expert

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