Medically reviewed by Kevin Wandler, MD, Chief Medical Advisor
When you cannot sleep, the nights feel endless and the days feel impossible. It is no wonder so many people reach for something to help: a nightcap, a gummy, a sleeping pill or a leftover prescription. At first, it may seem to work. But many substances that help you fall asleep end up damaging the quality of your sleep, and over time they can make insomnia worse while creating dependence.
This article explores the two-way relationship between insomnia and substance use, how common substances affect sleep and what actually helps. Long stretches of sleeplessness can take a heavy toll on mood. If you are having thoughts of suicide, call or text 988. If someone is very difficult to wake, is breathing slowly or has overdosed, call 911.
A Two-Way Relationship
Insomnia and substance use feed each other. Poor sleep can lead people to use substances to knock themselves out or to push through the next day. Substance use, in turn, disrupts the brain’s natural sleep cycles, which worsens insomnia. Sleep problems during early recovery are also linked with a higher risk of relapse, which is why sleep deserves attention in any treatment plan.
Mental health conditions add another layer. Depression, anxiety, PTSD and bipolar disorder can all disrupt sleep, and people with these conditions may be more likely to use substances to cope. When sleep, mood and substance use are all tangled together, integrated care makes a difference.
How Common Substances Affect Sleep
Alcohol
Alcohol can make you drowsy and help you fall asleep faster, but as your body processes it, sleep becomes lighter and more broken, often with middle-of-the-night waking. Alcohol also suppresses REM sleep, the stage linked to emotional processing and memory, and it can worsen snoring and sleep apnea. With regular use, people often need more to fall asleep, and stopping can bring rebound insomnia.
Cannabis
Some people find cannabis helps them fall asleep at first, but tolerance can develop. When regular users cut back, they often experience trouble sleeping and unusually vivid dreams, which can make quitting harder.
Sleeping Pills and Benzodiazepines
Prescription sleep aids and benzodiazepines can be useful for short periods, but they can lead to tolerance, dependence and rebound insomnia when stopped. The FDA has added a boxed warning to certain insomnia medications about complex sleep behaviors like sleepwalking and sleep driving. Withdrawal from benzodiazepines can be life-threatening and should always be medically supervised.
Opioids
Opioids can cause drowsiness but disrupt normal sleep patterns and can cause dangerous breathing problems during sleep, especially when combined with alcohol or sedatives. Opioid withdrawal commonly brings intense insomnia and restlessness.
Stimulants and Nicotine
Cocaine, methamphetamine, misused prescription stimulants, nicotine and large amounts of caffeine keep the brain alert and make sleep difficult. The crash after heavy stimulant use can bring long, heavy sleep followed by exhaustion and low mood.
Sleep in Early Recovery
Trouble sleeping is a very common complaint in early recovery. Withdrawal disrupts sleep, and the brain needs time to relearn natural sleep rhythms. For some people, insomnia lingers after withdrawal ends. This is normal and treatable, but it can be discouraging. Knowing to expect it, and having a plan, can keep a few rough nights from turning into a relapse.
Signs Sleep and Substance Use Are Linked
- You feel you cannot sleep without alcohol, cannabis or a pill
- You need more of a substance to get the same sleep effect
- You wake in the middle of the night after drinking and cannot fall back asleep
- You use stimulants or large amounts of caffeine to get through the day after poor sleep
- Your sleep gets dramatically worse when you try to cut back
Better Sleep Without Substances
A structured form of therapy called cognitive behavioral therapy for insomnia, often shortened to CBT-I, is recommended by many medical organizations as a first-line treatment for chronic insomnia. It targets the thoughts and habits that keep insomnia going. Everyday habits help, too:
- Get up at the same time every day, even after a bad night
- Use your bed only for sleep and intimacy, not scrolling or worrying
- Get daylight in the morning and keep evenings dim
- Limit caffeine later in the day and avoid alcohol as a sleep aid
- Build a calming wind-down routine before bed
- If you cannot sleep, get up and do something quiet until you feel drowsy
- Ask your doctor about screening for sleep apnea if you snore or wake gasping
Integrated Treatment for Sleep, Mental Health and Substance Use
At Promises Dallas-Fort Worth, dual diagnosis treatment looks at the whole picture: substance use, mental health and the sleep problems that connect them. Care may begin with medical detox to manage withdrawal safely. From there, cognitive behavioral therapy, mindfulness-based approaches and psychiatric evaluation and medication management can help address the anxiety, depression or trauma that disrupt sleep. For people who have come to rely on sedatives, benzodiazepine addiction treatment offers a medically supervised path off them. The daily structure of residential care, with regular meals, activity and routines, can also help reset sleep rhythms.
Frequently Asked Questions
Is a nightcap a good way to fall asleep?
Not really. Alcohol may help you fall asleep, but it disrupts sleep later in the night and can worsen insomnia over time.
How long does insomnia last after quitting alcohol or drugs?
It varies from person to person. Sleep often improves gradually as the brain heals, and therapy and healthy habits can support that process.
Are there sleep medications that are safer in recovery?
Some options have lower misuse potential than others. Talk openly with your prescriber about your substance use history so they can recommend the safest choice.
Rest and Recovery Go Together
You deserve real rest without relying on a substance to get it. Call our admissions team any time at (469) 546-9303. You can also verify your insurance or contact us online to learn more.