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Pandemic leaving you sleepless? A nightcap is not the way to fix it

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In the 15 years before the pandemic, Australia was reportedly cutting down on the booze.

Since COVID-19 came into our lives, with attendant economic anxieties, school life upended and unreliable, and certain world leaders getting a taste for sabre rattling, enthusiasm for drinking has made a return, no doubt as a drowner of sorrows and bedtime buddy.

In December, an international survey found that Australia now leads the world in getting drunk.

We’ve also topped the world for seeking emergency help after a binge.

“There’s an emerging picture [that] there is a significant proportion of people who are drinking at riskier levels … to cope with stress and anxiety,” Caterina Giorgi, chief executive at the Foundation for Alcohol Research and Education, told The Guardian, responding to the survey.

Well sure. It’s hard to sleep with so much bad news keeping on keeping on.

Why not have a nightcap? After all, even before the pandemic, one in five Australians were using alcohol as a liquid sleeping pill.

Makes sense. Alcohol, a sedative, does a pretty good job of turning the lights out, right?

Actually, what it does is help you pass out. But that doesn’t deliver you a good night’s sleep.

And a nation that doesn’t sleep well is a nation less resilient in dealing with bad times.

The science of alcohol and sleep

Researchers have known for decades that alcohol can initially deepen sleep during the early part of the night but then disrupts sleep during the latter part of the night; this is called a “rebound effect”.

This is where you wake up, perhaps not feeling great, but can’t get back to sleep.

Some people who routinely use alcohol as a sleeping aid respond to this rebound effect by drinking more, with the idea that the higher dose will keep them asleep longer.

It’s a brilliant way to develop a drinking problem – because you’re very quickly mucking up your circadian rhythms, which leads to a disordering of your mood, which leads to more self-medicating with alcohol.

Once you’ve bought into this cyclical trap, it’s not so easy to fix, because you’ve put things out of whack at a genetic level.

There is a lot of research in this area, much of it from the first 15 years of the century.

To summarise a useful 2010 study out of Taiwan:

Circadian clock genes are key to regulating physiological and behavioural activities. Animal studies have shown that chronic drinking can disrupt expression in these genes. A human study has found an association between deregulation of circadian clock genes and chronic drinking.

“The body’s daily biological, or circadian, rhythms modulate our physiological functions and related behaviours such as body temperature, hormone secretions, and sleep/wake cycle,” explained Professor Sy-Jye Leu, a researcher with the Taipei Medical University and corresponding author for the study.

“Circadian rhythms are the outward manifestation of an internal timing system which is driven by several genetic elements, what we call circadian clock genes.”

The appropriate expression or regulation of these genes “is necessary for any organism to efficiently ‘program’ physiological and behavioural activities in order to ensure survival,” she said.

Bottom line: Alcohol dependence is related to circadian rhythm dysfunction, such as sleep problems and mood changes.

But that’s not the whole picture. The relationship between sleep and alcohol is complex.

Why you’ll drop off to sleep during a business meeting

A 2014 study from the University of Missouri School of Medicine found that drinking alcohol to fall asleep interferes with sleep homeostasis, the body’s sleep-regulating mechanism.

This mechanism “balances the body’s need for sleep in relation to how long a person has been awake”.

If you lose sleep, the body produces adenosine, a naturally occurring sleep-regulating substance that increases a person’s need for sleep.

This leads to people falling asleep at inconvenient moments, such as the middle of the work day.

“Based on our results, it’s clear that alcohol should not be used as a sleep aid,” said Dr Pradeep Sahota, chair of the MU School of Medicine’s Department of Neurology and an author of the study.

Some perspective

We’ve all had a big night, now and again.

You have a sore head the next day, a moment of some self-mockery when looking in the mirror, and you take it easy and get on with your day. That’s the good times.

But we’ve all had occasion to take a drink to soften the pain of loss or stress or a failure of confidence.

It’s not hard to see that booze doesn’t make bad times better.

But it’s too easy to give it the benefit of the doubt and give it another go. Suddenly the nights of poor sleep add up, and so does the anxiety.

These reports that Australians are drinking more, and drinking hard, are not evidence of our larrikin spirit.

It suggests that quite a few of us need to talk to somebody.

If you wake up in a panic, call Lifeline on 13 11 14.

If you need a plan to get your battered mind and emotions in better shape, contact Beyond Blue.

And for resources to improve your sleep habits, contact the Sleep Health Foundation.

We’ve Already Come Too Far To End This Now.

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