How Do Drugs and Alcohol Affect Sleep?

Tired Man With Alcoholic Beverage

It is estimated that 50 to 70 million adults in the United States suffer from a sleep disorder, and 10 percent of Americans report chronic insomnia. Given the detrimental effects that insufficient sleep has on your body, mind, and quality of life, it is not surprising that people turn to various substances, including alcohol and drugs, to get a good night’s rest. The effects of alcohol and drugs on sleep are varied. Knowing which drugs keep you awake is vital for achieving restful sleep.

How Does Alcohol Affect Sleep?

Although many people view alcohol as a relaxant and often use it as a sleep aid, alcohol is disruptive to your sleep. Alcohol initially has a sedative effect and may help you fall asleep faster. However, after four to five hours, alcohol acts as a stimulant rather than a depressant. Drinking alcohol stimulates your brain to produce adenosine, a chemical that helps induce sleep. Unfortunately, the effects of adenosine wear off quickly, and you are more likely to wake up before you have had a full night of rest when you mix alcohol and sleep.

Alcohol also interferes with the quality of your sleep. Studies have reported that alcohol suppresses REM sleep, which is thought to be the most restorative part of your sleep cycle. Cutting down your REM sleep means you will wake up feeling groggy and tired, making you more likely to be sleepy during the day. In short, alcohol and sleep are not a good mix.

Marijuana and Sleep

With the increased legalization of marijuana, or cannabis, and the greater availability of cannabis-derived products, more people are using cannabinoids as sleep aids. But what are the effects of combining marijuana and sleep?

More than 100 cannabinoids are found in cannabis. Cannabidiol (CBD) and tetrahydrocannabinol (THC) are the two most researched and the most abundant cannabinoids. These two compounds bind to receptors in your brain and throughout your body, causing a variety of effects. CBD is the non-psychoactive component of cannabis, that is, it does not produce a high. It is the most widely used cannabinoid for medicinal purposes. THC is the psychoactive or high-producing component of cannabis.Your body produces internal cannabinoids known as endocannabinoids. The most abundant endocannabinoid is anandamide, and it induces relaxation. CBD interacts with CBD receptors in the brain and increases the amount of anandamide circulating in your brain. Research indicates that cannabis may help induce sleep in people with insomniaanxiety, or post-traumatic stress disorder; however, the possibility of long-term habit-forming effects has not been studied.

Man Taking Pill

Drugs That Prevent Sleep

Sometimes sleep disturbances are caused by medications and drugs that keep you awake. Both prescription drugs and over-the-counter products can interfere with your sleep. The following are categories of prescription drugs that interfere with your sleep:

  • Some high blood pressure medications, such as diuretics and alpha agonists
  • Hormones, such as birth control pills
  • Steroids, such as prednisone
  • Diet medications, including phentermine
  • Medicines that treat attention deficit and hyperactivity disorder (ADHD)
  • Some antidepressants, such as fluoxetine and sertraline

Over-the-counter drugs that can prevent sleep include the following:

  • Cough and cold preparations containing pseudoephedrine or other decongestants
  • Medications that contain caffeine, such as migraine headache products

What to Do If You Need to Take Drugs That Keep You Awake

If you must take any drugs that prevent sleep, you should take them in the morning or as far from your bedtime as possible. If your medication is taken multiple times a day, ask your healthcare provider about taking your last dose in the early afternoon. 

Afternoon doses of ADHD medication should not be taken later than 4:00 PM, and prednisone can often be taken as one or two doses early in the day. Diuretics, or water pills, should always be taken in the morning to avoid frequent night awakenings to use the bathroom. Be aware of over-the-counter cough and cold preparations that contain pseudoephedrine or other decongestants. You should not take these medications at bedtime. Talk to your pharmacist about nighttime versus daytime cold preparations, and use only the nighttime products before sleep.

Some illicit drugs can also prevent sleep. Cocaine, amphetamines, and methamphetamines are drugs that keep you awake and should be avoided for a good night’s sleep among other health reasons.


Insomnia is a frustrating and exhausting problem. Many people turn to alcohol and other substances to get some rest and relief. Knowing the effects of alcohol and sleep will help you find healthy ways to fall and stay asleep. Good sleep hygiene is the first step in managing your sleep difficulties. This includes avoiding medications and drugs that keep you awake, as well as using natural products such as CBD and other cannabis compounds cautiously as further studies are needed to determine long-term effects.

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