Sheri Spirt, M.D.-Blog

It has been reported that almost 90% of people that abuse alcohol have sleep disturbances. other problems also exist for abuse of marijuana, cocaine, pain killers, caffeine, and nicotine.  Substance use leads to disruption in a number of neurotransmitters including acetylcholine, GABA, glutamate, norepinephrine, and orexin.

Alcohol can promote sleep but leads to fragmented restless sleep. There is also a decrease in total REM percentage and prolongation in REM onset latency. Alcohol also selectively inhibits motor activity in the upper airway with a corresponding increase in inspiratory resistance and snoring. Gabapentin and trazadone have shown some positive effects as sleep aids in patients with alcoholism. Trazadone has been the medication of choice to treat insomnia in early recovery for many years. Gabapentin is also relatively safe with few drug-drug interactions, low addictive potential, and no hepatic metabolism. It is known to increase cerebral concentrations of the inhibitory neurotransmitter GABA and is involved in the modulation of glutamate and norepinephrine. Rozarem can be of help by acting as an agonist at melatonin receptor and increasing total sleep time and decreasing sleep onset latency.

Marijuana with chronic use can lead to a reduction in stage N3 and decreased total sleep time. IT can also lead to decrease in REM percentage and prolongation or REM latency.

Nicotine causes longer sleep latency, decreased total sleep time, increased REM onset and decreased stage N3 sleep.