How Does Alcohol Affect Sleep?

Wine at dinner knocks you out by 9:30. You wake at 2:48 a.m. wide awake, with a dry mouth and a pounding pulse, and you lie there until the alarm. You tell yourself the wine helps you relax. It does. It doesn’t help you sleep.

What it does to the night

The Sleep Foundation¹ says alcohol reduces REM sleep, and that this shows up as tiredness and poor concentration the next day. See waking at 3 a.m., which covers other reasons for waking in the early hours, and why you’re always tired.

The NHS lists alcohol, caffeine and nicotine among the habits behind insomnia, and the National Heart², Lung, and Blood Institute (NHLBI) recommends avoiding caffeine, nicotine and alcohol close to your bedtime. The Centers for Disease Control and Prevention (CDC)³ lists avoiding heavy meals and alcohol before bed among its sleep habits, alongside a steady sleep schedule, a cool, quiet bedroom and no screens for at least 30 minutes before bed.

Snoring and sleep apnea

The Sleep Foundation¹ says alcohol aggravates sleep apnea by relaxing the throat. Alcohol causes the tongue and throat muscles to relax, and changes blood vessels in the nose, leading to greater airway resistance in the nasal passages. For central sleep apnea, it says alcohol interferes with the brain’s chemical messages involved in breathing and decreases the body’s respiratory drive. See snoring and sleep apnea in women.

How long before bed

The Sleep Foundation¹ says experts recommend avoiding alcohol for at least three hours before bedtime, and that some people may benefit from avoiding it even longer or abstaining altogether, depending on how much they drink, whether the stomach is full and what medicines they take.

See night sweats and hot flashes for other sleep disruptors in menopause.

The play

Try this: a two-week alcohol-and-sleep test

For one week, drink alcohol as you usually do and record your bedtime, when you woke, how many times, and how you felt at 10 a.m.

For the second week, finish any alcohol at least three hours before bed, or skip it, and record the same things.

Compare the two weeks. If your nights are better without it, you have your answer.

When to get checked

The NHLBI² says CBT-I is the preferred initial treatment for long-term insomnia and that medicines exist for it. If you’re using alcohol to get to sleep, a clinician can offer better options. See insomnia and CBT-I.

Book an appointment if any of these fit:

• You use alcohol most nights to fall asleep
• You wake at night or early morning more often when you drink
• You snore, gasp or feel unrefreshed, and drink in the evening
• You find it hard to cut back
• Trouble sleeping has lasted several weeks

A glass of wine is a decision about the first hour of sleep and the last hour of the night. Make it on purpose.