Heroin Addiction - Help for Addicts

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Sleep Handbook

All the information on this page is from the leaflet called 'Sleep: a guide to getting enough sleep for drug and alcohol users' and is available from drug services in the UK. It is produced by HIT.

THE SLEEP HANDBOOK

Everyone needs sleep

It is almost as import to your health and well-being as food.

Although your body always makes sure you get enough sleep to survive, getting enough sleep to feel refreshed, alert and ready to face the day isn't so easy.

You don't have to be a drug or alcohol user to have problems with sleep: around 1 in 4 of all adults have real trouble getting enough sleep!

The amount of sleep we need at night to feel refreshed and alert the next day is as individual as the amount of food we need.

Most people need 6 to 8 hours sleep a night. If you are trying to sleep for longer than this, part of the solution may be to accept that you need less sleep than you thought.

Sleep problems tend to develop over a long period, and it usually takes weeks or months of effort and practice to improve sleep.

The main problems people have with sleep are:

• not being able to get to sleep;

• waking up in the night;

• having trouble getting back to sleep; and

• waking in the early hours of the morning - which can be a symptom of depression.

The amount and quality of sleep you get can be affected by many things,

including:

• how comfortable you are;

• light, sound, cold, heat;

• being hungry or thirsty;

• anxiety and stress;

• physical illness or pain;

• mental health problems such as anxiety and depression;

• drugs, alcohol; and

• how much exercise you’ve had during the day.

Another important factor is your ‘body clock’ - your body’s sense of whether it is time to be awake or asleep.

Your body clock can be affected by things like going to bed in the early hours of the morning, getting up later in the day and sleeping during the day.

The campaign to get into a routine that gives you enough sleep to feel refreshed may mean making fairly big - and long term - changes to the way you organise your day and night.

Your body clock is mainly ‘set’ by the time you get up in the morning. If you want to get it into a normal rhythm, keep getting up at the same time every morning (ideally before 9.30am) - even if you’ve had a terrible night’s sleep.

Getting into a routine that sets your body clock so you can sleep at night is a really important part of sorting out sleep problems.

Anything you do (other than drugs and alcohol!) that lowers your stress levels and makes you more comfortable and relaxed is likely to help you sleep.

Complementary therapies can all really help - such as relaxation therapy, massage, aromatherapy (including essential oils in a warm bath before bed), herbal teas, acupuncture and homeopathy. Although ear acupuncture is available from some drug and alcohol services, other complementary therapies are not usually available on the NHS.

Drinking warm, milky drinks before bed can also help.

Ways to restore a normal sleep pattern

• Get up at a regular time (which should really be before 9.30am!) and stick to it even if you haven’t had much sleep. 

• Go to bed at a regular time which isn’t so early that you are lying awake for hours, but isn’t so late that it messes up your body clock.  

• Exercise as much as possible - morning or afternoon is best (exercising just before going to bed may make getting to sleep harder). Around half an hour is ideal. 

• If this seems like a lot, start with a short walk and work up.

Keeping a sleep diary

It can be really helpful to keep a diary over a couple of weeks in which you record the times you:

• went to bed;

• went to sleep;

• woke up in the night;

• woke up for the day; and

• got out of bed.

The diary may help you see how best to change your sleep pattern. If you do it for several months it can be a useful way of measuring your progress towards a better night’s sleep. A sleep diary can also be useful to show your GP or other professional you see for help with sleep problems.

If you go to see your GP about sleep problems you probably won’t be given sleeping pills. This is because sleeping pills only really help with short-term sleep problems that have a clear cause, and because doctors are worried about creating dependence on sleeping pills.

Sleeping pills don’t work if taken for more than a couple of weeks because your body adjusts to having them there and, when they are stopped, sleeping normally can be harder than it was before you started.

Sleep Diary (Word Doc)

Drugs & sleep
Drugs can have a powerful effect on sleep. Sedative drugs such as heroin, valium, sleeping pills and alcohol may reduce the time it takes to get to sleep but they often disrupt sleep later in the night. They can also cause serious problems with getting to sleep (and staying asleep) when you stop taking them. Regular use of sedative drugs (often taken in an attempt to get to sleep) is a major cause of sleep problems.

Although stimulant drugs like amphetamine and cocaine might make it feel OK to be awake at night, and tired and ready to sleep when the effects wear off, the total disruption of your normal sleep pattern makes this a very short-lived gain.

Opiate detox
Coming off heroin, methadone or other opiates can be really hard. Often, even when all the other symptoms of withdrawal have faded, it is still difficult to get a decent night’s sleep. Many people find that one of the worst things is lying awake at night thinking that all they need to get to sleep is drugs. If you want to stay drug free you will have to be prepared to endure sleepless nights. But if you follow the advice in this booklet, you will eventually get into a routine that gives you enough sleep at night.

Nicotine and caffeine
Both nicotine and caffeine are mild stimulant drugs. They increase heart rate and release adrenaline. Tea, coffee and cola drinks contain caffeine unless they are labeled ‘decaffeinated’. Some ‘energy drinks’ contain lots of caffeine. Avoid caffeine, especially in the evening. Although many smokers feel that cigarettes calm them down, nicotine does not have any sedating effect - it only feels calming because it relieves nicotine withdrawal symptoms.

If poor sleep is getting you down, giving up smoking can help - non-smokers and ex-smokers get, on average, 20% more sleep than smokers each night! If you want help to give up smoking ring the NHS smokers’ helpline on 0800 169 0 169 for information (including details of local groups) and support.

Alcohol & sleep

Having a nightcap
Drinking alcohol in the hour before bed may reduce the time it takes to first get to sleep but, after about 3 or 4 hours, alcohol usually makes sleep more disturbed and wakeful.

There are several reasons for this. Alcohol fills your bladder which means you have to get up to go to the toilet. It can also trigger strange and disturbing dreams.

Alcohol can also affect your breathing during sleep - causing snoring and periods when breathing actually stops. This leaves you waking up feeling tired and ‘fuzzy’ even after several hours of sleep.

Dependent drinking
If you are, or have been, a dependent drinker, alcohol might have had a damaging effect on your sleep pattern.

Many regular drinkers find it takes them a long time to get to sleep and that their sleep continues to be affected for a long time after they stop drinking.

It is important to be prepared for poor sleep after stopping regular drinking as having a drink ‘just to get to sleep’ is a major cause of relapse.

Ways to improve your sleep

• Reset your body clock by getting up at the same time every morning.

• Don’t sleep during the day.

• Exercise for at least 30 minutes every day.

• Cut out caffeine and cigarettes - or avoid them in the evening.

• Don’t drink alcohol - especially in the evening.

• Do something relaxing before bed - have a bath or do a relaxation routine.

• Train yourself to be asleep in bed, rather than awake - if you have lain awake for more than half an hour, get up and do something relaxing until you feel sleepy.

• Don’t let yourself worry about things in bed - write them down, get up and do something relaxing or ring the Samaritans.

• Talk about your problems so they don’t worry you at night - ask your drug or alcohol service about counselling.

• Be patient (especially if you are detoxing) - your sleep pattern will get better, but it can take a long time.

• Keep a sleep diary and use it to identify the things which make your sleep better or worse.

Source:  www.hit.org.uk  (HIT)