When I was in my late twenties, I stopped drinking alcohol for two years. It was an illuminating and life changing experiment (more on that in another blog post). Many of my health coaching clients also experiment with reducing or eliminating alcohol. They usually remark on the increased mood and energy that booze-free living provides. I have historically chalked this benefit up to the fact that alcohol is categorized as a depressant, or the vague notion that alcohol affects sleep quality.
I had yet to encounter an in-depth and satisfactory explanation for the mechanism of some of the commonly reported benefits. Then I read Matthew Walker’s excellent book - Why We Sleep.
If you are a regular listener of the NPR radio circuit, you’ve likely heard interviews with Walker (known as the sleep diplomat). Walker is a sleep scientist at UC Berkeley, and one of the leading sleep researchers in the world. A section of his book completely changed my view on alcohol. I wanted to share my takeaways in case you find it similarly compelling.
First, I’m going to cut to the bad news. Walker essentially recommends that we all go dry. Not for any religious or moral sense of alcohol as an evil vice but because he understands the science on alcohol and sleep so well, he cannot in good faith advocate for alcohol at any amount. Yikes!
Alcohol negatively affects sleep in a couple ways. Paradoxically, many use alcohol as a sleep aid, as they perceive it helps them fall asleep. This may be true, but according to Walker, “alcohol sedates you out of wakefulness, but it does not induce natural sleep”. Rather than aiding in solid sleep it is more similar to a mild form of anesthesia. You may seem to fall asleep more quickly but the sleep you do get is littered with “mini-awakenings.” You may not remember waking up multiple times throughout the night, but you will likely not wake up feeling refreshed, even if you got a full night’s sleep.
Beyond the “mini-awakenings,” the second downside of alcohol is its impact on REM sleep, and, more specifically, its downstream effects on cognitive function, learning, and mental health. Walker lets us know that alcohol is one of the most powerful suppressors of REM sleep that scientists know of. According to Walker, “People even consuming moderate amounts of alcohol in the afternoon and evening are depriving themselves of dream sleep”.
We likely all know that REM sleep is the phase of sleep when you dream. Dreams are undoubtedly fascinating, and often provide fodder for conversations with friends and therapists, but do they benefit us beyond their entertainment value?
Scientists are finding that when it comes to mental and physical health, the REM stage is vital. We are still learning why each sleep stage is important but here’s what we do know about REM sleep. First, REM sleep aids in memory integration and association. Without REM sleep, our ability to learn and remember is impaired. In his book, Walker cites several compelling studies related to alcohol, REM, and memory.
Another benefit is related to the fact that REM sleep is the only time in a 24-hour period, when your brain is completely devoid of norepinephrine (brain equivalent of adrenaline). In other words, REM is a unique moment when you don’t have stress-hormones affecting your brain. It appears your brain takes advantage of this by addressing emotionally relevant content from the day but through a stress-free lens. This allows the emotional brain to process and catalog the events and place them in a wiser, calmer context. If your brain has the opportunity to undertake this process, you will likely wake up feeling better about yesterday’s stresses and perhaps even have novel insights. Walker refers to this as the “REM-sleep overnight therapy mechanism”, and highlights that when we drink alcohol in the evening or even late afternoon we diminish or eliminate this opportunity.
Walker connects this to PTSD patients, a hallmark of the condition being sleep disruptions, particularly to the REM phase. Walker theorizes that this may be due to high levels of noradrenaline within the brains of PTSD patients that block normal REM and the “overnight therapy” effect it has. When stress is abnormally high post-trauma, the brain cannot do its overnight emotional healing. Relatedly, when researchers systematically deprived research subjects of REM sleep, REM-deprived subjects the next day interpreted neutral faces as fearful and menacing at rates much higher than their well-slept counterparts. The world literally looks like a less-friendly place when you are REM-deprived! It’s remarkable that alcohol also inhibits REM and has the same downstream effects.
In such tumultuous times, we could all use some extra emotional support and healing. Many of us seek this from therapy, meditation, exercise, and even Netflix. These are all wonderful resources to take advantage of, but it’s remarkable that we have an innate, biologically hardwired standing therapy appointment (free of charge) accessible to us each night when we sleep. The fact that alcohol diminishes this golden opportunity is something to be aware of when we are deciding how big of a role we want alcohol to play in our lives. Knowledge of the true effects alcohol has on sleep and mental health can empower us to choose how we want to relate to it.
If going totally dry sounds like an unacceptable buzzkill, another strategy is opting for an aperitif (before dinner drink) or a drink with dinner rather than an after-dinner cocktail. One tool for making this a habit would be setting an alcohol curfew - a time in the evening where you stop drinking in order to protect your sleep. The earlier in the evening you stop drinking, the less alcohol will be present in your system while you sleep.
Many adults have a relationship with alcohol, and like any relationship, it can be useful to occasionally take stock of the quality of it. Is it providing more pleasure than harm? Is it enhancing the other areas of your life that you value? These are personal questions that do not have easy answers. And like any relationship, the answers can shift and change during different phases of life. I hope this article empowers you with information that helps you cultivate a relationship that works best for you!