Can't Sleep After You Stop Drinking? What's Normal and How Long It Lasts

It's night four without a drink. You expected sleep to be the first thing to improve. Instead you're lying there at 1am, then 2am, more awake than you've felt in months. Bad sleep is a common complaint when people stop drinking, and for most people it gets better with time. Here is why it happens, roughly how long it lasts, and what to do in the meantime.

Why stopping can make sleep worse first

If you drank most evenings, your brain adapted. Alcohol acts on GABA, the brain's main calming signal. To stay in balance, a brain that gets alcohol every night turns its own calming system down and its alerting systems up. When the alcohol stops, those adjustments don't reverse overnight. For a while you're left with a nervous system tuned toward arousal, and sleep is one of the first things to feel it.

Difficulty sleeping is a recognised withdrawal symptom. The NHS lists it alongside anxiety, sweating and shaking, with symptoms starting within 6 to 12 hours of the last drink.

There's a habit side as well. Using alcohol to get to sleep is common, and among people starting treatment for drinking, between 44 and 60 percent said they had used it that way. If a drink was how your evening ended, your body and your routine both need time to learn another way.

How long it tends to last

Most of the research comes from people treated for long-term heavy drinking, so it describes the harder end of the range.

• The first one to two weeks. Acute withdrawal lasts roughly this long. Taking longer to fall asleep and sleeping fewer hours are typical. The NHS says withdrawal symptoms usually last 3 to 7 days.
• The following weeks to months. In one study, insomnia hung on as a lingering withdrawal symptom for about five weeks. The NHS notes some symptoms can last a few months, especially if you drank heavily.
• Up to a year or two. After years of heavy drinking, some sleep changes last much longer. In follow-up studies, the time it took to fall asleep returned to normal after 5 to 9 months, and total sleep time took 1 to 2 years. Complaints of insomnia can persist up to 2 years into sobriety.

Those long numbers can sound grim, so keep two things in mind. They come from people at the heavy end. And most sleep problems in early abstinence do improve with sustained time off alcohol. If you drank moderately, there's much less research to go on, though how much and how long someone drank appears to shape how their sleep recovers.

The treatment that works best

The best-tested treatment for insomnia that has lasted a while is cognitive behavioural therapy for insomnia, CBT-I. It's a short, structured programme that changes the thoughts and habits that keep you awake. The American College of Physicians recommends it as the first treatment for chronic insomnia, and the American Academy of Sleep Medicine gives it a strong recommendation. The NHS notes it's available face to face or through online programmes.

It also helps people with alcohol problems. A review of nine studies found that insomnia treatment improved sleep quality in people with alcohol use disorder, and behavioural treatment did better than medication. The same review found no effect on whether people stayed off alcohol, so treat better sleep as support for your plan and keep the plan itself going.

What you can start tonight

Two core parts of CBT-I don't need a therapist to begin:

• Get up at the same time every day, whatever kind of night you had. Don't sleep in after a bad night, and skip daytime naps.
• Only go to bed when you're sleepy. If you've been lying awake and frustrated for a while, get up and do something calm in low light until you feel sleepy, so your bed stays linked with sleep.

Sleep habits help as a background. Cut tea and coffee in the six hours before bed, and keep the bedroom dark and quiet. On their own, though, sleep specialists don't recommend relying on these habits for insomnia that has lasted months. For more on how sleep changes once alcohol is out of the picture, see sleep, energy and fitness without alcohol. If vivid dreams are part of it, read vivid dreams after you stop drinking.

Why not to fix it with a drink or a pill

At 2am, a drink can look like the obvious fix. It does help you drop off, then it breaks up the second half of the night as it wears off, and tolerance to its sedative effect builds within about three nights. Poor sleep is also linked with going back to drinking. In several studies, people who had insomnia when they started treatment were more likely to return to drinking later.

Sleeping pills are no simple swap either. The NHS says GPs now rarely prescribe them for insomnia, because they can have serious side effects and you can become dependent, and when they are prescribed it's usually for a few days or weeks at most. Mixing them with alcohol is dangerous: the NHS warns that alcohol can increase the effects of zopiclone, a common sleeping pill, enough to cause breathing problems and make it very difficult to wake up. Don't take sleep medication that wasn't prescribed for you, and don't combine any with drinking.

When to see a doctor

The NHS suggests seeing a GP if changing your sleep habits hasn't helped, if you've had trouble sleeping for months, or if it's affecting your daily life. Mention loud snoring, gasping or choking at night too, since these can be signs of sleep apnoea. People who have recently stopped drinking are more likely to have breathing problems during sleep.

If you drink heavily every day, stopping suddenly can be dangerous. Talk to a doctor first. The NHS advises getting advice on stopping safely and on any medicine you may need for it. Sleeplessness together with shaking, sweating or anxiety can be withdrawal. Seek urgent care for severe shaking you can't control, confusion, seeing or hearing things that aren't there, a seizure, or a racing heart with heavy sweating. For more on what a doctor can help with, see when to see a doctor about drinking.