Alcohol and Marijuana

Alcohol

We are assuming that you do not have dependence on alcohol because we screened for that in the first part of the experiment and if you screened positive, we hope that you have sought help with your physician before moving on to the sleep experiment.  So, if you are reading this intervention, you are one of the many social drinkers who often have a glass of wine, a mixed drink, or a beer sometime before bed.  Maybe you have been doing this for years and see little problem with the practice.  You might even feel like this helps you get off to sleep.  Unfortunately, alcohol is a very potent disruptor of sleep and even a single drink can have a negative effect.  The part of your sleep that is most sensitive to the effects of alcohol is your REM sleep.  We see many patients who have a drink or two before bed and in many cases, it all but eliminates the REM sleep all together.  REM sleep is necessary for creativity and sharp thinking during the day and it also has an impact on emotional state.  So, when you don’t get REM sleep you are more prone to extremes of emotion such as anger or fear.  In our program, we recommend a trial of abstinence from alcohol and we ask our patients to specifically examine the impact of that abstinent period on Restlessness, REM sleep and Deep Sleep.

Record your restlessness score or use your own tossing and turning index, then record the amount of REM sleep, the amount of Deep Sleep and your Epworth sleepiness scale.  Begin a trial of abstinence from alcohol for not less than 2 weeks and record those same measures daily during your trial.  If you get substantial improvement on restlessness, REM, Deep and Epworth, then continue your new healthy habit of abstinence from alcohol.  If you must go back to some drinking, then try and limit it to no more than 1 drink and try to have the drink at least 4 hours before bedtime.

Marijuana

It may not be true in every state in the US but in San Francisco, where I live, a lot of people use marijuana daily.  This is not just young people.  I routinely see people in their 70s and 80s who use marijuana often to get off to sleep on an almost daily basis.  Just like alcohol, the THC component of marijuana is disruptive to healthy sleep.  Also like alcohol, it can increase onset of sleep a little bit but then the sleep that is induced is fitful.  The theme here is that anything with sedative properties such as sleeping pills, alcohol and marijuana will also disrupt the normal sleep pattern.  With marijuana it is often more subtle than it is with alcohol so typically experiments with marijuana take longer to carry out.

If you use regular marijuana for sleep, try a trial of abstinence for at least 4-6 weeks before determining your improvement.  Use the Epworth scale, restlessness score and amount of REM and Deep sleep as your guides to the effectiveness of this intervention.