Sleep Habits That Support Recovery

You are awake again, and a drink or a leftover pill looks like the only way the night will end. A steadier bedtime can help. In recovery it is often only half the problem. The National Heart, Lung, and Blood Institute at NIH publishes a short list of sleep practices for the general public. SAMHSA's brief on sleep in recovery tells clinicians to teach those kinds of habits, and to prefer non-drug care because many insomnia medicines can be misused. How each substance changes sleep, and the warning about benzodiazepines and other sedatives, is on the addiction-and-sleep guide. Read that before you add a pill, a supplement, or a drink.

If someone will not wake, is having a seizure, or cannot breathe, call 911. For a mental health crisis, call or text 988. A dark room is not a detox plan. After a long run of heavy drinking, stopping all at once can be dangerous, and so can stopping a benzodiazepine suddenly. The medical pages are the alcohol withdrawal guide and the benzodiazepine guide.

The NIH habit list

NIH says sleep is often the first thing busy people cut, and that protecting time for sleep protects health. The steps are ordinary. They are not a scored program, and seven tidy nights do not erase a substance use disorder.

Go to bed and get up at the same time every day. Try to keep weeknights and weekends within about an hour of each other. Staying up late and sleeping in on weekends can throw off the body's sleep-wake rhythm.

Use the hour before bed as quiet time. NIH says to avoid intense exercise and bright artificial light, including a TV or a computer screen, in that hour. The light can tell the brain it is time to be awake. A hot bath or a relaxation practice can be part of the wind-down. Daytime movement is the activity guide. Intense work belongs earlier, not in that last hour.

Skip heavy or large meals within a few hours of bed. A light snack is fine. Skip alcoholic drinks before bed. NIH's insomnia page explains the trap: alcohol can make it easier to fall asleep, and the sleep that follows tends to be lighter than normal, so waking during the night is more likely. In recovery, that nightcap is also a return to use.

Skip nicotine and caffeine near bed. NIH names cigarettes, and it names caffeine in soda, coffee, tea, and chocolate. Both are stimulants. Caffeine's effects can last up to 8 hours, so a late-afternoon cup can still be in the way at midnight. Nicotine is its own recovery issue. Quitting alongside substance use treatment is the tobacco guide. A cigarette is not a bedtime tool.

Spend time outside when you can, and be physically active during the day. Keep the bedroom quiet, cool, and dark. A dim night light is fine if you need one.

Napping has a limit. NIH says a nap may improve alertness, and that people who cannot fall asleep at night should limit naps or take them earlier in the afternoon. Adults should nap no more than 20 minutes. A three-hour afternoon collapse can steal the night you are trying to rebuild.

Shift work is a different clock

Some schedules fight the body clock on purpose. NIH's notes for shift workers are separate from the standard list: nap and protect more time for sleep, keep the workplace lights bright, limit how often the shift changes, keep caffeine to the early part of the shift, and block sound and light in the bedroom for daytime sleep, including with light-blocking curtains. If you still cannot sleep in the day, or you cannot adapt, NIH says to talk with a doctor about other options. A recovery program that only hands you the standard "same bedtime" card, while you work nights, has not read this part.

Habits sit beside clinical care

SAMHSA's 2014 brief tells clinicians to screen for sleep problems, to teach habits such as a regular sleep time and less caffeine and nicotine near bed, and to use the bed for sleep. It prefers non-drug treatment first. Cognitive-behavioral therapy for insomnia is one approach it says has helped, including people who are alcohol dependent. A habit list is education. It is not that therapy, and it is not a sleep study.

Bring the habit list to the same clinician who knows your substances and your medicines. Tell them if you snore, gasp, or fight sleep in the daytime. Breathing during sleep on methadone or buprenorphine, and why leftover sedatives are a poor workaround, belongs on the addiction-and-sleep guide. Do not stop those opioid medicines, or any prescribed benzodiazepine, in order to sleep better this week.

Other recovery facts change the list without replacing it. A residential program sets the lights-out time. Early recovery can make caffeine feel like the only way to get through a group. NIH's 8-hour caffeine window is still the window. A mutual-aid meeting that ends late does not repeal it. Move what you can, and tell the program what you cannot.

What to ask

1. Who on this staff actually teaches sleep habits, and who screens for a sleep disorder?
2. What time is caffeine available, and what happens if I want none after mid-afternoon?
3. Is alcohol being offered, joked about, or kept out of the bedtime plan?
4. If I work nights, whose advice are we using, the standard list or the shift-work list?
5. Which symptoms mean I need a medical visit, not another night of trying harder?

FindTreatment.gov lists programs. SAMHSA's National Helpline, 1-800-662-HELP (4357), refers people to treatment. Call or text (800) 653-9376 if you want help finding a program that can talk about sleep and substance use together.

Additional Resources

Sources cited on this page:

• NIH National Heart, Lung, and Blood Institute: Healthy sleep habits
• NIH National Heart, Lung, and Blood Institute: Insomnia treatment
• SAMHSA In Brief: Treating Sleep Problems of People in Recovery From Substance Use Disorders (SMA14-4859)
• SAMHSA FindTreatment.gov
• SAMHSA National Helpline
• 988 Suicide & Crisis Lifeline

Common Questions