What is the link between insomnia and binge drinking?

When you ask people about the challenges associated with quitting alcohol, one thing you hear often is “I can’t get to sleep without drinking.” When you ask people who begin drinking again after they try to stop – known as relapse – they often cite insomnia as one of the factors. In fact, research shows that around half the individuals diagnosed with alcohol use disorder (AUD) – formerly known as alcoholism – also have insomnia. Depending on what study you read, the number may be as low as 36 percent or as high as 72 percent.

Whether it’s 36 percent, 72 percent, or somewhere in between, experts agree that insomnia, alcohol use disorder, and relapse are related phenomena. Over the past twenty years, researchers have conducted experiments to try to unravel this relationship, and solve the problem of insomnia-related relapse. Several studies indicate that therapeutic interventions such as cognitive behavioral therapy (CBT), classes on sleep hygiene, and medication can reduce insomnia and help prevent relapse.

A recent study conducted at the University of Missouri-Columbia took a different approach. Rather than analyzing the effect of therapeutic intervention on the behavior of people with insomnia in recovery from AUD, they analyzed the effect of a specific therapeutic intervention – cognitive behavioral therapy (CBT) – on young, active binge-drinkers with a high risk of experiencing alcohol-related harm.

Finding a Path Around Stigma – Insomnia and Binge Drinking

The National Institute on Alcohol Abuse and Alcoholism (NIAA) defines binge drinking as “drinking more than four alcoholic beverages (women) and five alcoholic beverages (men) on one occasion.” This Missouri study focused on people aged 18-30 who reported binge drinking at least once in the month before the study began. The goal of the study was to find a way to reduce the harm associated with excess drinking by targeting the related phenomenon of insomnia without addressing the binge drinking directly.

In an interview with Science Daily, study author Mary Beth Miller, Ph.D., explained the approach:

The potential for insomnia treatment to influence alcohol-related consequences has significant implications for the prevention and treatment of alcohol use among young adults. Given the stigma associated with mental health issues and addiction, it’s crucial to identify other forms of treatment that either influence alcohol outcomes or open the door to alcohol-related treatment.”

The reasoning is rock-solid. Despite decades of awareness efforts and public advocacy campaigns to reduce stigma around alcohol use disorder and the treatment of alcohol use disorder, stigma around addiction and treatment still prevent people with drinking problems from seeking treatment. While we don’t have detailed information about why every person who needs treatment does not seek treatment, we know that a significant treatment gap exists. We also know stigma around treatment contributes to the treatment gap.

To learn more about the treatment gap and stigma, please read our article Alcohol Use Disorder in Adults: The Treatment Gap.

With regards to the effect of CBT on insomnia, and the knock-on effect on alcohol related harms, this Missouri study yielded important results. They indicate Dr. Miller and her team may be onto something important.

The Effect of Improving Sleep on Young Binge Drinkers

The study involved 56 participants who were divided into two groups. One group received five sessions of cognitive behavioral therapy (CBT) for insomnia. The other group received a single session on sleep hygiene. The CBT group received instruction on subjects such as sleep diaries and relaxation techniques. In contrast, the sleep hygiene group received instruction on how to create a consistent bedtime routine and arrange their sleeping space to improve their sleep environment.

Here’s what the researchers found:

• CBT group:
  • 56% decrease in the severity of insomnia symptoms
  • Moderate improvement in sleep efficiency: more hours asleep in bed
  • Moderate reduction in drinks per week
  • Reduction in negative consequences of drinking
• Sleep hygiene group:
  • 32% decrease in the severity of insomnia symptoms
  • No reported improvement in sleep efficiency
  • Moderate reduction in drinks per week
  • Moderate reduction in negative consequences of drinking

These results are modest, we admit. However, they contain an easter egg of sorts. The 56 percent reduction in the severity of insomnia symptoms for the CBT group is an important finding. We’ll return to that in a moment. The big picture takeaway is that the idea behind the study – discover a way to reduce alcohol harm that doesn’t involve stigma – showed itself as valid and worthy of further pursuit. Both groups reduced drinks per week and negative consequences of drinking. That’s a positive finding. But here’s where it gets interesting. They did it by addressing their sleeping patterns. They didn’t address their alcohol consumption directly. That’s a new development in the treatment of alcohol use disorder.

Cognitive Behavioral Therapy, Sleep, and Alcohol-Related Harm

Now we’ll talk about the specific data around insomnia. The cognitive behavioral therapy (CBT) group showed a 56 percent reduction in the severity of insomnia symptoms. We see this as an important data point for two reasons. The first is related to relapse. If insomnia is a significant driver of relapse, and CBT for insomnia reduces the severity of insomnia symptoms, it follows that CBT for insomnia for people in recovery from AUD may help them prevent relapse.

Let’s be clear.  The study authors do not say that. But we see that potential in the data.

The second reason is that CBT had a positive effect on the sleeping and drinking patterns of people who are neither in recovery nor receiving treatment for alcohol use disorder. This is another piece of evidence in support of the holistic, integrated model of AUD treatment.

The integrated model advocates treating the whole person. It doesn’t focus solely on the disorder. In the case of these 56 people between the age of 18 and 30 who reported binge drinking at least once in the month before the study, this means that treating an aspect of their overall wellbeing – sleep – had a positive effect on their drinking. It also led to an overall reduction in the number of drinks per week. Finally, it led to a reduction in the negative consequences of drinking.

This is good news and offers a novel entrée to the treatment of problem drinking in young adults. By sidestepping any question of stigma or fear of treatment, it offers young binge drinkers a potential pathway to reducing alcohol consumption. In addition, it may, in the long run, point them in the direction of seeking support for problem drinking, and help them take their first steps toward recovery.

If you need help with the detox process, The Ridge offers an inpatient rehab facility in Cincinnati and the outpatient and partial hospitalization treatments you can enroll in.

The presence of a drinking problem or an alcohol use disorder (AUD) can cause significant harm to any human relationship, including marriage. Decades of research show that for newlyweds and long-married couples alike, disordered alcohol use such as heavy drinking or binge drinking can lead to a host of negative consequences. In 2009, the journal Clinical Psychology Review published a review of over sixty studies on the effect of alcohol on marriage.

Here’s what the study concluded:

“There is an overwhelming amount of evidence for the conclusion that spousal alcoholism [AUD] is maladaptive, and that heavy and problematic alcohol use is associated with lower levels of marital satisfaction, higher levels of maladaptive marital interaction patterns, and higher levels of marital violence.”

That study lays the foundation for a data-driven, evidence-based understanding of the specifics of how alcohol affects marriage. More recently, a long-term research effort conducted by scientists at the Research Institute on Addictions (RIA) at the University of Buffalo examined the prevalence of alcohol use and its associated problems among married couples in the U.S. They published their research in a series of articles in 2013-2014. While much of their data and conclusions are not a surprise, there are some notable observations that are important for the general public to understand.

Alcohol Abuse Ruins Mairrages

One takeaway from the research on alcohol and marriage is that in a majority of cases, moderate alcohol use does not cause significant problems. Observable and quantifiable trouble appears most often in couples where one spouse or both report heavy alcohol use and/or patterns of binge drinking.

Different Types Of Alcohol Abuse And Their Effects On Marriage

Before we go any further, let’s look at how the experts at The Substance Abuse and Health Services Administration (SAMHSA) and the National Institute on Alcohol Abuse and Alcoholism (NIAA) define moderate, binge, and heavy drinking:

Moderate Alcohol Consumption

• 1 drink a day for women and 2 drinks a day for men.

Binge Drinking

• Alcohol consumption that brings blood alcohol concentration (BAC) up to 0.08 g/dl. That means:
  • 4 drinks in about 2 hours for women
  • 5 drinks in about 2 hours for men
• Consuming 5 or more alcoholic beverages on the same occasion on at least 1 day in the past 30 days.

Heavy Drinking

• Binge drinking on each of 5 or more days in the past 30 days

Now let’s look at the prevalence of these drinking patterns among married couples in the U.S. This is data reported by the research team at the University of Buffalo:

• 79% report neither partner meet criteria for heavy drinking
• 4.0% report both partners meet criteria for heavy drinking
• 12% report only the male partner meets criteria for heavy drinking
• 5.0% report only the female partner meets criteria for heavy drinking

Those statistics introduce a consistent trend throughout all the research – yes, all the research over the past several decades – that indicates a gender difference in heavy drinking. According to the data, the male partner in a married couple is more likely to engage in heavy or binge drinking than the female partner. Another notable fact emerges here, as well. The consequences of alcohol use differ when both partners drink heavily and/or have a clinically diagnosable alcohol use disorder (AUD).

We’ll return to that fact in a moment. To read and understand the criteria and risk factors for AUD, please consult this NIAA resource page .

Now let’s take a closer look at the core findings from the research we’ve been talking about.

The Negative Effects of Heavy Drinking on Marriage

The Research Institute on Addictions (RIA) team examined several key metrics: marital satisfaction, domestic violence, aggression, divorce, and the number of positive and negative interactions between married partners.

Here’s what they found:

• Marital satisfaction
  • Heavy drinking, problem drinking, and AUD in one or both partners were associated with lower marital satisfaction, as compared to marriages where neither partner reported heavy drinking, problem drinking, or AUD.
  • Stronger associations between lower marital satisfaction and drinking problems appeared when the male partner reported the problem drinking patterns.
  • Weaker – but still present – associations were noted when the female partner reported the problem drinking patterns.
• Domestic violence
  • Alcohol use was identified as a contributing factor in domestic violence for perpetrators and victims
    • Physical aggression is three times more likely to occur when the perpetrator consumes alcohol
    • Physical aggression is twice as likely to occur when the victim consumes alcohol.
  • Alcohol use was identified as a contributing factor in verbal and psychological aggression between married partners
    • Verbal aggression is twice as likely to occur when either the victim or perpetrator consumes alcohol within four hours prior to the reported aggression
• Divorce
  • • Alcohol and/or substance use are among the top reasons identified for filing for divorce:
      • They’re the 3^rd most common reason cited by female marriage partners
      • They’re the 8^th most common reason cited by male marriage partner
    • Alcohol and/or substance use is one of the most common reasons married couples cite for seeking marriage counseling
• Interactions
  • • More negative interactions than positive interactions appeared in married couples when one marriage partner reported alcohol dependence or AUD.

These statistics clarify – with numbers – the negative effects of alcohol on marriage. Findings like these are helpful when discussing alcohol and marriage, because it’s easy to make blanket statements like “too much drinking ruins a marriage.” Although that may feel true and seem obvious – and is true in many cases – historical research data does not support that statement. It’s also not what the results from RIA studies say.

So, what do the results say?

Different Drinking Habits Cause Problems

We start this section with a heavy qualification. We do not condone excess drinking in any form, for anyone, ever, whether they’re single, married, in a serious long-term relationship, a common-law domestic partnership, or dating. Issues of marriage, divorce, and alcohol and/or substance use and misuse can be highly charged. They’re often accompanied by complex relationship histories. They can be extremely emotional for everyone involved.

That’s why we stick to facts, derived from data, obtained from reliable scientists working in good faith to understand complex topics that have real ramifications for real people in the real world. If you suspect that you or your spouse is battling with drinking problems, its worth taking a look at our latest findings.

With that said, here’s what the RIA researchers found with regards to the following metrics:

• Marital satisfaction

  • Marriage partnerships in which both marriage partners report heavy alcohol consumption report higher levels of marital satisfaction than marriage partnerships in which one marriage partner reports heavy alcohol consumption and the other does not.

• Divorce

  • Marriage partnerships in which both marriage partners report heavy alcohol consumption are less likely to end in divorce then those in which one marriage partner reports heavy alcohol consumption and the other does not.
  • 50% of marriage partnerships in which only one partner reported heavy alcohol consumption end in divorce.
  • 30% of marriage partnerships in which both partners reported similar alcohol consumption ended in divorce.

• Interactions

  • Marriage partnerships in which both partners report having AUD report more positive interactions than partnerships in which one partner reports AUD and the other does not.
  • Marriage partnerships in which both partners report having AUD report a higher ratio of positive interactions to negative interactions than partnerships in which one partner reports AUD and the other does not.

Now you can see why we qualified the data before sharing it. This is tricky territory.

As the study authors say,

“The difference makes the difference.”

The data shows that for marriage partnerships in which both partners have similar drinking habits, those partnerships do not experience the same negative consequences as marriage partnerships in which partners have contrasting drinking habits.

Alcohol Abuse And It’s Effect on Children

Research identifies the presence of an alcohol or substance use disorder in the home as an adverse childhood experience (ACE). ACEs are a form of trauma. They’re a complex phenomenon by themselves. We’ll now offer a thumbnail version of what we think people reading this article should know about ACEs.

Researchers from the Centers for Disease Control (CDC) identify the following ten types of ACEs:

1. Physical abuse
2. Emotional abuse
3. Sexual abuse
4. Physical neglect
5. Emotional neglect
6. Mental illness in the family
7. Witnessing domestic violence
8. Divorce
9. Having a relative incarcerated
10. Alcohol and/or substance abuse in the home

The scientists who first identified ACEs published scores of peer-reviewed papers on the long-term consequences of ACEs. Taken together, these studies show that when individuals accrue four or more ACEs, they’re at increased risk of experiencing:

• Impaired neurodevelopment
• Social, cognitive, and emotional problems
• Chronic disease, disability, and impaired social productivity

In addition, children exposed to four or more ACEs are at increased risk of engaging in risky behaviors. These include alcohol use, drug use, and early sexual activity. In terms of chronic medical conditions, exposure to four or more ACEs increases the risk of developing:

• Cancer
• Diabetes
• Heart disease
• Depression

With regards to the negative effect of AUD among parents on their children, the research clearly indicates the presence of AUD – when combined with three or more other ACEs – increases the risk of those children developing a wide range of biological, social, psychological, and emotional problems when they reach adolescence and adulthood.

What Does This All Mean?

That depends on the marriage partnership, the individuals involved in that partnership, and the decisions they make with the knowledge they have.

In short, all this information means different things to different families. Therefore, we can’t tell anyone definitively what this marriage and parenting data means for them.

Does Alcohol Abuse Always End In Divorce

The presence of an alcohol use disorder in a marriage does not automatically mean that marriage will end in divorce. Nor does it mean the partners in the marriage will experience physical abuse, verbal abuse, or a disproportionate amount of negative interactions. It does, however, increase the risk for physical and verbal abuse. That increased risk is more pronounced in marriage partnerships in which the marriage partners have contrasting drinking habits, i.e. marriages in which one partner drinks heavily, and the other does not. In those partnerships with mismatched drinking habits, rates of divorce and negative interactions also increase.

The presence of alcohol abuse in a marriage does not mean that children of those parents will grow up to experience all the negative consequences associated with ACEs, either. It does, however, push those children closer to the threshold at which childhood trauma results in adolescent and adult disease and disability.

But no path is written in stone. Humans are resilient and have the ability to experience and transcend adversity of all types. That includes the trauma associated with AUD and ACEs.

Family And Marriage Counseling In Treatment for Alcohol Use Disorder

Associated with all this data on drinking, marriage, and children is the fact that alcohol use disorder is a chronic medical condition that responds to appropriate treatment. A corollary to that fact is that children who experience trauma can learn to process that trauma with the help of a capable adult – most often a therapist – and mitigate the negative effects of experiencing ACEs.

Therefore, married partners that know and understand the implications of AUD in marriage and parenting have options. If they also know and understand that one, or both, partners in the marriage have an AUD, they can seek treatment and support for the AUD. Evidence shows that an integrated treatment model is effective. Integrated treatment includes individual therapy, group therapy, experiential therapy, and family therapy.

This whole person approach can lead to long-term, sustained sobriety. Married parents with AUD in their partnership can seek support for their children, as well. The trauma associated with parental AUD can be mitigated with the help of a qualified, capable adult. The adults most qualified for helping children work through trauma are professional therapists, as mentioned above.

Get Family Therapy For Alcohol Use Disorder At The Ridge Ohio

The takeaway here is that AUD in marriage can have a negative impact on both individuals in the marriage partnership, as well as any children in the family. But that’s not the end of the story. Spouses and parents can take affirmative, proactive steps to recover from AUD and to help their children process any trauma associated with the AUD. A step toward treatment and support is a step toward empowerment and healing for everyone involved. Seeking support and receiving detox treatment are time-tested methods families can use to author their own narrative, write the next chapter of their personal family story, and rediscover the balance and harmony that the presence of an AUD often disturbs.