It may come as no surprise, but cocaine has a detrimental effect on sleep cycles. Many habitual cocaine users feel that their sleep gets better the moment they stop using cocaine.
While users often think they are getting better sleep the further they move from the last day of cocaine use, objective measurements found that this is not true in the short term. Impaired sleep quality and cognitive performance can be experienced up to two weeks after the last use of cocaine. Cocaine disrupts the circadian rhythm of the user, throwing off the balance and optimal functionality of many systems, including sleep cycles. What is unique about cocaine abuse is that users are generally not aware of the loss of sleep time and quality.
Cocaine, Sleep, and the Brain
Cocaine is a drug that derives from the coca plant. This plant is primarily found in South America.
Some health care providers use cocaine for its medicinal benefits, as it is useful in some surgeries as a local anesthetic. Recreational use of cocaine, however, is illegal.
Cocaine is a stimulant. As such, those who use cocaine frequently are likely to become sleep-deprived. This happens because cocaine increases the levels of dopamine, a naturally-occurring neurotransmitter in the brain. Dopamine is the neurotransmitter associated with reward centers of the brain as well as movement.
Naturally, dopamine will recycle back into the cell that released it, which shuts off the signaling between nerve cells. Cocaine works by inhibiting the recycling process, which causes massive amounts of dopamine to build up between neurons. The resulting flood of dopamine causes the reward centers to respond in kind, heavily reinforcing the cocaine-using behavior.
In time, brain circuitry will adapt to the large levels of dopamine present, progressively becoming less sensitive to it. This is what is known as tolerance, which leads to addiction, as more and more cocaine is taken to achieve the same effects and to avoid withdrawal symptoms.
The more someone uses cocaine, the less qualitative and quantitative sleep they will get. A significant portion of individuals who use cocaine regularly develop addiction and insomnia. This is partially due to the way cocaine use disrupts the circadian clock. The body relies on the circadian clock to let it know when it needs to sleep and when it should be awake. Cocaine use confuses this biological clock. The longer cocaine is used, the more it will throw off the clock and possibly lead to insomnia.
The Occult Insomnia Effect
A study published by the Sleep Research Society found that those who abuse cocaine experience what is called the occult insomnia effect. Fundamentally, cocaine users believe that they start to get better sleep once they stop using. Objective measurements of their sleep quality, however, report the opposite.
This study involved 43 people who were addicted to cocaine. They spent 12 days in an inpatient research facility. Their sleep was monitored via polysomnographic measurement on days three, four, 10, and 11. It was also measured when the subjects were off cocaine for one or two weeks on average.
The subjects also filled out a sleep diary questionnaire every night before bed and every morning when they woke. The polysomnographic and sleep diary recordings included sleep time, time awake after the onset of sleep, sleep latency (the amount of time it takes to go from being fully awake to sleep completely), and time in bed after final awakening.
The result of this study found that the subjects would accurately report their total sleep time during the first week off cocaine, but they would overestimate how much sleep they were getting by 40 minutes on average at two weeks without use. The subjects were underestimating their time spent awake after sleep onset as well as their sleep latency.
Overall, this study concluded that a positive sleep misperception occurs two weeks after cocaine use cessation. At the same time, there is an increase in sleep-related conditions, such as insomnia and periodic leg movement disorder.
Perception of increased sleep times is a common occurrence for those addicted to cocaine in the second week of cessation of use. This is an important phenomenon to understand considering how important sleep is for general health.
According to a study published by ScienceDirect, cocaine use increases wakefulness and suppresses REM (rapid eye movement) sleep. It is also important to note that the condition known as acute cocaine withdrawal has been linked with overall sleep disturbances and unpleasant dreams.
Cocaine withdrawal can cause several symptoms.
- Increased appetite
- Restless behavior
- Suicidal thoughts
Nightmares are a common side effect of cocaine withdrawal. Most heavy dreaming occurs during REM sleep. Usually, when we sleep, we go through cycles of non-REM sleep and REM sleep. REM sleep occurs every 90 minutes or so, and it typically lasts 20 to 25 minutes.
Scientists so far have not been able to determine with certainty what causes vivid dreaming and specifically nightmares, but they have recognized some patterns and associations. Stress and anxiety are often linked to unpleasant dreams. Many different medications cause this as well.
Withdrawal dreams are also a fairly common occurrence. These dreams are typically very startling, as they can be vivid and horrifying. Often, those who experience withdrawal dreams become concerned about their mental health because the dreams tend to be quite negative.
Some explain the dreams they have as horror movies going on in their heads. These vivid dreams can be accompanied by blood, murder, guts, gore, and fear. These dreams can be about massacres, dismemberment, or perversion. Many are startled by just how dark their subconscious can get. It is important to remember that these dreams can be a common side effect of withdrawal.
Nightmares can lead to fear and anxiety during wakefulness, and they can cause or exacerbate insomnia, according to Psychology Today. Most people dream for about two hours a night, and nightmares usually happen during the later cycles of REM sleep.
Some researchers refer to nightmares as “threat rehearsals,” claiming that the brain is rehearsing threatening scenarios as a form of training for real threats. Other researchers believe nightmares are ways the brain synthesizes upsetting information from the previous day.
Nightmares can become repetitive in the case of drug withdrawal. Some people report that they have the same or a similar dream up to 50 times.
Nightmares typically occur more frequently in females than males. Children and adolescents usually have nightmares more than adults, yet still about half of the adult population experiences nightmares on occasion.
Treatment for Withdrawal Dreams
Dealing with withdrawal dreams can be difficult, but therapy can help. Many of our dreams have an emotional driving force and base. Talking out these emotions can help an individual to better cope with what is happening.
A therapist can help an individual to explore the various emotions and traumas behind the dreams. They can also act as a supporting role during this trying time.
Reversing Sleep Issues
According to a study published by the Addiction Science and Clinical Practice journal, 70 percent of people admitted for detox report sleep problems before admission.
Substance use and sleep issues seem to have a bidirectional relationship.
This means that those who suffer from sleep problems increase their risk for developing substance disorders, while chronic substance abuse can lead to the development of sleep problems and disorders.
Studies like the one above also found that long-term cessation of drug abuse can aid in the reversal of some sleep problems.
This means that sleep disorders developed as a result of substance abuse may in some cases reverse, or at least improve when substance abuse is stopped.
The preponderance of data from clinical studies and surveys concludes that cocaine disrupts sleep through its stimulating effects and disturbing the circadian rhythm. Eventual withdrawal from the drug causes sleep issues as well.
One concerning and a specific problem with cocaine use is the occult insomnia effect, which leads users to think they are getting better quality and longer sleep when they are not. This misunderstanding can lead to even worse sleep deprivation without any knowledge to the user.
Nightmares can also be caused by cocaine withdrawal, leading to or exacerbating insomnia and other sleeping disorders. Long-term cessation of cocaine abuse can lead to a reversal of sleep problems in some instances.