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Alcohol & Drug Counseling, Assessment and Prevention Services

Substance Use & Sleep

When we sleep well, we wake up feeling refreshed and alert for our daily activities. Sleep affects how we look, feel and perform on a daily basis, and can have a major impact on our overall quality of life.To get the most out of our sleep, both quantity and quality are important. Teens need at least 8½ hours — and on average 9¼ hours — a night of uninterrupted sleep to leave their bodies and minds rejuvenated for the next day. Remember that most college freshmen are still teenagers!

If sleep is cut short, the body doesn’t have time to complete all of the phases needed for muscle repair, memory consolidation and release of hormones regulating growth and appetite. Then we wake up less prepared to concentrate, make decisions, or engage fully in school and social activities.

What is the normal structure of sleep?

The structure of sleep follows a pattern of alternating REM (rapid eye movement) and NREM (non-rapid eye movement) sleep throughout a typical night in a cycle that repeats itself about every 90 minutes. What role does each state and stage of sleep play?

NREM (75% of night): As we begin to fall asleep, we enter NREM sleep, which is composed of stages 1-4:

  • Stage 1
    • Between being awake and falling asleep
    • Light sleep
  • Stage 2
    • Onset of sleep
    • Becoming disengaged from surroundings
    • Breathing and heart rate are regular
    • Body temperature drops (so sleeping in a cool room is helpful)
  • Stages 3 and 4
    • Deepest and most restorative sleep
    • Blood pressure drops
    • Breathing becomes slower
    • Muscles are relaxed
    • Blood supply to muscles increases
    • Tissue growth and repair occurs
    • Energy is restored
    • Hormones are released, such as: Growth hormone, essential for growth and development, including muscle development

REM (25% of night): First occurs about 90 minutes after falling asleep and recurs about every 90 minutes, getting longer later in the night.

  • Provides energy to brain and body
  • Supports daytime performance
  • Brain is active and dreams occur
  • Eyes dart back and forth
  • Body becomes immobile and relaxed, as muscles are turned off

View normal sleep pattern graph for more.

Is getting good sleep a problem for students?

Getting good sleep is important to students and to their academic performance. Generally, students report that they don’t get enough sleep and that their sleep isn’t always restful because of social patterns, the need to study, disrupted sleep, and sleep environment/arrangements.
 
According to the spring 2016 WSU National College Health Assessment (NCHA) data on sleep:

  • 25% or 1/4 of WSU students reported that sleep difficulties had a negative effect on their academic performance.
  • 33% or 1/3 of WSU students reported that sleep difficulties had been traumatic or very difficult to handle.
  • Within the past 7 days, 60% of WSU students reported feeling tired, dragged out, or sleepy during the day on 3-6 days.
  • Within the past 7 days, 60% of WSU students reported getting enough sleep to feel rested in the morning on 3-6 of the days.

 
In general, these WSU NCHA data match or are slightly higher than national NCHA data.

Does drinking affect sleep?

Intoxication messes with your sleep! It takes longer than just one day to be fully recovered. Actually, it takes 2-3 days to fully recover from a night of drinking. This limits your ability to think and remember as well as your overall level of physical energy. As a depressant, alcohol may help you fall asleep more quickly. However, intoxication affects the cycle of consistent and balanced SWS (slow wave sleep) in Stages 3 & 4, which is the deep, restful, and restorative part of the sleep cycle. Drinking alcohol suppresses the cycle of consistent and adequate REM sleep and keeps you in the lighter stages of sleep.

View alcohol-influenced sleep pattern graph for more.

What amount of alcohol can affect sleep?

Alcohol can have sedating effects and can help one fall asleep initially, but drinking also can disrupt sleep with chronic use and/or use in moderate to large quantities.

  • A single alcoholic beverage taken before bedtime may actually improve sleep quality for some people; it both decreases sleep latency and increases total sleep time (Roehrs and Roth 2001).
  • A person who drinks moderate amounts of alcohol on a nightly basis (2-3 drinks) will typically experience episodic awakenings from dreams with sweating and disturbed, restless sleep, particularly in the morning when symptoms of mild alcohol withdrawal and hangover may occur. Daytime symptoms may include mild to moderate sleepiness and fatigue. Insomnia can occur on cessation of chronic bedtime intake of alcohol (Conroy & Culebras, Neurology Medlink, 2010).
  • Larger quantities of alcohol or the use of alcohol on a chronic basis to improve sleep can actually worsen sleep quality. A single night of alcohol ingestion leading to a 0.1% blood alcohol level results in an increase in SWS in the first half of the sleep period, an increased stage 1 (the lightest stage of sleep) during the second half of the night, and an overall decrease and disturbance of REM sleep throughout the night (Feige et al 2006). For example, a 140 lb. female will reach a BAL of approximately .01 after ingesting 4 drinks in 3 hours. A 180 lb. male will reach a BAL of approximately .01 after ingesting 6 drinks in 3 hours. (4 or more drinks for females and 5 or more drinks for males is considered “binge or a high risk” level of use).

Does smoking marijuana affect sleep?

Marijuana decreases sleep quality, which then affects your overall quality of life. As a psychotropic with sedative effects, marijuana may help one fall asleep more quickly.However, smoking compromises the cyclical balance of the stages of sleep throughout the night. Marijuana use affects the cycle of consistent and balanced SWS (slow wave sleep) in Stages 3 & 4, which is the deep, restful, and restorative part of the sleep cycle. Marijuana use suppresses the cycle of consistent and adequate REM sleep and keeps you in stage 2 of sleep.

However, smoking compromises the cyclical balance of the stages of sleep throughout the night. Marijuana use affects the cycle of consistent and balanced SWS (slow wave sleep) in Stages 3 & 4, which is the deep, restful, and restorative part of the sleep cycle. Marijuana use suppresses the cycle of consistent and adequate REM sleep and keeps you in stage 2 of sleep.

Disturbances in sleep patterns can remain for up to five days after use and normal sleep patterns may not return until after one week. With chronic use, sleep may be disturbed on an ongoing basis and even after one is abstinent.

View marijuana-influenced sleep pattern graph for more.

Does marijuana withdrawal affect sleep?

Withdrawal symptoms include: irritability and anger, anxiety and nervousness, restlessness, weight loss, sleep difficulty, and strange/vivid dreams. Less common symptoms are depressed mood, chills, shakiness, stomach pain, and sweating (Budney, et al, 2004). Effects on sleep: difficulties in sleeping (falling and remaining asleep) and strange/vivid dreams have been reported. These generally occur within 24-72 hours of discontinuation of cannabis use and persist for 6-7 weeks. Changes to one’s dream experience are thought to be linked to REM sleep disturbance (Budney, et al, 2004).

What about medical marijuana and sleep?

Cannabis-based medicines have improved subjective sleep quality in patients with chronic pain syndromes, such as Multiple Sclerosis, Peripheral Neuropathy, Rheumatoid Arthritis, and Cancer pain (Russo, et al, 2007). This improvement may be due to analgesic anti-inflammatory and spasmodic effects resulting in nocturnal symptom relief, in addition to the hypnotic properties of cannabis (Grotenhermen, 2003). Always consult with your physician for use of marijuana for medical purposes.