The Unseen Effects of Alcohol on Sleep, Recovery, and Fatigue

The notion of having a couple of alcoholic drinks in the evening just to “help your body unwind and fall asleep faster” may sound familiar to many; however, it's far from ideal, especially for those of you in high-stress, high-stakes professions. While the immediate sedative effects of alcohol might suggest a quicker transition to sleep, as the night goes on, it significantly disrupts sleep continuity and overall quality.

Many studies have looked at the relationship between alcohol and sleep, and the findings report that alcohol is known to alter sleep architecture, particularly by reducing Rapid Eye Movement (REM) sleep. As you may have learned throughout the SFR120 Programme, REM sleep is crucial for memory consolidation and emotional processing. This reduction can lead to cognitive deficits and poor mood regulation, which are particularly detrimental when you rely heavily on cognitive clarity and emotional stability to perform your duties effectively.

Furthermore, the use of alcohol as a sleep aid can contribute to dependency, which might complicate mental health issues such as anxiety and depression, often exacerbated by irregular and interrupted sleep patterns. 

Risks for emergency responders

By occupation, you may face unique challenges with alcohol use, often turning to it as a coping mechanism for the stresses of your critical roles. Cross-sectional data from the Airwave Health Monitoring Study, which surveyed 40,986 participants, examined the prevalence of hazardous and harmful alcohol consumption within the UK Police Service. The findings revealed that 32.6% of police employees engaged in hazardous drinking, while 3.0% reported drinking at levels considered harmful. 

Exposure to traumatic events significantly increases the risk of developing behavioral health disorders, including Alcohol Use Disorder. Notably, compared to their colleagues without mental health issues, police employees suffering from depression, anxiety, or PTSD were twice as likely to engage in harmful drinking. Additionally, they were only 1.3 times more likely to report complete abstinence from alcohol.

Many first responders avoid seeking help for addiction due to stigma and shame, despite the availability of treatment options that are crucial for ensuring public safety and effective job performance. And, unfortunately, the culture within first responder organisations can inadvertently promote alcohol consumption, exacerbating issues related to trauma and mental health disorders.

Understanding these risks is essential for developing targeted interventions that support the health and effectiveness of emergency responders.

How alcohol impacts sleep quality

Alcohol, a central nervous system depressant as referred to by the Sleep Foundation, significantly alters sleep patterns, particularly impacting the quality and structure of sleep. Initially, it may reduce the time it takes to fall asleep and increase slow-wave sleep (SWS), but this is followed by a reduction in REM and more frequent wakefulness in the less restorative stage 1 phase of sleep during the second half of the night.

This pattern—where the initial ease of falling asleep leads to subsequent poor-quality rest—can trigger a vicious cycle. You may begin to use alcohol as a self-treatment for insomnia, hoping for quick sleep onset. However, this often results in disrupted sleep, leading to fatigue during the day which you may try to counteract with caffeine. Unfortunately, increased caffeine consumption can further exacerbate insomnia, creating a dependency on alcohol for sleep, and perpetuating a cycle of poor sleep management. Read on, as we’ll discuss how to break that cycle further down the article.

But first, let’s break down how alcohol affects sleep:

Reduction in REM sleep: A high amount of alcohol consumption, that is more than two servings of alcohol for men and one serving per day for women, before bedtime can decrease REM sleep by up to 39.2%, leading to poor sleep quality and reduced cognitive function the next day.

Increased sleep disruptions: As the body gets busy metabolising alcohol, sleep becomes fragmented, resulting in increased wakefulness and a higher likelihood of insomnia symptoms. This disruption is compounded in individuals with alcohol use disorders, where insomnia can persist even months after achieving sobriety.

Exacerbation of sleep apnea: Alcohol relaxes the throat muscles, exacerbating conditions like sleep apnea and leading to more frequent awakenings due to obstructed breathing. A review of 21 studies over 30 years found that higher alcohol consumption could increase the risk of sleep apnea by 25%.

Suppress recovery: A study of more than 4,000 participants found that alcohol consumption took a toll on the autonomic nervous system and evoked the opposite effect of what is ideal during sleep. Alcohol intake was found to increase sympathetic activity and decrease parasympathetic activity, which then resulted in insufficient recovery.

Understanding these effects is crucial for optimal sleep, performance, and recovery. Limiting alcohol intake, especially before sleep, can mitigate these adverse effects, enhancing overall health and operational readiness.

Alcohol consumption and its impact on recovery

Alcohol's impact on recovery, particularly for emergency responders, is significant and multifaceted. Here are key insights based on recent studies:

Muscle recovery and performance: Alcohol consumption has been found to impair muscle recovery by inhibiting essential physiological processes. It reduces muscle protein synthesis, primarily by suppressing the mTOR pathways, that are key for muscle repair. Additionally, alcohol increases the expression of a muscle-specific enzyme, which promotes muscle atrophy, the loss of muscle mass.

Metabolic disruption: Alcohol means no good news for metabolic functions. It inhibits hepatic gluconeogenesis, which is essential for glucose production in the absence of food, and impairs the muscle's ability to uptake and store glycogen. Glycogen is the muscle’s primary fuel source. This disruption contributes to prolonged recovery periods, which may lead to decreased performance levels. Plus, the moment you ingest alcohol, your body stops metabolising everything else and works to break down alcohol first. 

Hydration and thermoregulation: Alcohol has diuretic properties, aka makes you go to the bathroom more frequently, that increase fluid loss. It’s not only a loss of water, but you also lose important minerals and electrolytes, exacerbating dehydration. Plus, alcohol is a peripheral vasodilator, which can interfere with body heat conservation, further impacting recovery and readiness for duty.

5 evidence-based strategies for better sleep and recovery

When it comes to enhancing sleep quality and recovery, particularly in relation to alcohol consumption, here are five evidence-based strategies:

1. Complete avoidance

Completely abstaining from alcohol is the most effective way to prevent its disruptive effects on sleep architecture, recovery, and both cognitive and physical performance. Studies consistently show that individuals who do not consume alcohol have better overall sleep quality compared to those who do.

2. Have a wind-down routine without alcohol

Creating a pre-sleep routine that promotes relaxation without relying on alcohol can significantly improve sleep quality. Activities like reading, light stretching, or meditation have been shown to help transition the body into sleep more naturally and are associated with more restorative sleep.

3. Set a cutoff time for drinking

If you’re not ready to say goodbye to alcohol completely, make sure to have your last sip at least 3-4 hours before bedtime to allow the body time to metabolise it, reducing its impact on sleep quality and recovery processes.

4. Stay hydrated

We all know too well - once you break the “seal”, the bathroom is calling your name every 30 minutes.  Being dehydrated is another factor that can negatively affect sleep quality. Drinking plenty of water throughout the day, especially in the hours after consuming alcohol can help counteract its dehydrating effects and improve overall sleep quality, and may prevent having you nurse a hangover headache the next day.

5. Monitor alcohol intake

Keeping track of how much and how often you consume alcohol can help in managing its impact on sleep. Reducing the quantity and frequency of alcohol intake has been shown to improve sleep outcomes and overall health. Not fancy taking notes manually? There’s an app for that! Drink trackers or apps, like “Less” can assist in monitoring and setting goals for reduction.