Insomnia and Addiction

With around 777,000 people in the UK admitting to using drugs more than once a month in 2023 and almost 1 in 5 struggling to get enough sleep, it’s no surprise that a dual diagnosis of addiction and insomnia is common. This page focuses on both insomnia and addiction and what to do if you’ve been dual-diagnosed with both.

What is insomnia?

Insomnia is a common sleep disorder that affects the ability to fall asleep or stay asleep or causes a person to wake up too early and not be able to return to sleep. When someone has insomnia, even if they have the chance to sleep, they may struggle to get sufficient rest, leading to daytime fatigue, reduced energy levels, mood disturbances and decreased performance at work or school.

In the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition), insomnia is classified under Sleep-Wake Disorders. It is specifically detailed as ‘Insomnia Disorder’, which is distinct from transient or short-term insomnia.

But insomnia isn’t just as simple as not being able to fall asleep; there are, in fact, different types of insomnia. Here are some of the signs of insomnia and insomnia symptoms:

  • Onset insomnia: Difficulty falling asleep at the beginning of the night. This type of insomnia can be related to stress, anxiety or an irregular sleep schedule.
  • Maintenance insomnia: The inability to stay asleep, with individuals waking up during the night and having trouble returning to sleep. It can be due to conditions like sleep apnea, chronic pain or an overactive mind.
  • Behavioural Insomnia of Childhood (BIC): This affects children and involves difficulty falling asleep and/or staying asleep. It is often related to poor sleep habits or bedtime resistance.
  • Idiopathic insomnia: A lifelong struggle with insomnia that starts in childhood and continues into adulthood without a clear cause.
  • Paradoxical insomnia: Individuals believe they are experiencing severe insomnia without objective evidence of sleep disturbance. They often perceive their sleep as being much worse than it is measured to be.

What causes insomnia?

Its causes vary, ranging from short-term (acute) factors to more persistent (chronic) issues. Here’s a look at both acute and chronic insomnia causes:

Acute insomnia causes

Acute insomnia, also known as short-term insomnia, typically lasts for days or weeks. It’s often triggered by:

  • Stress: Significant life stress such as job loss, death of a loved one, divorce or moving.
  • Emotional discomfort: General emotional distress not necessarily tied to a specific event can also trigger sleep issues.
  • Physical discomfort: Illness, injury or other physical conditions that cause pain or discomfort can disrupt sleep.
  • Environmental factors: Noise, light or temperatures that are not conducive to sleep can prevent or disrupt sleep.
  • Medications: Certain prescription drugs, including some antidepressants, heart and blood pressure medications and over-the-counter cold, allergy and weight loss medications, can interfere with sleep.
  • Change in sleep schedule: Jet lag, a shift in work schedule or other disruptions to the body’s internal clock can lead to insomnia.
  • Specific events or circumstances: For instance, sleeping in an unfamiliar bed or anticipating a significant event the next day can prevent sleep.

Chronic insomnia causes

Chronic insomnia lasts for a month or longer and can stem from a variety of sources, including:

  • Chronic stress: Prolonged stress or anxiety can establish a pattern of sleeplessness.
  • Mental health disorders: Conditions like depression, anxiety, bipolar disorder and others can significantly impact sleep patterns.
  • Physical health disorders: Chronic pain, asthma, diabetes, neurological conditions like Parkinson’s disease and others can interfere with sleep.
  • Substance use: Long-term use of alcohol, caffeine, nicotine, and other substances can lead to chronic sleep problems.
  • Poor sleep habits: Irregular sleep schedules, engaging in stimulating activities before bed or an uncomfortable sleep environment can develop into chronic insomnia.
  • Hormonal changes: In women, hormonal shifts due to menstruation, pregnancy or menopause can affect sleep.

What is a dual diagnosis of insomnia and addiction?

A dual diagnosis of insomnia and addiction signifies that a person is suffering from both a substance use disorder and a sleep disorder simultaneously. This situation involves challenges related to substance abuse or dependence alongside complications in achieving restful sleep.

Why do insomnia and addiction occur so often?

The co-occurrence of insomnia and addiction involves complex interactions shaped by various factors where each condition can both contribute to and amplify the other. Below, we explore these different examples and scenarios, shedding light on how it’s possible to be in the position of a dual diagnosis.

Insomnia leading to addiction

People experiencing insomnia often face significant distress in their daily lives, and the chronic inability to fall asleep or stay asleep can lead to a desperate search for relief. In some cases, people may turn to substances such as alcohol, benzodiazepines (like Xanax or Valium), opioids, or over-the-counter sleep aids in an attempt to self-medicate.

Alcohol, despite being a depressant that can initially induce sleepiness, often disrupts sleep architecture and leads to poorer quality sleep. Regular use also increases the chance of alcohol addiction and insomnia.

Similarly, while benzodiazepines and opioids might be effective in the short term for inducing sleep, they carry a high risk of dependence and addiction. Over time, the body may develop tolerance to these substances, requiring higher doses to achieve the same effect, further entrenching the cycle of addiction.

Some people might be prescribed sleeping pills by their healthcare providers to manage their insomnia. While these medications can be effective when used as directed for short periods, there’s a risk of developing insomnia and sleeping pill addiction if they are used for longer durations or in higher doses than prescribed.

Addiction leading to insomnia

On the flip side, drug addictions can significantly disrupt sleep patterns and lead to the development of insomnia. Stimulants such as cocaine, methamphetamine and even excessive caffeine can interfere with the brain’s natural sleep-wake cycles, making it difficult to fall asleep.

Withdrawal from these types of drugs can also lead to significant sleep disturbances. As the body becomes dependent on these substances to function, the absence of the drug can cause a rebound effect, where symptoms the drug was initially used to alleviate, such as insomnia, become more pronounced.

For those with pre-existing addictions, lifestyles can contribute to the development of insomnia. Irregular schedules, health problems, psychological stress and the environment associated with substance use can all interfere with healthy sleep patterns.

How can I get help for insomnia and addiction?

Tackling insomnia and addiction at the same time is challenging, but it’s definitely something you can overcome. At Sanctuary Lodge, we have a wealth of experience in helping people who are facing these dual issues head-on. The first step towards recovery often involves a medically supervised detox, which carefully reduces and then eliminates the addictive substance from the body. However, it’s important to remember that going through detox might make insomnia worse, so it’s crucial to address sleep problems at the same time.

Treatments that work well for addiction, like Cognitive Behavioural Therapy for insomnia (CBT-i), are also great for those struggling with sleep issues. CBT-i can be just as effective as sleep meds, but without the side effects, a lower risk of falling back into old habits and a better chance of keeping sleep problems at bay in the long run. This lasting improvement often comes from learning new skills that help enhance the body’s own sleep mechanisms.

Taking a whole-person approach is key to dealing with insomnia, which means looking after your mental, physical and spiritual health. Holistic treatments, such as yoga, meditation and aromatherapy, can really help by boosting relaxation and reducing stress, making it easier to get a good night’s sleep.

Aftercare plays a vital role in the recovery process, helping to sustain the progress made during treatment. This includes participating in group therapy sessions, which provide continued support and reinforce healthy lifestyle choices.

Will rehab cure my insomnia?

When it comes to treating both insomnia and addiction, rehab programmes, like Sanctuary Lodge’s, usually put a lot of their energy into dealing with the addiction. This focus is crucial because getting the addiction under control can often help improve sleep problems. But this doesn’t mean they ignore insomnia. In therapy, you actually work through the issues that make it hard to sleep, addressing those problems directly. As well as learning how to overcome addiction, you also learn how to find healthier ways to fall into deep, satisfying sleep.

For those looking to promote healthier sleep, especially in the context of recovery from addiction and insomnia, several practical steps can be taken:

  1. Establish a consistent sleep schedule: Going to bed and waking up at the same time daily helps regulate your body’s internal clock, improving your sleep quality over time.
  2. Create a relaxing bedtime routine: Engaging in calming activities before bed, such as reading, taking a warm bath or practising relaxation exercises, can help signal to your body that it’s time to wind down.
  3. Optimise your sleep environment: Make your bedroom conducive to sleep by ensuring it is dark, quiet and cool. Investing in a comfortable mattress and pillows can also make a significant difference.
  4. Limit exposure to screens before bedtime: The blue light emitted by phones, tablets and computers can interfere with your ability to fall asleep. Try to avoid these screens for at least an hour before going to bed.
  5. Mindful consumption: Limiting intake of caffeine and alcohol, especially in the hours leading up to bedtime, can improve sleep quality. Both substances can significantly disrupt sleep patterns and should be consumed in moderation, if at all.

What’s next?

If you’ve been diagnosed with or are suffering from either insomnia or addiction, it’s crucial to seek help. At Sanctuary Lodge, our team of expert medical professionals is ready to help you on your journey to a sober life, as well as on the road to consistent and fulfilling nights of rest. Reach out to us today to begin your new life.

(Click here to see works cited)

  • “Sleep and Mental Health.” Mental Health UK, 24 Mar. 2022,
  • “Sleep Onset Insomnia: Causes, Treatments and More.” Medical News Today, MediLexicon International, Accessed 27 Feb. 2024.
  • “Types of Insomnia.” Sleep Foundation, 22 Nov. 2023,
  • Vriend J, Corkum P. Clinical management of behavioral insomnia of childhood. Psychol Res Behav Manag. 2011;4:69-79. doi:10.2147/PRBM.S14057
  • “Idiopathic Insomnia.” MedLink Neurology, Accessed 27 Feb. 2024.
  • “Paradoxical Insomnia: Causes and Treatment.” Medical News Today, MediLexicon International, Accessed 27 Feb. 2024.
  • Diagnostic and Statistical Manual of Mental Disorders: DSM-5. American Psychiatric Association, 2013.
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