Celebrity Deaths Highlight Dangerous Association Between Insomnia & Substance Abuse
By Hugh C. McBride
In the past two years, two high-profile deaths have brought increased attention to the dangerous relationship between insomnia and drug abuse.
In January 2008, 28-year-old actor Heath Ledger was found dead in the bedroom of a New York apartment. The New York Medical Examiner’s Office determined that Ledger’s death was the accidental result of adverse reactions among six types of prescription pills, including temazapam, an anti-insomnia drug that is marketed under the brand names Restoril and Euhypnos.
A Feb. 6 CNN article noted that Ledger had told friends and journalists that the stress of filming the Bob Dylan-inspired film “I’m Not There” and the Batman film “The Dark Knight” in close proximity had left him incapable of getting a good night’s sleep.
"Last week I probably slept an average of two hours a night," Ledger told The New York Times in November 2008, CNN reported. "I couldn't stop thinking. My body was exhausted, and my mind was still going."
Seventeen months after Ledger’s death, pop music icon Michael Jackson died after suffering cardiac arrest in his home in Los Angeles, California. In August 2009, following reports that Jackson was regularly administered the powerful anesthetic propofol and other substances in order to get to sleep, the L.A. County Coroner’s Office ruled the death a homicide.
“The homicide ruling was based on forensic tests that found the anesthetic propofol combined with at least two sedatives to kill Jackson, a law enforcement official told The Associated Press,” the AP reported in an Aug. 25 article.
No one is naïve enough to assume that Heath Ledger and Michael Jackson were the only two people taking drugs in order to ward off the effects of insomnia, yet many remain unaware of the prevalent and dangerous relationship between insomnia and substance abuse.
Alcohol Abuse and Insomnia
Though Ledger and Jackson appear to have been taking drugs as a result of their inability to get to sleep, the cause-effect relationship between insomnia and substance abuse has been known to work in both directions. In other words, while some people turn to substances because of their insomnia, others begin to experience sleep problems as a result of recreational substance abuse.
In an article that appeared in the Feb. 1, 2004 edition of the journal Psychiatric Times, Maher Karam-Hage, M.D. (clinical assistant professor of psychiatry at the University of Michigan), addressed the ways in which one commonly abused substance - alcohol - can lead to significant sleep problems:
In actively drinking alcoholics, specific sleep disturbances are reported, such as increased time required to fall asleep, frequent awakenings and a decrease in subjective sleep quality associated with daytime fatigue. …
Further, these individuals undergo a vicious cycle when they attempt to stop drinking since an abrupt reduction or end to drinking usually triggers alcohol-withdrawal syndrome accompanied by pronounced insomnia and sleep fragmentation.
The connection between sleep problems and alcohol abuse was also the subject of a 1998 “Alcohol Alert” issued by the National Institute on Alcohol Abuse and Alcoholism (NIAAA):
It has been shown that alcohol interferes with normal sleep patterns by disrupting particular neurotransmitters in the brain which control or regulate sleep. When these neurotransmitters are disrupted, disturbances can result. …
Due to the natural elimination of alcohol from the body, arousal and sleep fragmentation can occur and the second half of the sleep period can be drastically interrupted. This is due to the fact that, although alcohol will cause sedation, it will also decrease REM sleep in the first half of the night resulting in the rebound of REM sleep later in the night. When the rebounding of REM sleep occurs, it causes frequent awaking during the night, and suppression of REM sleep.
Other Substances and Insomnia
While many people wrongly assume that alcohol’s sedative effects will help them sleep better, most have a better understanding of the stimulative properties of other commonly abuse drugs, such as cocaine and methamphetamine.
Cocaine is often abused by individuals who want to boost their intensity levels or become more alert, and meth users have been known to stay awake for days when under the influence of this powerful substance.
However, what many people fail to realize is that, as is the case with alcohol, other drugs that they think are helping (or forcing) them to sleep - or which they are taking for other legitimate reasons - may be impacting their ability to get an appropriate amount of quality rest every night.
For example, the Sleep Deprivation website reports that some antihistamines, antidepressants, decongestants, asthma medications, weight loss drugs and even sleeping pills themselves can have a disruptive effect on sleep patterns. In the case of sleeping pills, while these substances may provide initial relief from temporary sleeplessness, their ability to “override” the body’s natural cycles may leave the user dependent upon the drugs, and perpetually unable to fall asleep without a chemical relaxant.
And of course, the interaction of two or more drugs - prescription, over-the-counter, legal or illicit - can lead to a wide range of problems, including insomnia.
A Better Way
Everyone experiences temporary challenges regarding sleep. Stress, depression, physical pain, noisy neighbors and a host of other disruptions can make it difficult if not impossible to get an adequate amount of shuteye. But relying on drugs to eradicate these influences can lead one down a dangerous path.
If you or someone you love has developed a dependence upon drugs in order to get to sleep, or has been suffering from drug-related insomnia, you need to get help immediately. On their own, substance abuse and sleep deprivation can result in a host of physical and psychological problems, but together their effects can be exponentially worse.
