Alcohol withdrawal and nightmares

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When going through alcohol withdrawal, you will experience many symptoms that are uncomfortable. One of them is nightmares. This particular symptom can make things pretty scary and almost cause you to relapse. 

Nightmares are part of alcohol withdrawal symptoms, that's often neglected and disregarded, but it’s good to mention that you could experience it in the form of vivid dreams that alcohol withdrawal can lead to. 

Most people, however, are unaware of it, and when it develops, they have a hard time falling asleep, which will mess with their sleep cycle. 

Of course, there are other withdrawal symptoms you will experience, and when you add a lack of restful sleep in the mix, you end up with a serious problem during treatment of alcohol withdrawal.

But should these dreams be a source of concern?  

Well, yes. Here's why. Nightmare disorder or alcohol withdrawal nightmares refers to a pattern of having sleep disturbances when you try to fall asleep. The vivid dreams can be extremely uncomfortable and scary to experience. 

Nightmare disorder is however more than just having bad dreams when falling asleep and it can be a pattern of night terrors in the initial stages of treatment for recovering alcoholics.  

There is a strong connection between sleep disruption and alcohol withdrawal, and although experts are still trying to understand this concept, understanding how alcohol withdrawal leads to the nightmares disorder may help you find relief from the symptoms faster. 

This will also help rehab centres and professionals provide alcohol addicts with better treatment alternatives when they seek medical attention. 

The nightmares cause anguish, especially when they are recurrent and may prevent you from entering deep sleep, which is necessary to achieve complete relaxation. 

This is because the alcohol affects your rapid eye movements causing nightmares, blocking your physical and psychological health benefits during alcohol withdrawal treatment. 

Additionally, the fear of having a nightmare will also affect your daytime functioning during addiction recovery, as it will impair your occupational, and social performance.

This fear will generate some mild symptoms of anxiety affecting your sleep patterns and overall sleep quality and health. 

Diagnosing nightmare disorder 

Currently, there aren't any specific tests that can be done to diagnose this condition, and most often cognitive behavioural therapy will be used to identify it. 

Night terrors because of alcohol withdrawal are only deemed a disorder when they cause mental anguish and prevents one from sleeping. This lack of sleep will impair your ability to function properly. 

Even when the alcohol withdrawal is not part of the equation, any individual that experiences night terrors causing a lack of entering the deep part of sleep called REM rebound will suffer in their everyday life. 

A persistent lack of this, will soon become a medical emergency because your body desperately needs it to completely relax and re-energize. 

But, during alcohol dependency treatment, a medical professional will review you and rule out any other conditions such as physical and medical issues that may be causing the nightmares. 

In the end, when all else fails, they may recommend a polysomnogram or sleep study to help understand the main issue behind the night terrors. 

Nightmare disorder and substance abuse 

In people with alcohol abuse disorder (AUD), nightmare disorder or non-rapid eye movement is a common occurrence that causes an incomplete awakening from sleep, which is common with people that quit alcohol drinking cold turkey. 

The brain chemistry behind this for the average person is not completely well understood, but the precipitate nightmares are likely to alter your brain mechanisms when you go to sleep.  

This is especially true for people who have other problems such as addiction to amphetamines and cocaine. 

Marijuana especially diminishes your REM sleep, and this can lead to a high amount of nightmares.  

When the nightmares are co-occurring with other symptoms such as high blood pressure, mental health issues, anxiety, headaches, etc., you may need additional treatment options from an inpatient or outpatient care clinic to deal with the onset of these symptoms since your last drink. 

Are nightmares a withdrawal symptom? 

They can be. Any substance abuse problem can impact your dreaming and sleep. Some will either improve the quality of rest and sleep, while others will trigger unwanted effects such as nightmares and terrors. 

But this is not a 100% documented withdrawal symptom of alcohol addiction treatment, and in most cases, it is rarely diagnosed. 

However, if you are addicted to the following substances, for a prolonged period, there are high chances of experiencing nightmares during the withdrawal process accompanied with a condition like Delirium Tremens. 

They include: 

  • Antidepressants. 
  • Antihistamines. 
  • Blood pressure medicine. 
  • Steroids. 
  • Cholesterol medication 
  • Parkinson's medicine. 

If you find yourself in this condition, or any other drugs addiction, you should seek the help of a rehab clinic or medical supervision, to quit alcohol, or join local support groups for additional care. 

Why do you have nightmares when you stop drinking? 

You have nightmares when you stop drinking because alcohol normally depresses the functions of your brain, and actually late-night dinking often contributes to this. 

The main trouble is that your brain is normally on overdrive when drunk and working hard to achieve the same processes and functions and when you continue with heavy drinking, it can be unnoticeable due to the effects of alcohol depressing your central nervous system. 

Now, when you quit drinking, it will take your brain a while to get back to normal, without the alcohol depressing its functions. The brain and your CNS are normally overstimulated and overactive. 

This is the same issue that causes excessive muscle spasms, irritation, seizures and sweating in people with severe withdrawal symptoms. 

Again, the over stimulation will cause unusual brain activity when you sleep which includes switching between non-REM sleep and REM sleep, plus some abrupt and erratic sleep patterns. 

Experts also say that heavy alcohol use reduces the amount of REM sleep each month, and when you quit alcohol, the REM rebounds and presents in a much stronger form than ever.

Now, since REM is when you dream, therefore you tend to have nightmares when you do not achieve it. 

Vivid dreams after alcohol consumption are however possible and when you are overcoming alcohol addiction, the dreams can be vivid to the point of being scary and violent in nature. 

This is the leading cause of relapse when it comes to treatment of alcohol addiction and this is why, learning how to manage your sleep during this difficult stage can be crucial to your treatment. 

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How long do vivid dreams last after quitting alcohol? 

Lucky for most people, this is a temporary phenomenal that results from the imbalances in your brain because of heavy alcohol use. 

Typically, your brain's functions and normal sleeping patterns that are affected through drinking alcohol in excess will return to normal in about a week or two. The extreme cases of these could go on to about three weeks, but it’s not common, and rarely happens. 

Extremely vivid dreams can be stressful and uncomfortable, especially when they are accompanied by violent nightmares, insomnia, and agitation. The experience often will encourage you to drink more, to avoid the dreams. 

But please remember that this will pass soon enough, and you will be back to normal and continue with your treatment plan within no time. 

Those doing home detox programs can use prescription alcohol detox medication to help in managing the worst of the addiction symptoms when attempting alcohol cessation and how the alcohol's effects work on your body. 

Often, the doctors will use sedatives to maintain a healthy pattern of sleep and help in preventing vivid dreams.  

Those going through detox without professional help should consider real life help using simple things such as herbal medication to help them sleep better when quitting alcohol. 

Causes of nightmare disorder 

The exact cause of nightmare disorder without alcohol withdrawal is not known, but there are a few factors that will trigger this condition, which is also a part of Delirium Tremens.

They include: 

  • Traumatic episodes. 
  • Alcohol and drug abuse. 
  • Medication. 
  • Mental health issues. 
  • Sleep deficiency. 
  • Movies, or shows of a scary nature. 

Treating nightmare disorder 

The treatment of nightmare disorder will help with your withdrawal symptoms and if they are caused by a medical condition such as cancer, heart disease or other form of pain, this can be treated by alleviating the nightmares.  

In case there aren't any underlying conditions, then you can find some options for treatment in the following: 

Psychotherapy  

This will help in targeting the anxiety and stress in a bid to reduce it. 

Imagery rehearsal therapy 

This will help in reducing the incidences of the nightmares. 

Psychotropic medication 

This is used for highly intensive nightmares and is related to PTSD - Post Traumatic Stress Disorder. 

Practicing good sleep hygiene  

This involves a lifestyle change that ensures you have a healthy bedtime routine in order to improve your sleep cycle and the quality of your sleep. 

What is delirium tremens? 

Delirium Tremens, or DTs, is a condition associated with alcohol withdrawal and affects people who've had a prolonged addiction to alcohol. 

Having chronic alcohol addiction for a long time will increase the release of several chemicals such as GABA in your brain. 

GABA is actually a natural chemical that slows down your nervous system. Alcohol reduces this organic activity. 

When you reduce your alcohol intake, or you cease drinking altogether, the GABA production will also cease in your brain which causes overstimulation and shocks. 

This sudden process then causes symptoms of Delirium Tremens to develop and can ultimately highlight how the brain struggles with such adaptations without replacing the drug or alcohol order to restore order. 

Symptoms of delirium tremens 

The main symptoms of Delirium Tremens will include the following: 

  • Alcoholic seizures 
  • Alcoholic nightmares 
  • Extreme hallucinations, both auditory and visual 
  • Fever 
  • Vomiting 
  • Perspiration 
  • Tremors 
  • Heightened heart rate 

These normally develop around two or three days after deciding not to drink alcohol anymore, or after your last drink. They can peak in five or seven days as well. 

If left untreated, Delirium Tremens can be fatal and cause death. The above symptoms such as a high pressure and high heart rate will completely destroy your cardiovascular and cause it to collapse leading to respiratory failure. 

Alcohol seizures and nightmares are also part of Delirium Tremens symptoms, and they are significant enough to put pressures on your brain and result in vulnerabilities. It has been linked to mental disorders. 

Due to this, any development of Delirium Tremens MUST be treated as an emergency and medical assistance should be sort immediately to save your life. 

Abbeycare offer an alcohol detox programme (read more here) in their residential clinics to manage risks of withdrawal and DT symptoms.


Conclusion 

So, alcohol withdrawal and nightmares are essentially connected according to the national institute of drug and alcohol abuse, and they are common symptoms of addiction treatment. 

Abbeycare Pricing Bot

Last Updated: February 16, 2022

About the author

Peter Szczepanski

Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Peter also co-authored the new 6th edition of Drugs In Use by Linda Dodds, writing Chapter 15 on Alcohol Related Liver Disease. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.