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Cocaine and Sleep

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Cocaine is a powerful drug that can lead to dependency, overdose, and death. Because people feel an intense high immediately, it creates a desire to have more. In 2020, 5.2 million people aged 12 and older reported using cocaine in the past 12 months.

Cocaine use has significant short and long-term effects. Taking small amounts of cocaine makes the user feel alert, awake, more talkative, and confident. They might experience a reduced appetite and need for sleep.

Guardian Recovery will examine cocaine’s effect on sleep, the side effects of sleep deprivation due to cocaine use, and how you can improve sleep when seeking treatment for a cocaine use disorder.

If you or someone you love has a cocaine use disorder, Guardian Recovery is available to help. We are dedicated to providing the most comprehensive and individualized medically monitored detox program. To learn more about our programs, contact us today.

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Cocaine’s Effects on Sleep

A common side effect for cocaine users is the lack of sleep or need for sleep during and after use. As it is well known, cocaine is a stimulant that reduces dopamine reuptake and interferes with the REM sleep cycle. This creates an effect that prevents the need for sleep and disrupts the circadian rhythm one needs for quality sleep.

Unfortunately, it has been found that people who abstain from cocaine use struggle with the side effects of insomnia. Insomnia can be a common reason people may use drugs such as alcohol or cannabis to fall asleep or relapse, as their cocaine cravings may be more intense during this time.

Why Does Cocaine Affect Sleep Quality?

Like many substances, cocaine has long-term effects on the brain. Studies show that cocaine creates glutamate, an excitatory neurotransmitter. This type of neurotransmitter stimulates a nerve cell, making the chemical message move from nerve cell to nerve cell, not stopping. Glutamate is essential for proper brain function.

Glutamate is also necessary for producing GABA, another neurotransmitter responsible for sleep, deep relaxation, anxiety regulation, and muscle function.

Additionally,  cocaine has an immediate high; however, it only lasts 15-30 minutes. This leads to frequent use and can unintentionally lead to an overdose and a sudden low in behaviors as one person is coming off the high. When a person starts to come down from a high, they may experience withdrawal symptoms quickly. These withdrawal symptoms may also keep a person from sleeping as the symptoms can be uncomfortable and increase restlessness, leading to insomnia.

There can be severe consequences if continued cocaine use occurs or if a person attempts to detox without medical assistance. If you need help detoxing cocaine from your body, Guardian Recovery can help.

Sleep Disorders & Abnormalities Caused by Cocaine

Research indicates that sleep disturbances, hypersomnia, bad dreams, depressed mood, agitation, fatigue, and increased appetite characterize the first few days to several weeks of cocaine cessation. It’s not until continued abstinence over several weeks that sleep may begin normalizing.

Most Common Sleep Disturbances Associated With Cocaine Use:

  • Longer time to fall asleep.
  • Decreased total sleep time.
  • Diminished deep sleep or slow-wave sleep.
  • Suppressed REM sleep.

Numerous studies have indicated an improvement in sleep quality over the first few weeks of abstinence, with reported improvements in overall sleep quality, daytime alertness, concentration, depth of sleep, and energy/fatigue.

Although reports of sleep improvement following the initial withdrawal from cocaine, findings have consistently shown insomnia within the same period. The co-occurring decline in sleep and perceived gain in sleep quality was termed ‘occult insomnia.’

Acute cocaine use can increase the time it takes to fall asleep. The first few days of abstinence from cocaine in chronic users are associated with shorter awake times relative to later in abstinence, when awake times may be as long as 30–60 min or more.

Total sleep time during abstinence is reduced in chronic cocaine users.  According to research studies, it appears to be at its greatest sometime in the early abstinence period (first week of sobriety).

Chronic cocaine users appear to have dramatically diminished slow-wave sleep time relative to individuals without cocaine use. Further evidence suggests that slow-wave activity is increased by cocaine use earlier in the day, followed by a loss of slow-wave activity in the first several days after cocaine use has stopped, and finally, a drop over the following 2 weeks.

Cocaine use suppresses REM sleep. However, in chronic cocaine users, REM sleep decreases with low REM times observed during the second and third weeks of abstinence. At 3 weeks, abstinence does not differ substantially from healthy sleepers, despite low REM sleep time.

Side Effects of Sleep Deprivation Due to Cocaine Use

Sleep deprivation has a significant effect on people’s health. If people get less than 7 hours of sleep per night over time, it can lead to severe cardiovascular, nervous, immune, and endocrine impairment. Here is how long-term poor sleep can damage one’s health.

Long-term Impairment from Sleep Deprivation:

  • Obesity.
  • Diabetes.
  • Cardiovascular disease and hypertension.
  • Anxiety symptoms.
  • Depressed mood.
  • Alcohol-use disorder.

Additionally, research has indicated that sleep deprivation induced by cocaine triggers a significant increase in cocaine-induced seizures, suggesting that the absence of sleep leads to seizure activity.

The following symptoms are associated with chronic cocaine use: circadian rhythm deregulation, insomnia, mood swings, and cognitive performance.

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Circadian Rhythm Deregulation

All individuals have an internal system that helps them adapt to changes in light and darkness. This internal clock is located in the brain’s hypothalamus. The hypothalamus regulates body temperature, feeding, hormone secretion, and immune function.

Cocaine use can negatively impact the brain by disrupting circadian rhythms, sleep and wake patterns. Research indicates that sleep disruptions may influence drug use by triggering potential relapses.

Further, disturbances in sleep patterns often continue even after cocaine withdrawal.

Cocaine may impact circadian rhythms, driving someone to use the drug at certain times. Additionally, cocaine affects the activity of the hypothalamus, which leads to a disruption of a person’s sleep/wake cycles.

It is difficult to determine whether cocaine abuse leads to circadian rhythm disorders. However, it is known that chronic cocaine users show higher rates of sleep problems like insomnia and hypersomnia.

Insomnia

As mentioned, chronic cocaine use can lead to sleep disorders such as insomnia, hypersomnia, and occult insomnia. Insomnia is described as the inability to fall asleep as you should. Hypersomnia is excessive sleepiness during the day, even after sleeping. Occult insomnia is when people report better sleep after abstaining from cocaine use. However, the quality and quantity of sleep are worse when analyzing the actual brain waves of the person who is no longer using cocaine.

Mood Swings

Unfortunately, because cocaine impacts dopamine, GABA, and the structural components of the brain, there are psychological effects that occur from cocaine use. Psychiatric symptoms include agitation, paranoia, hallucinations, delusions, violence, and suicidal and homicidal ideation. Additionally, if a person is already diagnosed with a comorbid mental health disorder, cocaine can exacerbate the symptoms of the co-occurring mood disorder.

Additionally, when withdrawing from cocaine, a person may experience what is known as a cocaine crash. Here are the common symptoms one may experience when they have hit a cocaine crash.

Symptoms of a cocaine crash include: 

  • Agitation.
  • Irritability.
  • Restlessness.
  • Increased blood pressure.
  • Increased body temperature.
  • Intense cravings.
  • Mood swings.
  • Exhaustion.
  • Depression.
  • Suicidal thoughts.
  • Increased appetite.

Cognitive Performance

Primarily, the type of brain damage caused by cocaine can be short-term and be reversed if abstaining from cocaine use for at least 35 weeks. However, some complications can lead to permanent brain damage. For example, a person is at a high risk of developing a stroke from cocaine use. If a person suffers from a stroke and loses oxygen for a sustained time, severe and irreversible brain damage can occur.

How Long Do the Effects on Sleep Last After Quitting Cocaine?

It can take weeks, months, or even longer for the body to repair a person’s sleep cycle from chronic cocaine use. Typically, cocaine will continue to disrupt sleep after someone stops using. While sleep impairment may continue during the early withdrawal phase from cocaine, sleep improves as the person remains sober. Research suggests that total sleep time improves in those who have remained cocaine-free for approximately two months.

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