Health Column: October 25, 2007

Just say 'boo' to booze

Is it wise to drink alcoholic beverages before sleep?

Ethanol certainly is a central nervous system depressant, especially when it’s combined with many types of medications. All too often we read about someone who drank too much of an alcoholic beverage, lapsed into a coma and later died. So it would seem that drinking a lesser amount would result in a good night’s sleep. But, that’s not the case.

In fact, it’s just the opposite of what one might think. Ethanol disturbs sleep in many ways. Though it may decrease the amount of time it takes to fall asleep, consuming alcoholic beverages within one hour of going to sleep will disturb the second half of sleep, especially after repeated use. It’s a fact that sleep regulation is disrupted, and the disturbance alcohol has includes several negative cumulative effects.

Since most of stage REM sleep, also known as dream sleep, and slow wave sleep occur in the second half of the sleep period, they are more affected by ethanol when compared to the other sleep stages. Visual hallucinations and agitated vocal and physical activity are an intrusion of excessive REM sleep activity without the normal REM sleep muscle activity inhibition.

This causes the sleeping person to routinely awaken from dream sleep and not be able to fall asleep again. This non-restorative sleep causes daytime sleepiness and other problems caused by sleep deprivation, which can include lifestyle effects such as poor job performance and slowed reflexes that can be dangerous when driving or performing other activities.

In some of my previous columns, I’ve talked about obstructive sleep apnea (OSA), a common sleep disorder that occurs when the back of the throat closes off because the back of the tongue comes into contact with a low soft palate and other tissues in the back of the throat. The sedating effects of alcohol only hamper this condition and increase the likelihood of OSA, particularly in people who snore. It also increases the duration and severity of the apnea episodes. This can increase the risk of hypertension, heart disease, diabetes and stroke.

Outside of sleep disorders such as OSA, other sleep disturbances associated with chronic alcohol abuse can include both sleep onset insomnia and sleep maintenance insomnia, as well as degrees of signs and symptoms of alcohol withdrawal, the most serious being the “frightful delirium,” with a scientific name of delirium tremens.

Delirium tremens is severe alcohol withdrawal syndrome that can occur in up to 5 percent of alcoholics, and it can be fatal, if left untreated. Less-severe alcohol withdrawal symptoms, including alcohol withdrawal seizures, can begin from several hours to days after stopping or decreasing the amount of alcohol a person consumes. Manifestations of DT are tremors, irritability, insomnia, nausea, vomiting, hallucinations, confusion and severe agitation with fever, rapid breathing and heart rate, and sweating.

But, instead of losing sleep over how much of any alcoholic beverage is too much before bedtime, make the best decision available and say “boo” to booze.

Dr. Fredric M. Radoff is a neurologist specializing in sleep disorders medicine at The Center for Sleep Medicine, a partnership of Blount Memorial Hospital and East Tennessee Medical Group.

Draper joins Blount Memorial Pharmacy

Pharmacist Heather Draper has joined the Blount Memorial Hospital pharmacy and will establish clinical pharmacy services in the hospital’s emergency department.

Draper received a bachelor’s degree in biology from Grand Valley State University in Allendale, Mich., and a degree in pharmacy from Ferris State University in Big Rapids, Mich. She completed her residency training at Saint Mary’s Health Care in Grand Rapids, Mich.

Draper is a clinical professor for the University of Tennessee College of Pharmacy in Knoxville. Blount Memorial is her practice site, where she works with pharmacy students who are on clinical rotation.

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