The Link Between Sleep Deprivation & Substance Use

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Contributor: Staff at Timberline Knolls Residential Treatment Center

There’s nothing quite like a good night’s sleep, but for many of us, those evenings where we get the proper amount of peaceful slumber are few and far between. Studies have shown that adults ages 18-64 need seven to nine hours of sleep per night, but more than 35% of adults in the United States report that they get less than seven. Nearly half of Americans say that they feel sleepy between three and seven days per week [1].

That lack of proper sleep, or sleep deprivation, can lead to a variety of concerns, from insomnia to sleep apnea to chronic weight gain. Drowsy driving is responsible for 6,000 fatal car crashes each year in the U.S. [2], while people who have severe insomnia are seven times more likely than good sleepers to have work-related accidents [3].

Understanding the Relationship Between Sleep Deprivation & Addiction

The relationship between a lack of sleep and mental health disorders is somewhat complex, as many people who have mental illnesses such as depression also suffer from insomnia. But it’s also bidirectional, meaning that a lack of sleep can lead to mental health concerns such as depression, while the impact of those same mental illnesses can also be a precursor for sleep disorders.

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Similar to the insomnia and mental health disorder relationship, substance use disorders and sleep deprivation function in much the same way. Addiction can cause sleep problems, but insomnia and a lack of sufficient sleep also raise the risk for drug use.

There are many benefits to getting enough sleep, like improving your mood, boosting your immune system, and strengthening your heart. We also need sleep to process the events of the previous day and encode memories.

But proper sleep also reduces your risk of making bad decisions. Sleep can significantly alter reward-seeking and behavior, and if you’re not getting enough, it might cause you to use or abuse alcohol or other drugs.

Most kinds of substance use acutely disrupt sleep-regulatory systems in the brain, which affects how long it takes to fall asleep, how long you sleep, and the quality of your sleep. For many people who use drugs, they experience insomnia during withdrawal, which can fuel drug cravings and often leads to relapse [4].

One interesting finding of the relationship between addiction and sleep troubles came in 2018 when a team of UCLA researchers studied the role orexin, a neuropeptide in the brain that regulates arousal, wakefulness, and appetite, plays in narcolepsy.

Examining a postmortem brain sample, the researchers discovered an individual who had significantly more orexin-producing cells than others. After learning that that person had been addicted to heroin, the team analyzed a larger sample of hypothalamic brain tissue from individuals who had a heroin addiction and found that those people had 54% more orexin-producing cells in their brains than non-heroin users [4].

Possible Breakthroughs That Can Benefit Addiction Treatment

Another study, in 2020, analyzed how blocking the orexin system in mice could mitigate bad sleep’s numerous negative effects on drug-seeking in the animals [5]. Sleep deprivation enhanced the rewarding properties of cocaine.

Woman sitting watching the sunset struggling with Sleep DeprivationThe researchers found that sleep-deprived mice formed a preference for a lower dose of cocaine that didn’t affect rested mice. They also preferred a standard cocaine dose, an indicator that they found cocaine more rewarding than their rested counterparts. By looking at where the changes originated in the brain, the research team found that the orexin system was engaged.

“Therapeutically, this is important because it certainly directs attention to the fact that one might be able to treat problems with sleep and problems with addiction — which go hand in hand — with one drug,” said Robert Greene, one of the study’s co-authors and a neuroscientist at the University of Texas Southwestern [6].

Coming down off a drug like cocaine disrupts sleep, which makes your orexin system more active. That leads to a bias toward more addictive-like behavior or drug-seeking, Greene says. More experiments are needed to confirm that the dynamic present in mice is also there in people.

The study may bring scientists closer to understanding the underlying mechanisms that link drug use and sleep deprivation, which could help pin down the types of therapies that are necessary to combat this problem. Researchers are currently testing the efficacy of suvorexant, an FDA-approved insomnia medication that acts as an antagonist at orexin receptors, in people who have opioid use disorder.

Sleep Deprivation and Addiction: Areas of Potential That Still Require Progress

We’re learning more and more about the relationship between addiction, drug use, and sleep, but there’s still a lot of ground to cover. The National Institute on Drug Abuse (NIDA) is funding several projects related to the link between sleep and substance use disorders, along with the neurobiology of reward and its relation to circadian rhythms.

Because of the variety of substances people can misuse or abuse, there likely won’t be an overarching answer. But the work done to identify the orexin system’s role with multiple substances could provide a legitimate breakthrough to continue mapping out treatment that works — and what steps we can take moving forward to limit the risk for addiction resulting from sleep deprivation.


[1] Suni, E. (2021, Feb. 8). Sleep Statistics. Sleep Foundation. Retrieved from:

[2] Centers for Disease Control and Prevention. (2020, May 28). Drowsy driving: Asleep at the wheel. Retrieved from:

[3] Leger, D., Guilleminault, C., Baker, G., Levy, E., & Paillard, M. (2002, Sept. 15). Medical and socio-professional impact of insomnia. Sleep. 25(6): 625-9. Retrieved from:

[4] Volkow, N. (2020, March 9). Connections between sleep and substance use disorders. National Institute on Drug Abuse. Retrieved from:

[5] Bjorness, T. & Greene, R. (2020, Nov. 2). Sleep deprivation enhances cocaine conditioned place preference in an orexin receptor-modulated manner. eNeuro. Retrieved from:

[6] Pattillo, A. (2020, Nov. 2). Scientists find a troubling link between sleep deprivation and addiction. Inverse. Retrieved from:

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Timberline Knolls BannerAt Timberline Knolls Residential Treatment Center, located outside of Chicago, Illinois, we provide specialized care for women and girls who are living with mental health conditions such as substance use disorders and eating disorders. Our private facility offers female-only treatment programs for eating disorders, addiction, and a range of mental health conditions. We work closely with each person to develop treatment goals to maximize strengths while focusing on individual needs. Our treatment team understands that each woman has unique needs and that she must play a role in her journey to wellness.

The opinions and views of our guest contributors are shared to provide a broad perspective of addictions. These are not necessarily the views of Addiction Hope, but an effort to offer a discussion of various issues by different concerned individuals.

We at Addiction Hope understand that addictions result from multiple physical, emotional, environmental, and genetic factors. If you or a loved one are suffering from an addiction, please know that there is hope for you, and seek immediate professional help.

Published on July 7, 2021
Reviewed by Jacquelyn Ekern, MS, LPC on July 7, 2021
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About Baxter Ekern

Baxter Ekern is the Vice President of Ekern Enterprises, Inc. He contributed and helped write a major portion of Addiction Hope and is responsible for the operations of the website.