- Insomnia affects approximately 30% of adults with short-term symptoms and 10% with chronic insomnia
- Characterized by difficulty falling asleep, staying asleep, or waking too early
- Strong bidirectional relationship with substance use — insomnia drives use and use worsens sleep
- Insomnia in early recovery is a significant relapse risk factor
- Chronic insomnia increases risk for depression, anxiety, cardiovascular disease, and cognitive decline
- CBT-I (Cognitive Behavioral Therapy for Insomnia) is the first-line treatment
- Sleep medications carry dependence risk and are not recommended for long-term use
- Good sleep hygiene practices form the foundation of insomnia management
Published: February 2026 | Last Updated: February 2026 | Reading Time: 5 min
What Is Insomnia?
Insomnia is a sleep disorder characterized by persistent difficulty initiating sleep, maintaining sleep, or waking earlier than desired, despite adequate opportunity and circumstances for sleep. To meet diagnostic criteria, the sleep difficulty must cause significant daytime impairment (fatigue, irritability, difficulty concentrating) and occur at least three nights per week. Acute insomnia lasts less than 3 months; chronic insomnia persists for 3 months or longer.
Insomnia and Substance Use
The relationship between insomnia and substance use is bidirectional and clinically significant. Many people with insomnia self-medicate with alcohol, marijuana, or sedatives — substances that may induce sleep initially but ultimately worsen sleep quality. Chronic substance use disrupts sleep architecture. And insomnia during early recovery is one of the strongest predictors of relapse, as sleep deprivation increases cravings and impairs decision-making.
Treatment
CBT-I (Cognitive Behavioral Therapy for Insomnia)
CBT-I is recommended as the first-line treatment for chronic insomnia by the American College of Physicians. It is more effective than medication in the long term and does not carry dependence risk. Components include sleep restriction (limiting time in bed to match actual sleep time), stimulus control (associating the bed only with sleep), cognitive restructuring (challenging unhelpful beliefs about sleep), relaxation training, and sleep hygiene education.
Sleep Hygiene
Good sleep hygiene includes maintaining a consistent sleep schedule, creating a dark, quiet, cool sleep environment, avoiding caffeine and heavy meals close to bedtime, limiting screen time before bed, and exercising regularly but not close to bedtime.
Frequently Asked Questions
Can insomnia be a symptom of addiction?
Yes. Both active substance use and withdrawal commonly disrupt sleep. Post-acute withdrawal insomnia can persist for weeks to months after cessation, particularly with alcohol, benzodiazepines, and stimulants.
Are sleeping pills safe?
Prescription sleep medications (zolpidem, eszopiclone) can provide short-term relief but carry risks of dependence, tolerance, and rebound insomnia. They are not recommended for long-term use. For individuals with substance use disorder history, non-pharmacological approaches like CBT-I are strongly preferred.
How much sleep do adults actually need?
Most adults need 7-9 hours of sleep per night. However, sleep quality matters as much as quantity. Consistent, uninterrupted sleep with adequate time in deep and REM stages is essential for physical and cognitive health.
References
- American Academy of Sleep Medicine. (2014). International Classification of Sleep Disorders (ICSD-3).
- Qaseem, A., et al. (2016). Management of chronic insomnia disorder in adults. Annals of Internal Medicine.
- Brower, K.J. (2015). Assessment and treatment of insomnia in adult patients with alcohol use disorders. Alcohol.
- Morin, C.M., et al. (2006). Psychological and behavioral treatment of insomnia. Sleep.
- National Sleep Foundation. (2024). Insomnia.
This article was reviewed by the Valley Spring Recovery Center Editorial Team. For help with co-occurring sleep and substance use issues, call (201) 781-8812 or visit our admissions page.
Valley Spring Recovery Center — Evidence-based addiction treatment in Norwood, New Jersey.