Sleep and Relaxation

Sleep disturbance is common among people with heavy alcohol use. Many patients have poor sleep behaviours, and often have a history of relying on alcohol or sedatives to initiate sleep. While medication such as benzodiazepines can facilitate sleep during the first few days of withdrawal, long-term use of benzodiazepines or other sedatives for sleep following alcohol withdrawal (more than one week) is discouraged due to lack of effectiveness and harms. Most patients find that normal sleep routine can be established within weeks of stopping alcohol use, and appropriate sleep behaviours should be encouraged. If not, evaluation for other causes for sleep disturbance should be considered such as obstructive sleep apnoea. Patient literature about sleep and relaxation techniques (see Appendix) should be provided. 

Likewise, many patients experience difficulties with anxiety, irritability and even panic attacks during and after alcohol withdrawal. Benzodiazepines or other sedatives have a limited role, and behavioural approaches to relaxation and evidence-based approaches to anxiety management should be encouraged.

Chapter Recommendation Grade of recommendation
8.22 Sedatives (such as benzodiazepines) should not be continued beyond the first week of withdrawal. Behavioural approaches to management of anxiety and sleep problems should be encouraged in the first instance. D