Sleep Problems in Recovery: Why Insomnia Happens

Sleep is an important part of recovery from opioid use disorder (OUD). It’s when the body and brain rest and recharge. During OUD recovery, your brain and body will be going through a lot of changes, and they’ll need the extra support from a good night’s rest.

Sleep trouble is very common in opioid use disorder (OUD). Some studies suggest that many people with OUD have insomnia or other sleep problems, like sleep apnea. Sleep problems are also common in the general population. This article will discuss what insomnia is, how it’s related to OUD and recovery, and the steps you can take to help improve your sleep.

What Is Insomnia?

Insomnia is a sleep disorder. It can make it hard to fall asleep or stay asleep during the night, both of which disrupt your sleep and can therefore make it challenging to feel rested and ready to take on the day. Continued episodes of insomnia can lead to sleep deprivation.

Insomnia Symptoms

At night, insomnia symptoms include difficulty falling asleep, unintentionally waking up in the middle of the night, or waking up earlier than intended without being able to fall back asleep. It can also be any combination of the three.

When you aren’t sleeping well, your brain and body don’t get a chance to recover during the night. This affects how you function the next day, which can lead to:

• Daytime sleepiness
• Feeling unwell
• Slowed reaction times and reflexes
• Trouble concentrating
• Memory issues
• Mood changes (depression, anxiety, irritability)
• Difficult with daily tasks (work, hobbies, home life)

Insomnia Causes

There isn’t one specific cause of insomnia. There are many possible contributing factors. Genetics, medical conditions, hormone shifts during pregnancy or menopause, mental health conditions, life changes, and routines can all play a role in affecting your sleep patterns.

Some risk factors for developing insomnia include:

• Having fear or anxiety about sleep or your home environment
• Being a light sleeper
• Drinking alcohol

For people with OUD, there are additional factors that contribute to their likelihood of experiencing insomnia symptoms.

How Are Insomnia and OUD Recovery Related?

People with OUD are five times more likely to experience insomnia during recovery than at any other time. When your body is used to opioids, it affects how your brain and body function. When you start to taper and withdraw from opioids, your brain and body have to readjust to get back to normal, and this usually disrupts your sleep patterns, leading to insomnia. Insomnia is often a withdrawal symptom.

What Else About OUD Recovery Contributes to Insomnia?

Other aspects of OUD recovery can disrupt your sleep and lead to insomnia. When you first enter an inpatient recovery program, you’re living in the facility. This means you’re away from home, in a new bed, surrounded by a new environment and new people, and have new daily expectations on you. All of these factors are going to affect you. If you’re used to going to bed late and sleeping in, your sleep schedule is going to change since most treatment programs have residents start the day early and have a lot of schedule regularity. Getting used to your new schedule can throw off your natural sleep-wake rhythms until your body adjusts to the new routine.

Recovery is not an easy process. As your body adjusts to life without opioids, you’ll likely experience cravings, stress, and physical discomfort associated with withdrawal. Though these are all normal symptoms, they can create a more challenging environment for getting a good night’s sleep. The stresses of recovery and being in a new environment, mixed with any anxiety around life changes and worries of relapse, can keep your mind active and make it more difficult to fall asleep.

Since insomnia can alter your ability to regulate stress and can lead to mood changes, it can further feed into the issue. This makes it even more important to seek help along the way. Inpatient programs have many treatment and counseling options to support you in your recovery. Outpatient programs have counseling and other support group options as well.

Insomnia and Risk of Relapse

A 2025 study found that sleep disturbances affect recovery outcomes and relapse potential during and after recovery programs. Insomnia is associated with relapse for many reasons:

• When you don’t sleep well, cravings can feel stronger.
• Poor sleep can make it harder to think clearly, manage emotions, and control impulses.
• Stress often increases when sleep is poor, and stress can trigger urges to use.
• Sleep problems and OUD can affect brain systems involved in reward and stress, which may make recovery harder.

This risk further emphasizes the importance of finding ways to support your sleep health during and after your initial recovery treatment program.

Treating and Managing Insomnia During OUD Recovery

Sleep is an important part of OUD recovery. There are several steps you can take to improve your sleep. If these don’t help, speak with a healthcare provider about treatment options for your insomnia.

Also, tell your medical team if you snore loudly, stop breathing during sleep, or feel extremely sleepy during the day. Sometimes opioid use (and some treatments) can be linked with breathing problems during sleep, and those need medical care.

Tips for Getting a Better Night’s Sleep

There are a few ways to help your sleep hygiene, or your routine that contributes to getting a good night’s sleep. These include:

• Having a sleep-friendly environment, like a dark, quiet room that is typically a bit chilly
• Creating a solid bedtime routine to help put your mind in a place where it can rest, which typically means avoiding screen time or any stressors close to bedtime
• Having a consistent bedtime and wake-up time to help create regularity with sleep
• Avoiding caffeine later in the day, as this can keep you awake at night
• Not eating a large meal close to bedtime, which will make your gastrointestinal system have to work while you’re trying to rest
• Avoiding long naps or naps later in the day, which can interrupt your sleep cycle
• Exercising regularly to help tire you out so your body becomes ready for bedtime

Treatments for Insomnia

If working on your sleep hygiene isn’t helping as much as you’d hoped, other treatments can help. Make sure to chat with the medical staff in your recovery program so they can support you in your journey and provide tools to assist you.

Common treatments for insomnia include:

• Cognitive behavioral therapy for insomnia (CBT-I) — This is the most recommended talk-therapy approach for insomnia. It teaches skills to calm the mind and build healthy sleep habits.
• Sleep restriction (often part of CBT-I) — You limit time in bed at first, then slowly increase it as your sleep improves.
• Stimulus control (often part of CBT-I) — This helps your brain connect the bed with sleep again (not staring at the ceiling or worrying).
• Progressive muscle relaxation — This involves using guided muscle techniques to promote relaxation.
• Supplements — Supplements such as melatonin may help promote sleep. Always speak with your doctor before starting a supplement.
• Medications — Some medications can also support sleep. Your medical team will ensure the medications prescribed do not have known abuse potential and will be mindful of your recovery status.

Insomnia during OUD recovery is common. Your medical team will choose sleep medicines carefully, because some sleep drugs can be habit-forming or risky in recovery. They will pick the safest option for you and watch for side effects.

Join the Conversation

On MyOpioidRecoveryTeam, people share their experiences with opioid use disorder, get advice, and find support from others who understand.

Have you experienced insomnia during OUD recovery? Let others know in the comments below.