Why Do We Writhe All Night Long After a Bender?

Sometime halfway through an alcohol-fueled weekend, one of my friends turned to me and said, "This is fun, but I'm really dreading the writhe tomorrow night." That's what we call the hours spent tossing and turning, trying to fall asleep Sunday night. The writhe. If you're as equally irresponsible as us, you might know it as "the shakes" or "the fear." And, if you're a scientist who studies booze, you might not know it exists at all or what the hell causes it.

Any regular night out isn't going to cause you to writhe, at least, not in my experience. It's the Sunday nights after a music festival, or after your old friend leaves town, or happy hour turns into a night out turns into brunch turns into 4 AM all over again.

It's what happens when hair of the dog catches up to you and you simply can't responsibly drink one more night; when your body is begging for a rest; when you want to return to normalcy before a big week at work or just want to stop drinking because, while it was fun drifting through a weekend in a state that wasn't ever really quite sober, it's got to end sometime.

Surprisingly enough, an Urban Dictionary user named Honk82 couldn't have described what I'm talking about any better:

"An unknown phenomenon that occurs, usually on a Sunday evening, when one is extremely tired and or hung over from a long weekend, trip, or vacation and can not fall asleep. Symptoms include: angst, restlessness, irritability, frustration, flash backs, and sweating."

It manifests itself slightly differently in everyone—sometimes your heart will race, sometimes the anxiety you feel is so much that you have to stay sitting up, sometimes you'll sweat. In all cases, there's one constant: Hours spent alternatingly staring at the clock, and closing your eyes, begging your body to fall asleep.

Alcohol's effects on sleep are well known—it's a biphasic drug, meaning that, at first, the drug has stimulating effects (in fact, it helps stimulate the release of catecholamine, a group of hormones that includes adrenaline), but eventually it has ones more commonly associated with depressants. That's why it's often easy to pass out after a long night of drinking (though you will almost certainly have a lower overall quality of sleep), and it's why writhing isn't a problem on Friday or Saturday night. It's also why you'll go to sleep at 4 AM, wake up at 9 AM, and then, if you continue drinking (hello, brunch), you won't feel like you want to die all day.

Those effects have been well studied and, frankly, just aren't what I'm talking about here. This happens many, many hours after drinking has stopped, and often after anything I'd consider a "hangover" has passed.

So I went to the experts. I called up Richard Stephens, a professor at Keele University and one of the world's foremost hangover researchers. Yes, he's an alcohol researcher, but, specifically, he studies why we have hangover symptoms, which is a particularly rare breed of scientist.

"The definition of hangover is the 'effects of residual alcohol.' If you have 0 blood alcohol but are feeling effects, then you have a hangover," he told me. "It looks like the [general] sleep problem is a hangover effect. But, what could the mechanism be? We know a little bit about the mechanism of hangover, the headache and feeling ill is due to lower glucose levels, dehydration, an inflammatory response."

But the writhe, I told him, isn't quite like the traditional hangover. Lots of times when I writhe, I have a perfectly productive Sunday afternoon. I go for a bike ride, I exercise, I might even work a little bit. But still the sleep problems, heart palpitations, sweating.

"To that, I'm not sure. Hangover effects don't last all that long. You shouldn't have a real, 24-hour hangover," he said. "I guess if you drank late Saturday night and woke up at at 8 AM Sunday still drunk, you might still have a hangover up to 1 or 2 AM, that's my best guess. It's the remnants of the hangover."

It sounded plausible.

I took my question to Damaris Rohsenow, associate director for Brown University's Center for Alcohol and Addiction Studies. She studies hangovers, addiction, and has specifically done studies on alcohol and sleep. I theorized to her that, perhaps, we were suffering from alcohol withdrawal, as some of the symptoms seemed in line with the stories of addicts on various forums, Yahoo Answers pages, and the alcohol withdrawal Wikipedia page.

That was a nonstarter, and she said we aren't alcoholics because we have a bender every once in a while.

"Let's not use the word 'withdrawal.' That involves different physiological systems occurring as a result of chronic heavy drinking. (While some of my colleagues like to say that hangover may be a type of short term withdrawal, the withdrawal experts definitely disagree since the mechanisms are so very different.)," she told me in an email. "The pattern you describe [once a month benders, moderate drinking besides] is not consistent with inducing alcohol withdrawal so I'd let that word go."

"The subjective hangover effects all dissipate within a few hours of blood alcohol returning to zero. So the question is whether there are residual effects of two nights of heavy drinking (maybe from the longer catecholamine release) that would affect sleep the night after the second heavy drinking night," she added.

If not withdrawal, then what? Merely an extended hangover without the headache and queasy stomach? I told one of my friends what she had said. He wondered if it was all in our heads, if we all have some horrible anxiety problem, some phantom disease.

And therein lies one of the paradoxes of alcohol research today: It's unethical to get your subjects sufficiently fucked up to study such things, and most studies on alcoholics deal with the long-lasting effects of alcohol on the body, not the day-two hangover annoyances.

It's one of the problems that Stephens has tried to circumvent by randomly scheduling his studies on people for early in the morning on weekends. That'll help our understanding of the hangover, but it might not help us learn why we writhe 24 hours later.

In the meantime, the best writhe researcher I know is one of my friends, who told me he drinks a beer or two and pops on Netflix rather than trying to fall asleep. Embrace the writhe, he says, and eventually you'll fall asleep without even realizing it.