Dr Zac Turner on why we feel anxious and tired after drinking alcohol

A feeling of dread and paranoid thoughts, anxiety when hungover – or “hangxiety” – is a common problem. But why do we feel this way?

Welcome to Ask Doctor Zac, a weekly column from news.com.au.

This week Dr Zac Turner reveals why we feel anxious after drinking alcohol.

Question: Hi Dr Zac, I need you to solve a mystery for me. Every time I go to bed after a night of drinking, I have the most insane nightmares. They leave me in a cold sweat lying in bed with all my lights on. I usually drink vodka cruisers, Midori pineapples and Vodka Red Bulls. Almost every time I drink there is always at least a nibble of cheese, sometimes a whole grazing board – which is what I’ve been told is the cause of my nightmares. Please let me know what is causing these nightmares, they cause the worst ‘hangxiety’ the morning after – Ella, 29, Melbourne

Answer: Hi Ella, let’s put on matching tweed overcoats and get to solving this mystery.

More often than not patients present me with their mystery ailments along with a printed out WEBMD diagnoses that claim they are a month away from dying. I can’t stress this enough, never diagnose yourself from the internet and go to your doctor first.

The internet may be good as a research tool, however it can be the worst kind of doctor. Often it gives the worst case scenario – when in reality, the cause is always to blame.

In this scenario the cause is blaring right at us: Alcohol.

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Exhibit A: Booze.

Why does alcohol make you sleep badly?

Remember alcohol is a poison and it causes detrimental effects on your body, and when drunk at night can really affect our sleeping patterns.

The other poison that many of us forget is sugar, and pumping our bodies with this right before bedtime can play a huge factor in our ability to process alcohol and amplify our hangover the next day.

Yes, a few drinks before bed can make you fall asleep ‘easier’ but studies have shown that it causes you to wake up during the night, leaving you feeling tired in the morning.

Dreaming, or in your case nightmares, is caused by the stage of sleep called REM – Rapid Eye Movement. Your body is working overtime to manage all the alcohol in its system which increases stress and leads to nightmares while at the same time trying to process high levels of sugar.

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Alcohol can make you sleep badly and feel anxious.

What causes ‘hangxiety’ after drinking?

‘Hangxiety’ (anxiety when hungover) is a real condition and it’s caused by your body’s efforts to rebalance your brain’s chemicals post drinking. When we drink, our brain begins to shake up its own cocktail of chemicals that all blend together to give you the feeling of being drunk.

Alcohol opens the floodgates of your brain’s neurotransmitters, such as dopamine and serotonin, which is why you initially feel a rush of euphoria.

Your brain also begins to release GABA (gamma-aminobutyric acid) which makes you feel calm while simultaneously blocking glutamate which causes anxiety. This is why you often have the feeling of never wanting the party to end.

It doesn’t last forever, and never will, and so once these chemicals recede you are suddenly hit with a barrage of stress and anxiety. Your well-meaning brain embarks on a mission to rebalance these chemicals, blocking GABA and increasing glutamate which is why it’s a rapid swing from calm to anxiety.

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Dr Zac Turner on why alcohol makes us feel bad.

How to cope with hangxiety

The best ways to deal with your hangxiety is to focus on the physical side of it. Drink plenty of water, eat a light meal and sleep. Try some deep breathing and meditation.

Now for the sake of scientific curiosity, let’s ignore the alcohol factor and delve into the other factor apparent in your nightmare scenario: Sugar.

All the drinks you listed are laden with sugar and calories. Sugar has been linked in studies to nightmares as it keeps you awake at night, disrupting your REM leading to stress-induced nightmares. The caffeine from the Red Bull is having the same effect on your body.

Cheese does not cause nightmares. It is an old myth that has been carried on with no scientific backing whatsoever. Go for your life on the cheese boards (responsibly).

Ella, if these nightmares persist you may need to do some personal reflection on what is causing them. If it is a recurring nightmare try to pinpoint what your body is trying to tell you. Keep a nightmare journal and speak to a professional about what’s happening. You may find you are harbouring stress deep within that is causing your anxiety.

Dr Zac Turner has a Bachelor of Medicine and Bachelor of Surgery from the University of Sydney. He is both a medical practitioner and a co-owner of telehealth service, Concierge Doctors, and is also a qualified and experienced biomedical scientist | @drzacturner