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Users of large amounts of alcohol show a sleep pattern which is "prematurely aged", with many awakenings, many stage changes, and decreased restful sleep. Because the sleep is shallow and fragmented, total time in bed may be increased and the sleep/wake rhythm becomes blurred. This can result in excessive daytime sleepiness, and once again in poor sleep patterns at night. Even after one or two years of abstinence, the sleep of many former alcoholics remains disturbed. It is unclear whether these sleep disturbances are a result of permanent damage caused by alcohol or whether poor sleep always existed and alcohol was used initially to medicate the sleep problem.