before alcohol consumption causes alcohol to absorb more slowly. Hydration also plays a role, especially in determining the extent of hangovers. After binge drinking, unconsciousness can occur and extreme levels of consumption can lead to alcohol poisoning and death (a concentration in the blood stream of 0.40% will kill half of those affected). Alcohol may also cause death indirectly, by asphyxiation from vomit. Alcohol disrupts normal sleep patterns thereby reducing sleep quality and can greatly exacerbate sleep problems. During abstinence, residual disruptions in sleep regularity and sleep patterns are the greatest predictors of relapse. Heavy alcohol consumption while in a hunger state can cause alcoholic ketoacidosis, a life-threatening metabolic derailment. Long-term effects According to the World Health Organization's 2018 Global Status Report on Alcohol and Health, there are more than 3 million people who die from the harmful effects of alcohol each year, which amounts to more than 5% of the burden of disease worldwide. The US National Institutes of Health similarly estimates that 3.3 million deaths (5.9% of all deaths) were believed to be due to alcohol each year. Guidelines in the US and the UK advise that if people choose to drink, they should drink moderately. Even light and moderate alcohol consumption increases a person's cancer risk, especially the risk of developing squamous cell carcinoma of the esophagus, cancers of the mouth and tongue, liver cancer, and breast cancer. A systematic analysis of data from the Global Burden of Disease Study, which was an observational study, found that long-term consumption of any amount of alcohol is associated with an increased risk of death in all people, and that even moderate consumption appears to be risky. Similar to prior analyses, it found an apparent benefit for older women in reducing the risks of death from ischemic heart disease and from diabetes mellitus, but unlike prior studies it found those risks cancelled by an apparent increased risk of death from breast cancer and other causes. A 2016 systematic review and meta-analysis found that moderate ethanol consumption brought no mortality benefit compared with lifetime abstention from ethanol consumption. Risk is greater in younger people due to heavy episodic drinking which may result in violence or accidents. Long-term heavy use of alcohol damages nearly every organ and system in the body. Risks include alcohol use disorder, malnutrition, chronic pancreatitis, alcoholic liver disease (e.g., permanent liver scarring) and several types of cancer. In