Which Medications Affect Sleep?

Trouble sleeping? A surprising number of the medications you may be taking can interfere with sleep, cause insomnia, or trigger daytime drowsiness.

By Sheryl Grassie

Our medications can be lifesavers, whether mediating a heart condition or getting us through a rough night with the flu, but all drugs have side effects. Some are minor, some are serious, and some can affect sleep. If sleep is your concern, there are common categories of medications to be aware of, including blood pressure medicines, asthma medication, cold and flu remedies, heart medications, smoking cessation patches and gums, depression medications, thyroid medicine, and more. If you’re having trouble sleeping, you might want to review your medicines; prescription, over-the-counter and herbal, can all be a culprit.

Blister pack of sleeping pills, blindfold and earplugs

Medications can directly cause insomnia, making it difficult to fall asleep or setting you up to wake up during the night. They can interfere with the quality of your sleep, meaning its consistency, they can alter healthy sleep architecture which is your sleep cycles, or they can keep you from getting enough time in deep sleep states like rapid eye movement (REM). Some medicines can cause daytime sleepiness, while others can cause disturbing dreams.

Be aware that although certain drugs can cause sleep problems, they don’t cause problems for everyone who takes them. Let’s look at the categories of offending medications and their effects on sleep for most people. Then, we’ll address how to manage your meds and get the sleep you need.

Prescription Medications for…

Asthma

There are a number of different drugs that can be prescribed to treat asthma. Common ones are corticosteroids, long-acting beta agonists (LABAs) and Theophylline, or combination inhalers containing a corticosteroid and a LABA.

Corticosteroids, which are prescribed for inflammation, are known to cause insomnia. They upset the systems that allow you to relax and sleep and can additionally cause nightmares. You may be familiar with drugs like cortisone and prednisone that are sold under many different names.

Next are the LABAs, which have side effects of nervousness, hyperactivity, and trouble sleeping. Theophylline has an effect on the body similar to caffeine and can cause difficulty sleeping.

ADHD

You might think that medications to help someone be calmer and more relaxed would actually help with sleep, but that is not the case. ADHD medications primarily target the ability to focus and are stimulant based. These drugs, like well-known Ritalin, can make it difficult to fall asleep and keep you from entering into deep sleep, like REM. This can further cause problems with memory in addition to sleep deprivation.

Depression and Anxiety

A common category of drugs prescribed for depression and anxiety are SSRIs or selective serotonin-reuptake inhibitors. These drugs, like Prozac, Zoloft, and Paxil are very effective for helping people feel better and almost equally as commonly they cause difficulty with sleep. In particular, they cause insomnia and being awake for periods in the middle of the night.

Heart Problems

Medications for the heart like ACE inhibitors for congestive heart failure and Beta-blockers for abnormal heart rhythms can cause sleep problems. ACE inhibitors cause problems indirectly with side effects like chronic dry cough, leg cramps, and achy muscles and joints that can create difficulty staying asleep.

Beta-blockers are believed to inhibit melatonin production which can interfere with sleep. People on beta-blockers report waking up during the night and the occurrence of disturbing dreams and nightmares.

High Blood Pressure

Sleep and high blood pressure have connections beyond medication effects, but the primary drugs used to treat high blood pressure are similar to those for heart problems, ACE inhibitors, beta-blockers, and alpha-blockers.

As mentioned above, ACE inhibitors have side effects that can keep you awake, beta-blockers lower melatonin and cause difficulty falling and staying asleep, and alpha-blockers seem to inhibit the ability to get in and stay in deep REM sleep. They are also linked to daytime drowsiness.

High Cholesterol

The class of drugs known as Statins, which are commonly prescribed for lowering cholesterol, have an indirect effect on sleep. Drugs like Zocor and Lipitor can cause muscle pain and sometimes it can be quite severe, causing difficulty falling asleep or staying asleep. These drugs are also fat-soluble and can cross the blood-brain barrier which may contribute to insomnia and nightmares.

Smoking Cessation

Drugs to help you stop smoking work by delivering small amounts of nicotine into your system to help curb withdrawal symptoms and allow you to resist smoking. Nicotine, however, whether it comes in a patch, a gum, an inhaler, or a pill, is a stimulant that can interfere with a good night’s sleep. Insomnia is considered common with smoking cessation medications and nightmares are reported as well.

Thyroid

Medications like Synthroid and Levoxyl that are used to treat hypothyroidism are known to cause insomnia, especially if prescribed at higher doses. Thyroid medication is also known to cause sleepiness during the day.

Over-the-Counter Medicines and Herbal Remedies for…

  • Allergies, Colds, and Flu: Medication for these common ailments can have decongestants that cause insomnia. Some formulas also contain alcohol which can interfere with maintaining deeper sleep states like REM and can cause waking during the night.
  • Pain Relief: Some brands of pain relievers, and some specific formulas, contain caffeine which can interfere with sleep. It can delay falling asleep and interrupt sleep cycles. Since formulas change and manufacturers differ, read labels to check for caffeine.
  • Depression: Natural remedies for depression like St. John’s Wort and natural herbs like ginseng that can ward off depression both are known to cause insomnia.

Things That Can Help 

If you suspect that one or more of your medications might be behind your sleep difficulties, then talk to your doctor or health professional. There are solutions, such as getting a different prescription, trying a single dose earlier in the day, lowering the dosage, or taking supplemental melatonin.

What you don’t have to do is compromise your health with too little sleep. Medical professionals are aware of medication side effects, and it may be as simple as trying something different in order to get a good night’s sleep.


Summary

Many people are not fully aware of the side effects of their medications. A common side effect of numerous drugs is interference with sleep. Many different prescription drugs and non-prescription remedies can cause insomnia, reduced sleep quality, lack of deep sleep, daytime drowsiness, and nightmares. Be aware of your medications’ side effects, look for caffeine in over-the counter meds, understand the properties of herbal remedies, and ask your doctor for help. Solving sleep problems related to medications can be fairly simple and result in a much-needed good night’s sleep.


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