Could Your Medications Be Keeping You Up at Night? Explore the Connection

Many medications, used to treat a variety of conditions, can cause sleeplessness. Diuretics, antidepressants, and ADHD meds are common culprits.

WEB-188 – Medication and Sleep How Prescription Drugs Can Impact Your Sleep

Do you often lie awake night after night staring at the ceiling wishing for sleep that won’t come? Or, maybe you wake up in the middle of the night unable to fall back to sleep. Not getting enough sleep can ruin your night and the next day, as well.  
 
If you’ve ever been unable to sleep well only to find yourself extremely short-tempered the next day, you’ve experienced a common effect of sleep deprivation. Sleep allows the body to rest and it restores important functions. Without it, your body and mind won’t function properly.  
 
If you experience sleep deprivation, you are not alone. More than 30 percent of all Americans suffer from insomnia. What causes so many people to have problems sleeping? It turns out that prescription medications could be one of the culprits behind this common problem.  

Prescriptions Meds and Sleep  

Unfortunately, many medications interfere with sleep and can alter normal sleep patterns. That includes some blood pressure medications, antidepressants, diuretics, and decongestants, according to the National Council on Aging. 
 
Most of the drugs that impact sleep do so by increasing neurotransmitters (chemicals) in the brain that promote wakefulness. Others block neurotransmitters that make you sleepy. Some delay sleep onset, interfere with the different stages of sleep or cause frequent awakenings during the night.   

Medications That Can Disrupt Sleep  

Here are some common medications that can disrupt sleep. 

Heart Medications  

Common heart medications that disrupt sleep include both alpha and beta blockers. These medications are used to treat high blood pressure, heart rhythm problems, and other heart conditions. They are also commonly used off-label for anxiety as they dampen the body’s physical response to stress.  
 
Alpha blockers interfere with rapid eye movement (REM) sleep while beta blockers like metoprolol and propranolol interfere with your body’s natural sleep-wake cycle or 24-hour clock. They also lower the body’s natural production of melatonin, the hormone that helps regulate sleep. Beta-blockers increase the risk of strange dreams, as well.  
 
ACE inhibitors, such as Lisinopril, which are used to treat heart failure and high blood pressure, can also interfere with sleep indirectly. These medications can cause painful leg cramps, which can keep you awake.  

Diuretics 

Diuretics, also known as “water pills,” are used to reduce blood pressure. They work by increasing urination, which helps reduce excess sodium in the body. This lowers blood pressure. But, it can also cause nocturia, which is waking up excessively to pee during the night.  
This interrupts your sleep cycle and can make it hard to fall back to sleep.  

Antidepressants 

Certain antidepressant medications including Effexor (venlafaxine), Paxil (paroxetine),  Wellbutrin (bupropion), and Prozac (fluoxetine) all have insomnia as a side effect. Antidepressants can also cause nightmares and strange, vivid dreams.  
 
Many older antidepressants (TCAs) suppress REM sleep. Getting less REM sleep has been linked to a higher risk of death.

Stimulants 

These drugs are typically prescribed for attention-deficit/hyperactivity disorder (ADHD) and narcolepsy.  
 
One of the most common side effects of stimulants is sleep problems. One study found that people taking (Ritalin) methylphenidate for ADHD were more than 2.6 times as likely to have sleep problems as those not taking this medication.  
 
Stimulants interfere with both the quality of sleep (sleep efficiency) and the sleep quantity. It doesn’t matter which stimulant you take, all of them can cause sleep problems, according to the University of Washington.  

Decongestants  

Some decongestants, such as pseudoephedrine, are stimulants. Like ADHD medications, they can keep you awake because they are stimulants. In addition, common side effects of decongestants (even ones that aren’t stimulants) include heart palpitations, nervousness, and anxiety. This can make it very hard to fall asleep.  

Corticosteroids 

 Corticosteroids are used for a variety of conditions including severe allergic reactions and asthma. They are also often used in critical care settings, as they are powerful at reducing inflammation in the body. These medications have been found to interfere with sleep.  
 
It is thought that corticosteroids disrupt sleep because they mimic the effects of your body’s natural stress hormone cortisol, which has a powerful effect on sleep patterns. This can throw off your body’s circadian rhythm, and interfere with your body’s ability to produce melatonin.  

Alzheimer’s Medications  

 A popular class of Alzheimer’s medications, cholinesterase inhibitors, block the destruction of the neurotransmitter acetylcholine in the brain, which helps improve memory and cognitive functioning in adults with Alzheimer’s. However, these medications have been found to prolong the length of REM sleep. They also significantly increase the risk of nightmares and insomnia. 

What You Can Do  

Here’s what to do (and not do) to sleep better if you take prescription medications.  

Practice Good Sleep Hygiene  

Anyone who is having difficulty sleeping should have a solid sleep routine in place. A bedtime routine is a cue that tells your body it’s time to sleep. First, make sure you set a consistent wakeup and bedtime every day, even on weekends. Next make sure your bedroom is quiet, slightly cool, and dark.  
 
Every night, sixty minutes before bed, prepare to wind down. Switch off all devices or place them into “Sleep” mode. Do something that relaxes you like practicing meditation or breathing exercises, sipping on a warm tea, or listening to a relaxing sleep story.  

Give It Some Time  

If you have just started taking the medication, give it a couple of weeks or even months for your body to adjust. The human body takes some time to get used to new medications. Side effects are most common in the first couple of weeks or months. But, then they may go away.  

Talk to Your Doctor if You Experience Sleep Problems  

If you've been having trouble sleeping at night and recently started taking new medications, it start tracking your sleep using Pillow so that you can show your sleep patterns to your doctor.  
 
Even if there is a clear link between a new medication and the start of your sleep problems, it’s important to talk to your doctor about it. There could be other causes of insomnia that require treatment.  
 
If your doctor determines that your medication is the cause, they may decide to lower your dose, change the time of day that you take it, or switch you to a different medication. Never abruptly stop or adjust the dose of your medication without talking to your doctor about it first. 

emily

Written by

Emily Mendez

Emily Mendez is a former therapist and mental health author. She is one of the leading voices in mental health. Emily's writing has appeared in eCounseling, SonderMind, and more. Emily is frequently interviewed by Healthline, Fatherly, INSIDER, Family Circle, and other national media for her advice and expert opinion on the latest mental health topics.

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