Do you find your medications impacting on sleep?

medications and sleepMany of the medications used to treat medical or mental health conditions can impact on sleep. Whilst sometimes those effects can be positive, such as a sedating effect that can help with sleep, often they can have a negative effect on sleep, causing problems with sleep disturbance or changing sleep quality so that it is not as restorative as it should be. If you find you’re having trouble with sleep and think your medications may be playing a role, discuss it with your doctor.

Medications for depression and anxiety

Whilst some medications for anxiety can help with sleep, such as benzodiazepines, many of the medications commonly used for anxiety can cause insomnia, particularly when starting them. Similarly, modern medications used for depression, can also cause insomnia, unlike some of the older medications used for depression, which are less commonly used now because they are less effective at treating depression and have other side effects.
  • Selective seretonin re-uptake inhibitors (SSRIs) – Common drugs in this class are paroxetine (Aropax) and sertraline (Zoloft). Although they are often used to treat anxiety, and can lessen the insomnia associated with anxiety, this effect takes some time to develop, often some weeks. When starting these medications, insomnia is one of the common side effects.
  • Seretonin-norepinephrine re-uptake inhibitors (SNRIs) – Examples are venlafaxine (Efexor) and desvenlafaxine (Pristiq). Like the SSRIs, they can help with depression and anxiety in the long-term, but can cause insomnia for the first few weeks. For some people SNRIs and SSRIs cause ongoing sleep disturbance.
  • Benzodiazepines – Drugs such as diazepam (Valium) and temazepam (Temaze) are in this class. They can be used for short-term treatment of anxiety, and are also used to treat insomnia. Whilst these drugs can help with sleep, they can have negative effects on sleep patterns, reducing REM and N3 non-REM sleep, so don’t always result in people feeling better throughout the day.

 Medications for respiratory conditions

medications and sleepSome of the medications used to treat respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD), can cause sleep disturbance.
  • Beta-agonists – Examples of beta-agonists are sulbutamol (Ventolin) and terbutaline (Bricanyl). These drugs are used to treat both asthma and COPD, and can cause insomnia, particularly when taken in high doses, such as when people are feeling unwell and using more than normal or taking Ventolin via a nebuliser.
  • Inhaled corticosteroids – medications used as preventers for asthma such as budesonide (Pulmicort) or beclomethasone (Becotide) are usually well tolerated, but can cause insomnia for some people, particularly when used at high doses. There are also combination puffers (Seretide or Symbicort) that contain both a beta-agonist and inhaled corticosteroid and can cause insomnia.
  • Prednisolone – is used to treat exacerbations of asthma or COPD, or sometimes used as a maintenance treatment in severe cases. It commonly causes trouble getting to sleep or staying asleep, particularly when used for short periods at high doses.
  • Varenicline – also called Champix, is used to help with smoking cessation. It acts by stimulating the nicotine receptor, to replace the same stimulation that comes from cigarette smoking. But as nicotine is a stimulant, anything that activates the nicotine receptor, like varenicline, can cause sleep disturbance.

Medications used for neurological conditions and pain

Pain and sleepDisturbed sleep is already a common symptoms with pain or chronic neurological conditions such as dementia or other neurodegenerative disorders. But medications used to treat these conditions can also have an effect on sleep.
  • Opioids – Medications such as codeine (in Panadeine Forte) or oxycodone (Endone or Oxycontin) are used for severe pain. They can be sedating, but can also result in sleep being fragmented and feeling light and easily disturbed. People on long-term opioids have an increase in N2 non-REM sleep and reduced REM and N3 non-REM sleep.
  • Acetylcholinesterase inhibitors – are used to treat dementia and include drugs such as donepezil (Aricept) and rivastigmine (Exelon). Via their effects on acetylcholine, an important neurotransmitter in sleep regulation, they can increase REM sleep and nightmares in some people.
  • Dopamine agonists – such as levodopa (Sinemet) or pramipexole (Sifrol) are used to treat Parkinson’s disease and can also be used to treat restless legs syndrome. Some people can find them sedating, whereas in others they can cause sleep disturbance.

Medications for high blood pressure or heart problems

The main group of medications used for high blood pressure or heart problems are beta-blockers.

  • Beta-blockers – such as propranolol (Inderal) and metoprolol (Lopressor) have been shown to increase dream awareness and cause nightmares in some people. They can also cause tiredness. Beta-blockers that don’t get in to the brain as readily such as atenolol are less likely to have effects on sleep.

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Need more information about how you can sleep better?

At Sleephub we understand the struggle people endure with sleeping problems which is why we have created a comprehensive FAQs page with information for those seeking information about sleep disorders and potential solutions.

Check our resources or take our Sleep Wellness Quiz for a free assessment of elements that may be keeping you from a good night’s sleep.

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