Do you find your medications impacting on sleep?
Medications for depression and anxiety
- 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
- 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
- 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.
Related posts & links:
- Medications that can cause insomnia – blog from AARP.org
- Medication treatment options for insomnia – blog post
- Sleep in dementia – blog post
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