Do you take medication for a chronic health condition? That drug may be disturbing your sleep.
Working with a doctor to adjust the dose or time you take it—or replace it with a similar drug that does not stimulate the central nervous system—may be all you need to hold insomnia at bay.
Which drugs can interfere with sleep? You’ll find a complete list in the 2010 edition of Principles and Practice of Sleep Medicine. Following are a few most widely prescribed.
Cardiovascular and Cholesterol-Lowering Drugs
Cardiovascular agents (for high blood pressure, heart disease, and kidney disease) and cholesterol-lowering drugs were the two most common types of drugs prescribed in 2007-2010, according to a CDC report released in May. Some may disrupt your sleep:
- Beta Blockers, aimed at lowering blood pressure and reducing the risk of repeated heart attacks, are used by many adults. Metoprolol, for example, was the fourth most prescribed medication in the US last year, according to data from IMS Health. Yet metoprolol and other fat-soluble beta blockers—such as propranolol and pindolol—have caused insomnia and nightmares in some users, as well as reductions in REM sleep. Beta blockers also decrease the release of melatonin, which might disturb the continuity of your sleep.
- Statins are widely prescribed to lower cholesterol and prevent heart attacks and strokes. Simvastatin, for example, was the fifth most prescribed medication in the US last year. Clinical trials of simvastatin and similar drugs—atorvastatin, lovastatin and pravastatin—have generally failed to show that these drugs impair sleep. But anecdotal reports suggest they cause insomnia and nightmares in some users.
The CDC cites antidepressants as another commonly used type of medication. About 10.6 percent of Americans aged 18-64 years report using them, as do 13.7 Americans aged 65 and above. The antidepressant duloxetine (Cymbalta) was the fifth highest selling drug in 2013.
Some antidepressants are sedating (trazodone, nefazodone, and doxepin, for example). Others tend to be arousing (desipramine, nortriptyline, and protriptyline) and may disrupt sleep. But some antidepressants are neither fish nor fowl, and their effects on sleep are harder to predict:
- Selective serotonin reuptake inhibitors (SSRIs) cause insomnia in some people and daytime sedation in others. Fluoxetine (Prozac) reportedly caused insomnia in 10 to 17 percent of users and daytime sedation in 5 to 21 percent.
- Serotonin and norepinephrine reuptake inhibitors (SNRIs) also cause insomnia in some people and daytime sedation in others. Duloxetine, for example, caused insomnia in 10 to 18 percent of users and daytime sedation in 8 to 13 percent.
See your doctor if you’re wondering whether a drug you take is contributing to your insomnia. Small adjustments in timing or dosage may be all it takes to put you on track to sounder sleep.
Please share questions or comments about drugs you take and their effects on your sleep.