Knowledge Center

Certain medications can upset your normal sleep patterns. Switching medications or lowering doses under your doctor’s supervision can often fix the problem.

If you rely on medications for a chronic condition or even minor ailments, you may find yourself sleep-deprived or battling daytime drowsiness.

“Certain heart, blood pressure, and asthma drugs, as well as over-the-counter medicines for colds, allergies, and headaches, can interrupt normal sleep patterns,” says James Wellman, MD, medical director of the Sleep Disorders Center of Georgia in Augusta.

In fact, a number of common medications can prevent you from falling asleep or staying asleep; others can make you groggy or sleepy during the day. Chemicals work differently on everyone, so a given medication may not affect you and your best friend the same way, but the following drugs could cause sleep problems for most people.

Sleep: Prescription Medication Side Effects

These drugs can affect both the quality and quantity of your sleep:

• Heart medications. Anti-arrhythmic drugs used to treat heart rhythm problems can cause insomnia and other sleep difficulties. Beta blockers, used for high blood pressure, arrhythmias, and angina, increase the chance of insomnia, awakenings at night, and nightmares. Additionally, some cholesterol-lowering drugs have been linked to poor sleep. “There have been some reports of people on statins, such as Zocor, having insomnia and nightmares,” says Dr. Wellman.
• medications. Theophylline, an asthma medication that is sometimes used to ease inflammation and help clear airways, can cause insomnia, as well as daytime jitters. “The chemicals in this medication are related to caffeine,” explains Wellman. Corticosteroids, such as prednisone, are frequently prescribed for asthma and can cause similar medication side effects.
• Depression medications. About 10 to 20 percent of people who take a class of antidepressants known as selective serotonin reuptake inhibitors, or SSRIs, such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil), experience sleep problems. “Insomnia is one of the common medication side effects of SSRIs,” says Wellman.
• Anti-smoking medications. Nicotine patches used to help people quit smoking work by delivering small doses of nicotine into the bloodstream 24/7, and one common medication side effect is insomnia. Some people using the patches have also reported nightmares.
• ADHD medications. Attention-deficit hyperactivity disorder (ADHD) is usually treated with stimulant-like medicines that boost alertness, but can lead to insomnia. “People taking these medicines may have trouble falling asleep,” says Wellman. “And once they’re able to get to sleep, they may spend more time in non-REM sleep.” REM sleep refers to the stage of sleep accompanied by rapid eye movements and is a deeper level of sleep. Examples of medications with these side effects include methylphenidate (Ritalin) and dextroamphetamine (Dexedrine).
• Thyroid medications. An underactive thyroid gland (hypothyroidism) can cause extreme sleepiness during the day, but some drugs used to treat the condition can result in insomnia. However, this side effect usually only occurs at higher doses, says Wellman.

Sleep: Over-the-Counter Medications

Sleep problems aren’t limited to prescription drugs. These common medications can also affect sleep:

• Medications for colds and allergies. Antihistamines used to treat colds and allergies cause drowsiness in most people. Worse, this medication side effect can be long-lasting. “Antihistamines can continue to cause drowsiness six to eight hours after taking them,” notes Wellman. Decongestants have the opposite effect, causing insomnia. Be aware of cough medicines, too. They often contain alcohol, which can prevent deep REM sleep and cause you to wake frequently throughout the night.
• Pain-relief medications. Over-the-counter painkillers sometimes contain caffeine, which can stimulate the brain and drive away sleep. Pain relievers with caffeine include the brands Excedrin, Anacin, and Motrin Complete. “The effects of caffeine can last six to eight hours in some people,” says Wellman. To avoid this medication side effect, scan the label before purchasing a pain reliever to see if it contains caffeine — not all pain relievers do.
• Herbal medications. “Natural” medications can still interfere with sleep. “Some people taking St. John’s wort for depression have reported overstimulation and insomnia,” says Sheila Kingsbury, ND, a naturopathic physician and chair of the botanical medicine department at Bastyr University in Seattle. Sam-e (S-adenosylmethionine, a dietary supplement that is sometimes used as an antidepressant, can also cause sleep difficulties, says Dr. Kingsbury. Insomnia is a common side effect of the Chinese herb ginseng as well.