Can’t Sleep? Your Prescriptions Could Be to Blame

Medications That Can Cause Insomnia and Other Sleep Problems

Therapies such as acupuncture and herbal medicine can be highly effective treatments for insomnia. However, my clinical experience (and numerous studies) has shown that one of the causes of insomnia can be the medications you take on a regular basis. So, when my patients are taking something that could be causing their sleeplessness, I recommend that they work with their doctor to adjust the dosage or change the medication completely.

Prescription medications and over-the-counter formulas—as well as caffeine, alcohol, and illegal drugs—can cause all sorts of sleep problems, including difficulty falling asleep, inability to stay asleep, dream interruption, frequent awakenings, nightmares, and decreased production of necessary melatonin.

Here are some categories of drugs and other substances that can cause insomnia, plus a few examples of each.

Antihistamines:

Non-sedating antihistamines, the kind that don’t make you feel drowsy, are often taken during the day to relieve symptoms like itching, sneezing, runny nose, and nasal congestion, but without putting you to sleep. However, in some patients, non-sedating antihistamines can cause anxiety that leads to insomnia.

These drugs include cetirizine (Zyrtec), desloaratadine (Clarinex), fexofenadine (Allegra), and loratadine (Claritin).

Alpha-Blockers and Beta-Blockers:

Alpha-blockers and beta-blockers are both prescribed to combat high blood pressure, while beta-blockers are also used for abnormal heart rhythms, migraines, and some types of glaucoma. Alpha-blockers can disrupt REM sleep (the dreaming stage), and beta-blockers can cause frequent awakenings and nightmares.

These drugs include tamsulosin (Flomax), silodosin (Rapaflo), doxazozin (Cardura), metoprolol (Lopressor, Toprol), propranolol (Inderal), and sotalol (Betapace).

Corticosteroids:

If you’re taking corticosteroids, it’s mostly likely because you have inflammation associated with rheumatoid arthritis, lupus, gout, or certain allergic reactions. Corticosteroids can keep the mind awake and stimulated, causing sleeplessness and, if  you do fall asleep, nightmares.

These drugs include cortisone, prednisone (Deltasone, Sterapred, and many others), and methylprednisolone (Medrol).

SSRI Antidepressants:

Selective serotonin-reuptake inhibitors treat symptoms of moderate to severe depression. Although it’s not exactly clear to researchers how they cause sleep problems, almost 20% of people who take them experience agitation that leads to insomnia.

These drugs include fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), escitalopram (Lexapro), paroxetine (Paxil, Pexeva), and sertraline (Zoloft).

ACE Inhibitors:

Angiotensin-converting enzyme inhibitors are prescribed to those with high blood pressure, congestive heart failure, and other conditions. These drugs increase the patient’s levels of bradykinin, which helps enlarge blood vessels, which in turn causes a dry, hacking cough in more than 35% of patients. This cough and the medication’s other side effects like leg cramps and achiness are enough to keep anyone up all night. If you’re unable to tolerate ACE inhibitors, you’ve probably been prescribed an angiotensin II-receptor blocker (ARB), which can cause many of the same insomnia-inducing side effects as ACE inhibitors.

ACE inhibitors mostly include drugs whose chemical names end in “pril”—captopril (Capoten), fosinopril (Monopril), perindopril (Aceon), quinapril (Accupril), benazepril (Lotensin), lisinopril (Prinivil, Zestril), ramipril (Altace) and trandolapril (Mavik). ARB drugs normally end in “atan”—telmisartan (Micardis), calsartan (Diovan), and candesartan (Atacand) are all examples.

Glucosamine and Chondroitin:

These popular dietary supplements are often taken to help relieve joint pain and lessen inflammation. Researchers aren’t exactly sure how they work (and the jury is still out on whether they do work), and it’s not clear why they can cause headaches and insomnia, but these are common complaints.

Statins:

Statins are used to treat high cholesterol, but they’re also known to cause muscle pain, which can keep patients up at night, unable to get into a comfortable sleeping position. Researchers have found that fat-soluble statins also cause insomnia and nightmares.

These drugs include simvastatin (Zocor), atorvastatin (Lipitor), lovastatin (Mevacor), and rosuvastatin (Crestor).

Alcohol:

Although alcohol has sedative effects that can cause you to fall asleep, it’s not often prolonged, good-quality sleep. If you want to sleep better, don’t drink too close to bedtime, and drink in moderation.

Common Stimulants:

Coffee, black tea, cola drinks, chocolate, and cigarettes all contain stimulating properties that perk you up. Some pain medicines, decongestants, and weight-loss products also contain caffeine and other stimulants. However, if consumed too close to bedtime, they can keep you from falling asleep. Then you’re so tired the next day that you consume more stimulants, and the cycle continues. To combat insomnia, do not take any stimulants in the late afternoon or later.

Prescription stimulants include some thyroid drugs and asthma inhalers.

Illegal Drugs:

Most drugs in this category (cocaine, methamphetamines, etc.) are stimulants and should be avoided for the same reasons as above. The process of withdrawing from regular use of these drugs can have the same effects on sleep quality.

Acupuncture has the ability to help regulate your sleep and support your needs exactly where you are. If changing the medication or the dosage is not an option for you, then we will still be able to help by assisting your body and helping minimize the side of effects of the drugs you are taking.

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Damiana Corca is an Acupuncture Sleep Specialist in Boulder and Denver, Colorado. She is helping people sleep better by offering sleep treatments locally. Damiana is also available for phone sessions and clinical support for your local acupuncturist.