Which drugs cause insomnia

There are a number of things you can try to help yourself get a good night's sleep if you have insomnia. Some people find over-the-counter sleeping tablets helpful, but they don't address the underlying problem and can have troublesome side effects.

Read more self-help tips for insomnia. Make an appointment to see your GP if you're finding it difficult to get to sleep or stay asleep and it's affecting your daily life — particularly if it has been a problem for a month or more and the above measures have not helped. Your GP may ask you about your sleeping routines, your daily alcohol and caffeine consumption, and your general lifestyle habits, such as diet and exercise.

They will also check your medical history for any illness or medication that may be contributing to your insomnia. Your GP may suggest keeping a sleep diary for a couple of weeks to help them gain a better understanding of your sleep patterns. Each day, make a note of things such as the time you went to bed and woke up, how long it took you to fall asleep, and the number of times you woke up during the night.

Your GP will first try to identify and treat any underlying health condition, such as anxiety, that may be causing your sleep problems. This is a type of talking therapy that aims to help you avoid the thoughts and behaviours affecting your sleep.

It's usually the first treatment recommended and can help lead to long-term improvement of your sleep. Prescription sleeping tablets are usually only considered as a last resort and should be used for only a few days or weeks at a time. This is because they don't treat the cause of your insomnia and are associated with a number of side effects. They can also become less effective over time.

Read more about treating insomnia. Insomnia can be triggered by a number of possible factors, including worry and stress, underlying health conditions, and alcohol or drug use.

Some people develop insomnia after a stressful event, such as a bereavement, problems at work, or financial difficulties. The problem can continue long after the event has passed because they start to associate going to bed with being awake. This develops into an anxiety about sleep itself. Having more general worries — for example, about work, family or health — are also likely to keep you awake at night. These can cause your mind to start racing while you lie in bed, which can be made worse by also worrying about not being able to sleep.

You may struggle to get a good night's sleep if you go to bed at inconsistent times, nap during the day, or don't "wind down" before going to bed. A poor sleeping environment can also contribute to insomnia — for instance, an uncomfortable bed or a bedroom that's too bright, noisy, hot or cold.

Drinking alcohol before going to bed and taking certain recreational drugs can affect your sleep, as can stimulants such as nicotine found in cigarettes and caffeine found in tea, coffee and energy drinks. These should be avoided in the evenings.

Changes to your sleeping patterns can also contribute to insomnia — for example, because of shift work or changing time zones after a long-haul flight jet lag. Check the leaflet that comes with any medication you're taking to see if insomnia or sleeping difficulties are listed as a possible side effect.

Insomnia can often be improved by changing your daytime and bedtime habits or by improving your bedroom environment. Making small changes may help you to get a good night's sleep. Try some of the methods below for a few weeks to see if they help. Insomnia will often improve by making changes to your bedtime habits.

If these don't help, your GP may be able to recommend other treatments. If you've had insomnia for more than four weeks, your GP may recommend cognitive and behavioural treatments or suggest a short course of prescription sleeping tablets as a temporary measure.

If it's possible to identify an underlying cause of your sleeping difficulties, treating this may be enough to return your sleep to normal. Your GP will be able to advise you about what you can do at home to help you sleep. This is known as "sleep hygiene" and includes:. Read more about self-help tips for insomnia. If changing your sleeping habits doesn't help, your GP may be able to refer you for a type of cognitive behavioural therapy CBT that's specifically designed for people with insomnia CBT-I.

However, if you need to take your prescription on a set schedule, talk to your doctor before you do anything. Before we go any further, you still want to talk to your doctor if you plan on incorporating a sleep supplement.

A lot of natural sleep aids are readily available in the market, so it can be a little intimidating to figure out what works best for you. Here are some of my recommendations:. I also recommend my own formula, Sleep Doctor PM , for your short-term sleep issues. In fact, between 70 and 80 percent of patients showed improvement in their symptoms following CBT-I therapy! CBT works by helping patients cope with their anxieties and stop the cycle of negative thinking that keeps them up at night.

This awareness and self-reflection encourage personal growth and wellness as patients recover. Along with CBT, proper sleep hygiene can go a long way in helping you get the deep, restful REM sleep you need each night. This includes going to bed and waking up at the same time each day, making your bedroom an ideal sleep environment, and giving yourself plenty of time to unwind before bed.

If you need help finding accredited sleep specialists or sleep centers near you, I recommend using this tool by the American Academy of Sleep Medicine. Alternatives: If you're taking an ACE inhibitor for a cardiovascular problem, talk with your doctor or pharmacist about possibly switching to a benzothiazepine calcium channel blocker, another form of blood-pressure medication that is often better tolerated by older adults.

This is especially important for African Americans and Asian Americans, who, because of differences in their renin-angiotensin systems, have much higher incidences of adverse side effects. If your condition is accompanied by fluid retention, your doctor may consider adding a low dose of a long-acting loop diuretic, such as torsemide. Why they're prescribed: ARBs are often used to treat coronary artery disease or heart failure in patients who can't tolerate ACE inhibitors or who have type 2 diabetes or kidney disease from diabetes.

Instead of blocking the body's production of angiotensin II, ARBs prevent it from exerting its blood vessel-constricting effects. How they can cause insomnia: Like ACE inhibitors, ARBs frequently lead to potassium overload in the body, causing diarrhea as well as leg cramps and achy joints, bones and muscles — all of which can disturb normal sleep. Alternatives: As with ACE inhibitors, I'd recommend you consult with your health care provider about the advisability of switching to a benzothiazepine calcium channel blocker, which is often better tolerated by older adults.

This is especially important for African Americans and Asian Americans, who because of differences in their renin-angiotensin systems, have much higher incidences of adverse side effects. Why they're prescribed: Cholinesterase inhibitors are commonly used to treat memory loss and mental changes in individuals with Alzheimer's disease and other types of dementia. Examples: donepezil Aricept , galantamine Razadyne and rivastigmine Exelon.

The main side effects of these drugs include diarrhea, nausea and sleep disturbances. How they can cause insomnia: These drugs are thought to work by inhibiting the enzyme in the body that breaks down acetylcholine a neurotransmitter that's important for alertness, memory, thought and judgment and thus boosting the amount available to brain cells. This, in theory, slows the patient's loss of memory and helps him or her perform daily activities with fewer problems.

But blocking the breakdown of acetylcholine — which is everywhere in the body, not just in the brain — can interfere with all kinds of involuntary body processes and movements, including those related to sleep. In addition to insomnia and abnormal dreams, the identified side effects of cholinesterase inhibitors include serious changes in heart rhythm, diarrhea, nausea and vomiting as well as leg cramps and muscle spasms — all of which can interfere with normal sleep patterns.

Alternatives: It's important to remember that cholinesterase inhibitors cannot reverse Alzheimer's disease or slow the underlying destruction of nerve cells. And because the Alzheimer's-afflicted brain produces less acetycholine as the disease progresses, all medications in this class eventually lose whatever effectiveness they may be presumed to have. For these reasons, it may be worthwhile to talk with your doctor or the doctor treating your loved one about whether the adverse effects of the drug prescribed outweigh its possible benefits.

In my experience, that's nearly always the case. Why they're prescribed: H1 antagonists, which are in a class of drugs commonly known as antihistamines, inhibit the body's production of histamine — the chemical that's released when you have an allergic reaction. Elevated histamine levels cause such common allergic reaction symptoms as itching, sneezing, runny nose, watery eyes, nasal congestion and hives. Second-generation H1 antagonists, also known as nonsedating antihistamines, do not have the same side effects as first-generation antihistamines, such as diphenhydramine Benadryl , which suppress the central nervous system, causing severe drowsiness.

Examples of second-generation H1 antagonists include: azelastine Astelin nasal spray, cetirizine Zyrtec , desloratadine Clarinex , fexofenadine Allegra , levocetirizine Xyzal and loratadine Claritin.

How they can cause insomnia: In varying degrees, all H1 antagonists block acetylcholine, a nervous system neurotransmitter, and thus can cause anxiety and insomnia.

Alternatives: Since these second-generation antihistamines are typically active in the body for around eight hours, you may find that taking your daily dose in the morning may be all that's needed to resolve any sleep-related problems it may be causing. Why they're used: Glucosamine and chondroitin are dietary supplements that are used to relieve joint pain, improve joint function and lessen inflammation. Both are found naturally in the human body.

Many arthritis supplements contain glucosamine and chondroitin, both of which are regulated by the Food and Drug Administration as a food rather than a drug. How they can cause insomnia: Researchers aren't sure exactly how glucosamine and chondroitin work, but studies identify a range of gastrointestinal side effects, including nausea and diarrhea, as well as headaches and insomnia. Alternatives: While many people take glucosamine and chondroitin, alone or together, for osteoarthritis, they may not help at all.

A recent analysis of many studies of these supplements failed to find evidence that they slow joint destruction or relieve pain. A survey of Consumer Reports subscribers found that among those who identified osteoarthritis as one of their most bothersome conditions, yoga and massage were rated twice as helpful as glucosamine and chondroitin.

If you choose to use one or both of these supplements, you should be aware that glucosamine has a longer half-life the time it's active in the body than chondroitin. So if glucosamine is part of your medication regimen, taking your daily dose in the morning should prevent problems with insomnia.

You may also wish to consider asking your doctor for a prescription of tramadol 50mg tablets and taking one with an acetaminophen mg tablet two to three times a day.

This should work well to relieve pain. Why they're prescribed: Statins are used to treat high cholesterol. The top-selling statins are atorvastatin Lipitor , lovastatin Mevacor , rosuvastatin Crestor and simvastatin Zocor. How they can cause insomnia: The most common side effect of all types of statins is muscle pain, which can keep people who take them awake at night and unable to rest.

Both insomnia and sleepiness are common and transient symptoms in the first two weeks of agomelatine use 45, Lithium - A drug of first choice for all stages of bipolar disorder.

At the onset of treatment, it is subjectively associated with improvement of nighttime sleep and increased daytime sleepiness Epilepsy affects over 50 million people worldwide, with over 40 clinical syndromes already described.

Currently, strategies for treatment of this disease are only symptomatic, not curative, aiding in the suppression of clinically manifested seizures with either mono-or poly-drug therapy.

Since the s, 10 new anticonvulsants have been approved for additional treatment of partial seizures.

The mechanisms of action of anticonvulsants include sodium channel blockade on the neuronal cytoplasmic membrane level, effects on gamma-aminobutyric acid GABA action agonism of receptors and reuptake and transaminase inhibition , blockade of glutamate receptors, and other mechanisms, several of which are unknown According to controlled placebo studies, they cause mainly sedation at the begging of treatment 52, Lamotrigine, in addition to its sedative effect, can also cause insomnia Moreover, they show muscarinic anticholinergic effects, central alpha-adrenergic action, and serotonergic effects.

They cause sedative effects significant enough that they are indicated as hypnotics by some professionals off-label. Therefore, they exert little effect on the central nervous system.

A meta-analysis of 18 studies 58 concluded that second-generation antihistamines cause much less sedative effects than the first-generation antihistamines, although mild sedation has been detected. Among the second-generation drugs, cetirizine is cited as showing a greater subjective sedative effect.

However, these drugs can interact with other classes of drugs that have sedative effects carbamazepine and benzodiazepines or insomnia effects theophylline and beta-blockers , increasing their levels and adverse effects.

Pseudoephedrine is often used in association with analgesics or antihistamines, indicated as nasal decongestants in rhinitis, and over-the-counter in cold medication. The major sleep disorder reported with the use of pseudoephedrine is insomnia Several studies and subjective reports describe an increased incidence of insomnia with the use of these stimulants; cognitive functions may improve as an effect of these drugs Antipsychotics - The antipsychotics classically act by antagonizing dopamine D2 receptors in the mesolimbic system In addition to blocking dopamine D2 receptors, they antagonize the serotonin receptors especially 5-HT2A Antipsychotics, formerly called neuroleptics or major tranquillizers 63 , effect some blockade of alpha-adrenergic, muscarinic cholinergic, and histamine receptors, which gives them a sedative property to a greater or lesser degree, depending on the action at these sites Among the classical drugs, chlorpromazine and thioridazine are more sedative than haloperidol.

Aripiprazole is the one that shows the least sedation. Insomnia may be caused by typical and atypical antipsychotics. This symptom is attributed to their ability to act as agonists of serotonergic 5-HT1A receptor or to the restless legs syndrome caused by dopamine blockade, even with the use of atypical antipsychotics Anxiolytic drugs - Several medications are currently used to treat anxiety disorders.

Antidepressants that inhibit serotonin and norepinephrine duloxetine, venlafaxine, and desvenlafaxine , the SSRIs, the benzodiazepines, and buspirone partial 5-HT1A receptor agonist are considered drugs of first choice in the treatment of anxiety disorders Antiepileptic drugs and atypical antipsychotics can also be indicated for use in anxiety. However, buspirone has the great advantage of not causing addiction or sedation; however, it can cause insomnia as an undesirable symptom 68, These complaints tend to worsen with progression of the disease and may result from abnormalities in the sleep-wake cycle, nocturnal motor symptoms, other drugs in use, or even other disorders: sleep apnea, periodic limb movements, or comorbid or psychiatric diseases.

Dopamine replacement is a priority in this disease. Interestingly, this compound has been listed as a better therapeutic option in the treatment of attention deficit-hyperactivity disorder, with similar results and lower rates of side effects than stimulants commonly used in this condition Higher doses of dopaminergic drugs are more likely to be associated with the sedative effect Sudden sleep attacks, which can cause traffic accidents, are also described.

Such attacks, which may occur without previous symptoms, are observed with the use of any dopaminergic agent, but less frequently with levodopa alone In recent years, drugs inhibiting the enzyme that degrades acetylcholine in the synaptic cleft acetylcholinesterase have been developed, enabling a more effective treatment of these patients. The others are indicated for use only in the mild to moderate stages. Donepezil is the only one with the potential to alter sleep and can be administered in the morning or evening.

Donepezil is recommended for use only in the morning in case of insomnia or nightmare Many drugs used in the treatment of chronic diseases have the ability to cause sedation or insomnia as adverse effects.

Drugs with higher fat-solubility more easily traverse the blood-brain barrier. Any drug with activity in the central nervous system has the potential to affect the sleep-wake cycle; preserving the quality and operation of this cycle can be important for successful treatment of the underlying disease. Anderson G, Hovath J. Schweitzer PK. Drugs that Disturb Sleep and Wakefulness.

Principles and Practices of Sleep Medicine. Louis, MO: Elsevier Saunders. Labetalol and Other Agents that block both alpha and beta-adrenergic receptors. Cleverland Clin J Med. Tufik S. Medicamentos e Sono. In: Tufik S. Medicina e biologia do sono. Rev Bras Hipertens. New York: McGrawHill. Prazosin for treatment of nightmares related to posttraumatic stress disorder.

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