If you have been feeling restless lately and unable to get a good night’s sleep, it could be a side effect of one of the medications you are taking. Certain medications are known to disrupt normal sleep patterns and affect sleep. Please continue reading to find out which medications that can cause insomnia and restlessness.

Can medicine cause restlessness?

Yes, several medications, including prescription drugs, over-the-counter medicines, and dietary supplements, which are used to treat various medical conditions, can cause side effects such as restlessness and sleep problems, including insomnia (trouble falling asleep and staying asleep).

Medications that cause insomnia and sleepless nights do so through different mechanisms. For example, some medications interfere with sleep directly by affecting REM (rapid eye movement) sleep, a phase of deep sleep when vivid dreams occur; REM sleep is important for healthy brain development, learning, and memory. Other medicines cause nighttime awakenings by increasing urinary frequency. Some medicines increase the levels of the hormone adrenaline or cortisol (made by the adrenal glands in the body), preventing you from relaxing and sleeping well. Yet others cause cough, leg cramps, or achy muscles as side effects, which can keep you awake at night.

What drugs cause restless sleep?

Alpha blockers

Examples: Doxazosin (Cardura), terazosin (Hytrin), alfuzosin (Uroxatral), silodosin (Rapaflo), tamsulosin (Flomax), and prazosin (Minipress)

Prescribed for: High blood pressure and prostate conditions

Side effects: Decreased deep REM sleep and increased daytime sleepiness

Steroid medicines

Examples: Prednisone, methylprednisolone, cortisone, and triamcinolone

Prescribed for: Inflammatory conditions such as allergic reactions, asthma, inflammatory bowel diseases, and arthritis

Side effects: Jitteriness and disturbed sleep

Asthma medications

Examples: Theophylline, albuterol

Prescribed for: Asthma medication. Also used to treat COPD (chronic obstructive pulmonary disease).

Side effects: Asthma drugs like theophylline and the rescue inhaler albuterol can cause frequent nighttime awakenings and other sleep problems.

What medication keeps you awake?

Selective serotonin reuptake inhibitors (SSRIs)

Examples: Fluoxetine (Prozac), citalopram (Celexa), escitalopram (Lexapro), paroxetine (Paxil), fluvoxamine (Luvox), and sertraline (Zoloft)

Prescribed for: Major depressive disorder (MDD) and other mental health conditions

Side effects: Sleep disturbances, finding it difficult to fall asleep and stay asleep

Stimulant medications

Examples: Methylphenidate (Ritalin, Concerta), dextroamphetamine (Dexedrine Spansule), mixed amphetamine and dextroamphetamine (Adderall)

Prescribed for: Attention deficit hyperactivity disorder (ADHD), narcolepsy

Side effects: ADHD medications can cause insomnia, delayed sleep onset (difficulty falling asleep), and disturbances in circadian rhythm (sleep-wake cycle).

Nicotine replacement treatments

Examples: Nicotine patch, gum, nasal spray, and lozenge

Prescribed for: Nicotine replacement therapy (NRT) is an effective method to help quit smoking.

Side effects: Unusual dreams, sleep problems (more common with the 24-hour patch), and trouble sleeping. Certain nicotine replacement products can cause nasal congestion, which leads to difficulty falling asleep.

Dopamine agonists

Examples: Ropinirole (Requip), pramipexole, apomorphine, and rotigotine

Prescribed for: Parkinson’s disease and restless leg syndrome (RLS)

Side effects: Higher doses of these drugs are known to cause somnolence and sleep attacks, causing people to fall asleep during the day. This can lead to reduced deep REM sleep, increased wakefulness, and insomnia.

Allergy Medications with Allergy medications

Examples: Pseudoephedrine (Sudafed), phenylephrine (Sudafed PE)

Prescribed for: Sinus pressure and nasal congestion due to seasonal allergies

Side effects: Allergy medications that contain a decongestant, such as pseudoephedrine can cause sleep disturbance. In fact, insomnia is one of the most common side effects of oral decongestants.

Which blood pressure medications cause insomnia?

Some of the common medications prescribed to treat high blood pressure that can cause insomnia include:

Beta blockers

Examples: Propranolol (Inderal), atenolol (Tenormin), metoprolol (Lopressor, Toprol), carvedilol (Coreg), timolol (Timoptic), and sotalol (Betapace)

Prescribed for: Blood pressure medication. Also used to treat arrhythmias, congestive heart failure, chest pain, tremors, migraine, and glaucoma (increased pressure in the eye)

Side effects: Unusual dreams, insomnia, sleep disorders, nightmares, decreased REM sleep, increased awakenings at night, difficulty falling back asleep, and daytime sleepiness

Angiotensin converting enzyme (ACE) inhibitors

Examples: Enalapril (Vasotec), lisinopril (Prinivil, Zestril), captopril (Capoten), benazepril (Lotensin), fosinopril (Monopril), moexipril (Univasc), quinapril (Accupril), perindopril (Aceon), trandolapril (Mavik), and ramipril (Altace)

Prescribed for: To lower blood pressure and treat other heart conditions

Side effects: Dry, hacking cough and leg cramps, which can lead to sleep disturbances

Angiotensin II receptor blockers (ARBs)

Examples: Losartan (Cozaar), valsartan (Diovan), irbesartan (Avapro), candesartan (Atacand), and telmisartan (Micardis)

Prescribed for: To treat hypertension

Side effects: Increased potassium levels, which can cause muscle pain, joint pain, and leg cramps, resulting in sleep disruptions and changes in sleep patterns

Wrapping up

These are just some of the drugs commonly associated with sleep issues. Many other medications can cause insomnia. Also, keep in mind that many health conditions can cause sleep problems. For example, dopamine agonists used to treat Parkinson’s disease are known to cause sleep problems; however, people with Parksinson’s disease often suffer from depression, which is a significant contributing factor to insomnia.

If you suspect a prescription medication is causing insomnia, restlessness, or other sleep disturbances, discuss alternative treatments for your health problems with your doctor. Your provider may offer other medications for your health conditions or change your medication regimen to enable you to get a better night’s sleep.

For example, lowering the dose of a medicine or switching to a different medication from the same class may reduce sleep-related side effects, treat insomnia, and allow you to get restful sleep.

If this does not work, you may need a referral to a sleep medicine specialist to get to the bottom of what is causing your sleep problems.

References:

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