10 Common Medications That Can Affect Sleep

Just as our bodies and minds change throughout life, so does our ability to get the recommended seven-plus hours of good, quality sleep each night. In fact, it’s estimated that 40 to 70 percent of older adults routinely experience sleep problems, like difficulty falling asleep or staying asleep.

Insufficient sleep doesn’t just wreck your mind and mood the next day; it’s a symptom of a number of chronic health conditions, including type 2 diabetes, cardiovascular disease, obesity and depression. What’s more, lack of sleep can increase your risk of accidents and falls.

Poor sleep can be traced back to a number of causes, from stress to screen time to health-related issues like heartburn. Commonly used prescription and over-the-counter medications can also contribute.

What are non-REM parasomnias?

Non-rapid eye movement (non-REM) parasomnias are actions you do during the early stages of sleep. Though you’re not awake and may not remember them, they can disrupt your sleep. Non-REM parasomnias include sleepwalking, sleep talking, sleep eating, confusional arousals (waking up disoriented and confused) and night terrors (awakening in a frightened state).

A number of medications can cause these sleep-related disorders, including anti-anxiety drugs like benzodiazepines, certain antidepressants, high blood pressure medicines, antipsychotic drugs, anti-seizure medications, and asthma or allergy medicines.

REM sleep behavior disorder and drugs that cause it

REM sleep behavior disorder (RBD) is a parasomnia where you act out your dreams during the REM stage of sleep. This includes talking, yelling, kicking, punching or even jumping out of bed in response to what’s happening in your dream.

“Anything that alters sleep architecture [normal sleep patterns] can cause muscle-related sleep disruptions, or acting out dreams,” says Alex Dimitriu, M.D., who is double board-certified in psychiatry and sleep medicine and the founder of Menlo Park Psychiatry & Sleep Medicine in Menlo Park, California. “Common substances include alcohol, certain antidepressants, sedatives like zolpidem [Ambien] or eszopiclone [Lunesta], and [the beta-blocker] metoprolol [Lopressor].” Antidepressants may cause REM sleep behavior disorder by altering levels of the brain chemicals dopamine and serotonin, which play a role in REM sleep.

Here are 10 sleep-disrupting drugs commonly used by older adults.

1. Cold and allergy decongestants

Class of medications: alpha-agonists; decongestants commonly used for runny nose and nasal congestion

Common names: phenylephrine (Sudafed PE), pseudoephedrine (Sudafed) and various other combinations. Always check the active ingredients on the product’s label.

How they affect sleep: These drugs increase heart rate and heart muscle contractions, which can stir up heart palpitations, anxiety, blood pressure and excitability that prevents sleep or deep sleep. 

What to do: Because these medications can affect the heart, check with your doctor or pharmacist before reaching for one — an alternative such as a steroid nasal spray may be recommended. If you get the OK from your health care provider and then find you need a decongestant for more than seven days, or if your symptoms are worsening during use, contact your doctor to make sure there’s not another issue causing your symptoms, like an infection.

To read about other medications that can cause sleep disturbances, from AARP, CLICK HERE.