7 Medications to Avoid For Better Sleep

By Libby Pellegrini MMS, PA-C

March 30, 2021

Medications Cause Bad Sleep

Nothing is more agonizing than ending a long day by staring at the ceiling of your bedroom, unable to fall asleep. If you are struggling to flip the switch at night, consider your medicine cabinet. Some medications should not be taken at night because they can make it hard to fall or difficult to stay asleep.

Read on to learn more about how avoiding these seven types of medications at bedtime may improve your nightly rest.

1. Beta-Blockers

Beta-blockers are cardiovascular medications used to control heart rate and blood pressure. Physicians also use them to treat headaches, tremors, and anxiety. However, studies have shown that beta-blockers may change sleep patterns and trigger insomnia and nightmares. Researchers believe that beta-blockers disturb sleep because they reduce the release of melatonin, a pro-sleep hormone. If your medical provider has prescribed you a beta-blocker, make sure to discuss the best time of day to take your medication to avoid the possibility of sleeplessness.

2. Diuretics

Diuretics are medications that help the kidneys filter more water and salt out of the body. This filtering, which results in increased urine production, can help with cardiovascular conditions like high blood pressure and heart failure. Depending on the dose and strength of the medication, diuretics can cause sleep problems due to their tendency to cause more frequent nighttime urination. Make sure to talk with your medical provider about the ideal time of day to take your diuretic medication.

3. Selective Serotonin Reuptake Inhibitors (SSRIs)

SSRIs are medications used to treat depression and anxiety disorders. SSRIs increase the usable supply of the serotonin neurotransmitter within the brain. However, all SSRIs are known to cause a degree of insomnia or agitation (some are more notorious than others). For this reason, clinicians generally advise their patients to take their SSRIs in the morning instead of before bedtime.

4. Stimulants

Stimulant medications, such as Adderall or Ritalin, are used to manage conditions such as attention-deficit/hyperactivity disorder (ADHD) and narcolepsy. Research has shown that stimulants can disrupt the sleep-wake cycle, making it more difficult to fall asleep and stay asleep for long periods. You should take stimulants in the morning or before activities during which their effects will be most needed — not right before bed. Similarly, medications used for wakefulness, such as Modafinil, should not be taken before bed because they intentionally cause insomnia.

5. Laxatives

If you struggle with occasional constipation and are considering taking a laxative, make sure you understand how quickly the medication will take action. Some laxative medications, such as Miralax, are gentle and slow-acting, triggering a bowel movement within one to three days. However, other stimulant laxatives (such as oral or suppository forms of bisacodyl) trigger a bowel movement within a few hours of their ingestion or a few minutes of placement. Taking a stimulant laxative before bed is a recipe for sleeplessness because they irritate the lining of the intestine, cause discomfort, and stimulate gas production and stool elimination.

6. Corticosteroids

Corticosteroids are medications used for a wide range of inflammatory conditions, including asthma, allergies, and arthritis. Types of corticosteroids include prednisone (Deltasone, Cortef) and prednisolone. These medications can negatively impact the sleep cycle, causing restlessness and insomnia. For some people, taking a corticosteroid may be akin to drinking a shot of espresso. If prescribed a corticosteroid (often referred to colloquially as a steroid) for a medical condition, talk to your medical provider about whether you may be able to take this medicine during the day instead of at night.

7. Cold Medications

If you are reaching for a cold medication at bedtime, make sure to check the label. Some formulations have ingredients that may make it hard to sleep. These ingredients include pseudoephedrine and phenylephrine, both of which have activating properties. Additionally, some cold medications include diphenhydramine (Benadryl) for its sedating effect, but people with certain genes may experience a paradoxical effect of excitation after taking diphenhydramine. Talk to your medical provider about what treatment options are best if you suffer from an upper respiratory infection.

How to Get Better Sleep

It can be daunting to sort through your medications and decipher how to take them most strategically to avoid sleeplessness. Consider discussing with your medical provider how to best organize your daily prescriptions into a pillbox, and what steps you can take to improve your sleep hygiene. You may also want to sign up for My Medicine Chest, which has free tools that can help you simplify your pill regimen.

Libby Pellegrini is a nationally certified physician assistant. She has worked in numerous healthcare settings, including the rural United States, an inner-city Level I trauma center, several suburban acute care centers, and a boutique, personalized medicine clinic in Southeast Asia. She graduated Magna Cum Laude from Northwestern University’s Medill School of Journalism.

References:

https://link.springer.com/article/10.2165/00002018-199716020-00005

https://www.wellrx.com/diphenhydramine%20hcl/drug-interactions/

https://pubmed.ncbi.nlm.nih.gov/10335905/

https://medlineplus.gov/druginfo/meds/a682858.html

https://www.uptodate.com/contents/selective-serotonin-reuptake-inhibitors-pharmacology-administration-and-side-effects?search=ssri&source=searchresult&selectedTitle=2~136&usagetype=default&display_rank=1#H399779851

https://www.wellrx.com/prescriptions/adderall/

https://www.wellrx.com/prescriptions/ritalin/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3441938/

https://www.wellrx.com/prescriptions/modafinil/

https://www.wellrx.com/MIRALAX/drug-information/

https://www.wellrx.com/bisacodyl/drug-information/

https://www.wellrx.com/prednisone/coupon/

https://pubmed.ncbi.nlm.nih.gov/24347992/

https://www.wellrx.com/SUDAFED/lifestyle-interactions/

https://www.wellrx.com/phenylephrine%20hcl-d5w/coupon/

https://www.wellrx.com/diphenhydramine%20hcl/drug-interactions/

https://pubmed.ncbi.nlm.nih.gov/18227744/#:~:text=We%20describe%20three%20CYP2D6%20UMs,at%20higher%20risk%20for%20excitation

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