Hope2SleepGuide

Sleep Apnoea Forum Bringing Help + Support to the Patient

A number of drugs disrupt sleep, while others can cause daytime drowsiness. Your clinician may be able to suggest alternatives.

Medication

Used to treat

Examples

Possible effects on sleep/daytime function

Anti-arrhythmics

Heart rhythm problems

procainamide (Procanbid), quinidine (Cardioquin), disopyramide (Norpace)

Nighttime sleep difficulties, daytime fatigue

Beta blockers

High blood pressure, heart rhythm problems, angina

atenolol (Tenormin), metoprolol (Lopressor), propranolol (Inderal)

Insomnia, nighttime awakenings, nightmares

Clonidine

High blood pressure; sometimes prescribed off-label for alcohol withdrawal or smoking cessation

clonidine (Catapres)

Daytime drowsiness and fatigue, disrupted REM sleep; less commonly, restlessness, early morning awakening, nightmares

Corticosteroids

Inflammation, asthma

prednisone (Sterapred, others)

Daytime jitters, insomnia

Diuretics

High blood pressure

chlorothiazide (Diuril), chlorthalidone (Hygroton), hydrochlorothiazide (Esidrix, HydroDIURIL, others)

Increased nighttime urination, painful calf cramps during sleep

Medications containing alcohol

Cough, cold, and flu

Coricidin HBP, Nyquil Cough, Theraflu Warming Relief

Suppressed REM sleep, disrupted nighttime sleep

Medications containing caffeine

Decreased alertness

NoDoz, Vivarin, Caffedrine

Wakefulness that may last up to six to seven hours

Headaches and other pain

Anacin, Excedrin, Midol

Nicotine replacement products

Smoking

nicotine patches (Nicoderm), gum (Nicorette), nasal spray or inhalers (Nicotrol), and lozenges (Commit)

Insomnia, disturbing dreams

Sedating antihistamines*

Cold and allergy symptoms

diphenhydramine (Benadryl), chlorpheniramine (Chlor-Trimeton)

Drowsiness

Motion sickness

dimenhydrinate (Dramamine)

Selective serotonin reuptake inhibitors (SSRIs)

Depression, anxiety

fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil)

Decreased REM sleep, daytime fatigue

Sympathomimetic stimulants

Attention deficit disorder

dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), methylphenidate (Ritalin)

Difficulty falling asleep, decreased REM and non-REM deep sleep

Theophylline

Asthma

theophylline (Slo-bid, Theo-Dur, others)

Wakefulness similar to that caused by caffeine

Thyroid hormone

Hypothyroidism

levothyroxine (Levoxyl, Synthroid, others)

Sleeping difficulties (at higher doses)

*These medications are also found in over-the-counter sleep aids.

Taken from Harvard Medical School http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Wat...

Drug-Induced Sleep Disorders / Sleep Disturbances

There is a multitude of drugs the side effects of which can affect sleep by stimulating or aggravating sleep disorders. Drugs may suppress rapid eye movement (REM) sleep, affect slow-wave sleep (SWS), or cause insomnia, parasomnias, nightmares, excessive sleep, difficulty falling asleep, early-morning awakening, and periodic awakenings. These common sleep disorders and disturbances may be symptoms of, or result in secondary conditions that can prove severely consequential to one's health.

Many drugs suppress REM sleep. Withdrawal of these drugs often result in REM rebound nightmares, which will be discussed further. While the drugs are being taken, the severity of sleep apnea, a temporary suspension of breathing occurring repeatedly during sleep, may be underestimated. Alcohol, anesthetics, and opioid analgesics tend to worsen sleep apnea while thyroxine, progesterone, nicotine, theophylline, and antidepressants have been known to improve nighttime breathing patterns.

Suppression of REM sleep is frequently seen with opioid analgesics, long-term antihypertensives, beta-blockers like pindolol and propranolol, stimulants of alpha adrenoreceptors like guanfacine  and clonidine, serotonin stimulators like ketanserin and ritanserin, and methyldopa (Aldomet). In fact, most antidepressants suppress REM sleep, and may also cause insomnia and increase the likelihood of experiencing some parasomnias.

But while most antidepressant drugs cause sleep disturbances, some drugs such as the now rarely used antihypertensive drug reserpine can actually cause depression. There is a complex relationship between sleep and depression. Symptoms of depression often include sleep disturbances such as periodic awakenings, difficulty falling asleep, and early-morning awakening.

Common sleep abnormalities observed in those with depression include the early onset of the first REM period (although not as early as that in narcolepsy, which is characterized by brief attacks of deep sleep, sometimes with cataplexy and hypnagogic hallucinations), increased duration of REM sleep, and a reversal of the occurrence of slow wave sleep (SWS) between the first and second periods of sleep.

SWS suppression, such as seen with use of corticosteroids, leaves a patient “unrested” after sleeping, and may induce insomnia. SWS suppression may be counteracted with medications such as zopiclone. Sleepwalking, a parasomniac behavior to be discussed further, usually occurs during SWS, and may be induced by drugs that increase this state of sleep.

Insomnia may be induced by both REM sleep and SWS suppression. It may be caused by drugs with central stimulant effects like methoxyphenamine and ephedrine, appetite-suppressing drugs, and possibly sympathomimetic vasodilators like phenylpropanolamine and pseudoephedrine, which is commonly included in over-the-counter cold medications.

Parasomnias are sleep behaviors that include sleepwalking, sleep talking, sleep starts, sleep terrors, REM behavior disorders, teeth grinding, bedwetting, and “confusional awakenings”. Tricyclic antidepressants and triazolam (Halcion) increase the likelihood of some parasomnias by suppressing REM sleep.

Sleepwalking occurs in about three percent of adults and possibly in over 15 percent of healthy children. Drugs that may induce sleepwalking by increasing the SWS state include lithium, amitriptyline (Elavil), and thioridazine (Mellaril).

Nightmares are reported to occur at least occasionally by 40 to 50 percent of adults. Nightmares are associated with REM sleep and occur primarily in the second half of the sleep period. Some beta-blockers, such as propranodol (Inderal), can predispose a patient to experiencing nightmares. Clomipramine (Anafranil), on the other hand, may suppress REM related nightmares.

Excessive daytime sleepiness can be caused by sedatives as well as by stimulants that disrupt sleep and cause sleep deprivation. Stimulants that can disrupt nighttime sleep include the anti-asthmatic drug theophylline, sympathomimetic bronchodilators such as ephedrine, and even caffeine. The effects of commonly prescribed sleeping medications, such as flurazepam (Dalmane) and antihistamines such as diphenhydramine (Benadryl) can persist beyond the normal period of sleep. Other drugs with similar effects include beta-blockers and prochlorperazine (Compazine), a dopamine-blocking drug used for nausea.

Anticancer chemotherapy, antiasthmatic, and  antiparkinson medications can also cause sleep disturbances. In the case of chemotherapy drugs, daytime sleepiness and fatigue are only a couple of the numerous side effects a patient faces. The other side effects, such as depression, gastrointestinal distress, and muscle and joint pain contribute to sleep disruptions, not to mention the primary pain of the cancer itself.

Most antiasthmatic drugs are known to alter sleep, but in varied ways. And since they are often used in combination with other drugs, the net effect is difficult to predict or understand. Asthmatics also suffer from symptoms and secondary conditions that affect sleep. One of these symptoms, gastroesophageal reflux, can also be aggravated by the antiasthmatic drug theophylline. Conversely, at least one antiasthmatic drug, salmeterol, a beta-adrenergic stimulator, has been shown to improve the quality of sleep.

Patients with Parkinson's Disease complain frequently with regard to sleep disturbances. 74–96 percent of those who suffer from Parkinson's report some kind of sleep disturbance, and sleep disorders associated with the disease vary greatly. And although antiparkinson’s medications are known to cause sleep disturbances, the mechanism behind this is not understood. Antiparkinson medications include levodopa (Sinemet), direct stimulators of dopamine receptors such as pergolide (Permax) and bromocriptine, drugs that inhibit the breakdown of dopamine like seligiline (Eldepryl), dopamine releasing agents like amantidine (Symmetrel), and drugs that block receptors for acetylcholine like benztropine (Cogentin) and trihexyphenidyl (Artane).

Taken from 'Diseases & Conditions' http://www.diseasesandconditions.net/sleep_disorders.html

Views: 336

Add a Comment

You need to be a member of Hope2SleepGuide to add comments!

Join Hope2SleepGuide

Sleep Apnoea Forum

New to the Sleep Apnoea Forum? 

1. Stop by our Sleep Apnoea Welcome Center to introduce yourself to the SleepGuide community.
2. Start a New Topic of Conversation.
3. Post your photos - of yourself, your old CPAP machine, your new CPAP machine, your pet, something about you!

Interested in advertising, have a problem or need to contact us? Click the Report an Issue page.

 

Latest Activity

Bill Thomson added a discussion to the group Buy-Sell-Swap
Thumbnail

ResMed DC-DC converter for S9

I have for sale a converter which allows the S9 machine, which requires a 24v supply, to run from a vehicle 12v or 24v DC socket, or direct from a 12v battery. The converter can power a humidifier and heated tube as well as the CPAP machine,…See More
Saturday
Bill Thomson joined The SleepGuide Crew's group
Saturday
Sleep2snore replied to Chris Vesey's discussion Cure for wind
"It would depend if there was a smell or not "
Oct 9
Sleep2snore replied to Edam's discussion Double inhaling
"I'll be interested to know what you have found.  Give it time so you can prove what is happening. I had my machine pulse at full pressure for the second time when it was switched on, turning it off then on again a couple of times with a…"
Oct 9
Mark bowerman is now a member of Hope2SleepGuide
Oct 9
Renee Rowlands posted a discussion

Recommendation please for Oximeter purchase.

Hello everyone!I would very much like to check my oxygen levels during the night.  Can anyone recommend an Oximeter to purchase please?My mask is a F&P Brevida which has soft straps and one of the straps slips up my head during the night, making…See More
Oct 7
Kyla Davies replied to Kyla Davies's discussion Soclean machine in the group Buy-Sell-Swap
"Thanks Kath, edited with price. "
Oct 5
Kath Hope replied to Kyla Davies's discussion Soclean machine in the group Buy-Sell-Swap
"Oh what a shame Kyla.  We are all so different with our sensitivies to smells, as I love the clean smell after using mine.  I'd advise you edit this with the price you're looking for, to save lots of messages agreeing and…"
Oct 5
Kyla Davies added a discussion to the group Buy-Sell-Swap
Thumbnail

Soclean machine

SOLD!! !  I am selling my soclean machine. It is a fantastic machine and does the job, however I am struggling with the "ozone" smell it turns my stomach. I only purchased it on 18/09/18 so only had a couple of weeks use. I purchased it with an…See More
Oct 5
Edam replied to Edam's discussion Double inhaling
"I believe I have found a reason for the pressure going up to 20 and staying there. Its early days yet and I need to find the best fix"
Sep 27
Chris Vesey replied to Chris Vesey's discussion Cure for wind
"I could always go on the stage, le petomaine made a living I believe"
Sep 26
Edam replied to Edam's discussion Double inhaling
"If the top limit is unrestricted then it will go up to 20 for up to 5 hours a night.  The hospital say that I need this pressure as my Apnea is getting worse but my AHI is nearly always under 1"
Sep 20
Sleep2snore replied to Chris Vesey's discussion Cure for wind
"It is very common for people to get wind in there stomach using CPAP/APAP.  As Kath say, at the start it can be quite bad for some people, others are not bothered.  In fact the ResMed is less likely to give you this problem, but saying…"
Sep 19
Sleep2snore replied to Edam's discussion Double inhaling
"Your machine should not go higher unless you need more pressure. The machine I have was set at 10 to 20 when I got it and it has never ventured above 12.9. I have a ResMed 10Auto which I found to be a little better than the Dreamstation.  I…"
Sep 19
Edam replied to Edam's discussion Double inhaling
"I trialled the Sleepweaver before it came out, I believe I still have it somewhere, but I could not get on with it then. I used a liner on the Dreamwear last night but still was too painful to use and had to change masks during the early hours..…"
Sep 19
Edam replied to Edam's discussion Double inhaling
Sep 19
Kath Hope replied to Chris Vesey's discussion Cure for wind
"This is a common problem Sally, and especially when new to CPAP, irrespective of whatever machines people use.  It's definitely not just an Airsense 10 problem. If you've not clicked on the link I posted above in my reply to Chris…"
Sep 17
Sally Gray replied to Chris Vesey's discussion Cure for wind
"Hi, it’s interesting to read Chris’s comment that the AirSense 10 has given him flatulence whereas his previous CPAP wasn’t a problem.  I’m new to using a CPAP and have been provided with an AirSense 10 which I’m…"
Sep 17
Kath Hope replied to Bob Blair's discussion So Clean sanitiser
"I'm not aware of finance, and we at the Hope2Sleep Charity certainly couldn't offer this unfortunately.  However, if you have a Paypal account then you can apply for Paypal Credit which is offered for products over £150 I…"
Sep 16
Kyla Davies replied to Bob Blair's discussion So Clean sanitiser
"Hi Kath In relation to the Soclean do you know if any finance is available to purchase one of these machines? I do not mind spending that amount on one but would be very helpful especially this time of year to purchase one on a finance…"
Sep 16

© 2018   Created by The SleepGuide Crew.   Powered by

Badges  |  Report an Issue  |  Terms of Service