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: 298

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

Paul Hepworth is now a member of Hope2SleepGuide
5 hours ago
Kevin Pigott added a discussion to the group Buy-Sell-Swap
Thumbnail

Selling ResMed Power Station II

I am selling a virtually new ResMed Power Station II.It is a battery pack which I purchased directly from ResMed to use on a trek in Nepal when mains electricity was unavailable.  It was used for only six nights and is virtually new.The battery pack…See More
yesterday
Kevin Pigott joined The SleepGuide Crew's group
yesterday
Ellen Phillips is now a member of Hope2SleepGuide
Apr 18
Mathura Dutt Kalauny replied to Mathura Dutt Kalauny's discussion Pressure difference between Resmed S8 Vs Breas Z1
"Yes, it is. It is also less cumbersome due to its small size. Thanks."
Apr 18
Sleep2snore replied to Dave Cheeseman's discussion New diagnosis!
"If you do buy one make sure you get a good one and ask if they will look after it if you do buy one. Some clinics will supply filters and check it every year after the warranty is out.  They might even repair and give you a loan machine. …"
Apr 17
Sleep2snore replied to Ruth Furniss's discussion New to cpap
"It is quite normal, some feel it interrupts sleep due to using the machine and mask, turning over can disturb you with the mask moving and leaks.  Give it a month or two and you should start to feel a lot better.  If not contact your Sleep…"
Apr 17
Sleep2snore replied to Mathura Dutt Kalauny's discussion Pressure difference between Resmed S8 Vs Breas Z1
"It may be just responding a bit quicker or just suits you better. It amazes me that anything so small can produce enough pressure to work in the first place. I wouldn't worry about unless you start to feel it is not keeping you feeling…"
Apr 17
Kath Hope replied to Mathura Dutt Kalauny's discussion Pressure difference between Resmed S8 Vs Breas Z1
"You're welcome Mathura"
Apr 16
Mathura Dutt Kalauny replied to Mathura Dutt Kalauny's discussion Pressure difference between Resmed S8 Vs Breas Z1
"Hi Kath Thank you very much for your response.  No I am not travelling. There is a significant difference in pressure in the two machines. That was the cause of my worry. Thank you again for allaying it. Regards"
Apr 16
Kath Hope replied to Mathura Dutt Kalauny's discussion Pressure difference between Resmed S8 Vs Breas Z1
"Hi Mathura and welcome to our forum.  With good results like that it shouldn't cause a concern, as it could just be that the Z1 algorithm suits you better.  Just like with masks suiting people better, so can machines, but mostly…"
Apr 15
Mathura Dutt Kalauny posted a discussion

Pressure difference between Resmed S8 Vs Breas Z1

I have been using RESMED in auto mode. The pressure used to settle around 11cmWG with AHI between 2 and 4. I have recently switched over BREAS Z1 in auto mode. The pressure has now changed to around 5.5 cmWG with AHI remaining below 5. What would be…See More
Apr 15
Profile IconMathura Dutt Kalauny and callum blackley joined Hope2SleepGuide
Apr 14
Kath Hope replied to Savannah A.'s discussion Sleep Centre in UK that measures UARS
"Great to hear you're having an in-patient sleep study Savannah.  You may not need to investigate UARS either, because if a simple study (probably pulse oximetry) has picked up an issue that warrants an in-patient study, then it's…"
Apr 13
Kath Hope posted a discussion

Philips Respironics New Sleep Apnoea Diagnostic Service

If you snore and are tired, you could be suffering from sleep apnoea (see signs + symptoms on our website)…See More
Apr 8
Kath Hope replied to Ruth Furniss's discussion New to cpap
"Sometimes the tiredness can feel worse Ruth if you're having some interrupted sleep when new to CPAP.  I definitely felt like that.  Although I'd been diagnosed with severe sleep apnoea I slept through it all, whereas when I was…"
Apr 8
Ruth Furniss posted a discussion

New to cpap

Hi I'm new to cpap nearly 2 weeks into therapy and feel really tired has anybody felt like this? Or is it normal to feel like this when new to cpap? See More
Apr 8
Ruth Furniss is now a member of Hope2SleepGuide
Apr 7
Savannah A. replied to Savannah A.'s discussion Sleep Centre in UK that measures UARS
"Dear Sleep2snore, thanks for your reply and apologies for my late response. In the case that UARS is detected, may I enquire what you mean regarding a more complex machine? Are you referring to BiPAP machines? Many thanks!"
Apr 4
Savannah A. replied to Savannah A.'s discussion Sleep Centre in UK that measures UARS
"Dear Kath, many thanks for your reply and the link to the page; apologise my late response. I have recently had a simple sleep study done at home, and am awaiting a more comprehensive inpatient sleep study. I will ask whether Esophageal…"
Apr 4

© 2018   Created by The SleepGuide Crew.   Powered by

Badges  |  Report an Issue  |  Terms of Service