TrySleep Elixir Mix
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 prevent sleep or deep sleep. Although less likely than oral decongestants to make you feel jittery, decongestant nasal sprays like oxymetazoline (Afrin) can do so too, keeping you awake. But other types of nasal sprays, including steroid sprays (Flunose, Nasonex), have not been linked to sleep problems in clinical trials.
2. Asthma medications
Class of medications: short-acting beta-2 agonists (bronchodilators), commonly called “rescue” medications or inhalers for quick symptom relief
Common names: albuterol (Proventil HFA, ProAir, Ventolin HFA), levalbuterol (Xopenex), albuterol/ipratropium (Duoneb, Combivent)
How they affect sleep: Although many people with asthma have trouble sleeping, drug manufacturer data shows that only 1 to 3.1 percent of the users of these medications reported insomnia linked to these drugs. But other side effects — such as excitability, headache, heart palpitations and tremors — may be the bigger culprits for the sleep troubles these medications can cause, especially with frequent use.
3. Blood pressure medications
Class of medications and common names:
- Angiotensin-converting enzyme (ACE) inhibitors: benazepril (Lotensin), enalapril (Vasotec, Epaned), lisinopril (Prinivil,
- Beta-blockers: Propranolol (Inderal, InnoPranXL)), nadolol (CorGard), labetalol (Normodyne, Trandate), metoprolol (Lopressor, Toprol XL), sotalol (Betapace, Sorine, Sotylize) and carvedilol (Coreg) are all associated with sleep disturbances.
How they affect sleep:
- Beta-blockers can interfere with sleep by lowering your natural melatonin level, suppressing REM sleep and triggering vivid nightmares. In fact, a 2025 analysis in the Journal of Psychiatric Research found that beta-blocker use is linked to a 29 percent higher risk of sleep disturbances and poor sleep quality. Some of these drugs, such as metoprolol (Lopressor) and propranolol (Inderal XL), cross the blood-brain barrier, reducing sleep quality and causing you to wake up more often.
- ACE inhibitors do not directly cause insomnia, but some of their side effects — such as a dry, persistent cough or leg cramps — may affect sleep.
4. Diabetes medications
Class of medications: sulfonylureas, meglitinides, antihyperglycemics, hormones
Common names: glipizide (Glucotrol), glyburide (Diabeta, Glycron, Micronase), glimepiride (Amaryl), repaglinide (Prandin), nateglinide (Starlix), insulin
How they affect sleep: People with diabetes who take insulin or certain oral medications that lower blood glucose may experience nocturnal hypoglycemia, when blood glucose levels fall below 70 milligrams per deciliter (mg/dl) at night. Low blood sugar can cause restless and irritable sleep, along with symptoms such as night sweats, shaking, changes in breathing, nightmares and a racing heartbeat.
5. Dementia medications
Class of medications: acetylcholinesterase inhibitors
Common names: donepezil (Aricept), galantamine (Razadyne), rivastigmine (Exelon)
How they affect sleep: People with dementia and those experiencing changes in memory often have disrupted sleep cycles. To add to it, medications used to treat these conditions often have “wake-promoting” effects meant to improve alertness. Side effects of these medications can also disrupt sleep; they include pain, muscle cramps, increased blood pressure, agitation and lack of appetite (which can cause low blood sugar).
6. Mood and anxiety medications
Class of medications and common names:
- Selective serotonin reuptake inhibitors (SSRIs): fluoxetine (Prozac, Sarafem, Selfemra), citalopram (Celexa), escitalopram (Lexapro), sertraline (Zoloft), paroxetine (Paxil, Brisdelle, Pexeva), fluvoxamine (Luvox)
- Serotonin and norepinephrine reuptake inhibitors (SNRIs): venlafaxine (Effexor), desvenlafaxine (Pristiq, Khedezla)), milnacipran (Savella), levomilnacipran (Fetzima), duloxetine (Cymbalta, Drizalma , Irenka)
- Norepinephrine and dopamine reuptake inhibitors (NDRIs): bupropion (Wellbutrin, Zyban, Aplenzin, among others)
How they affect sleep: Depression, anxiety and other mental health conditions often cause sleep problems. These medications can improve baseline sleep, but occasionally their effects on common neurotransmitters (serotonin, dopamine and norepinephrine) can worsen sleep. A 2023 analysis of 216 trials found that about half of the 21 antidepressants evaluated were more likely than a placebo to cause insomnia.
SSRI depression medications “have been known to lessen slow-wave sleep and suppress REM a little bit,” Dimitriu says. But he adds that in his experience, “the overall benefit greatly outweighs costs.”
The antidepressant Wellbutrin can also keep you awake, says Michael Breus, a clinical psychologist and sleep specialist practicing in Los Angeles: “Wellbutrin is a very stimulating medication that can cause insomnia for some people.”
7. Pain medications
Class of medications: opioid pain relievers
Common names: fentanyl (Duragesic, Ionsys), morphine (Avinza, Kadian, MS Contin, among others), hydrocodone (Norco, Lortab, among others), oxycodone (OxyContin, Roxicodone, among others), oxymorphone (Opana) and tramadol (Ultram, ConZip, among others)
How they affect sleep: Pain can make it difficult to fall asleep and stay asleep. In some people, opioid pain medications, which are sometimes prescribed to treat moderate to severe pain following surgery or an injury, can contribute to sleep issues by causing altered sleep cycles and even sleep apnea, which is when breathing stops and restarts throughout the sleep cycle.
8. Prostate medications
Class of medications: alpha-blockers
Common names: alfuzosin (Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), terazosin (Hytrin, Tezruly) and tamsulosin (Flomax)
How they affect sleep: Alpha-blockers usually don’t cause sleep problems, but they can reduce REM sleep. REM is a critical component of the sleep cycle because, in addition to its role in dreaming, it’s also involved in memory, emotional processing and healthy brain development.
9. Stimulants
Class of medications: Stimulants work in the central nervous system and increase alertness, attention and energy. Although commonly used to treat attention-deficit/hyperactivity disorder (ADHD), these medications are also used to treat conditions affecting alertness and concentration, especially in older adults.
Common names: amphetamine-dextroamphetamine (Adderall), methylphenidate (Ritalin, Concerta, among others), dextroamphetamine (Dexedrine, ProCentra, Zenzedi, among others,), dexmethylphenidate (Focalin), methylphenidate (Ritalin), lisdexamfetamine (Vyvanse, Arynta) and many other formulations.
How they affect sleep: Stimulants can make it take longer for a person to fall asleep (this is called sleep onset latency) and are associated with insomnia and disruptions to a person’s internal sleep clock.
10. Steroids
Class of medications: Glucocorticoids, or steroids, are used as short-term anti-inflammatory medications or long-term immunosuppressive agents for conditions including rheumatoid arthritis, multiple sclerosis, leukemia, lymphoma and systemic lupus.
Common names: prednisone (Deltasone, among others), methylprednisolone (Medrol), dexamethasone (Decadron among others)
How they affect sleep: With steroids, changes in sleep may be due to restlessness caused by the medications, along with decreased natural melatonin levels and disruption of sleep cycles.
What to do: In drug studies, insomnia associated with the use of these medications was considered mild, but symptoms can be made worse with high doses and long-term use. Only use these medications if needed, in the lowest possible amount, and as your doctor prescribes. If your condition worsens and you need additional steroid symptom relief, talk to your doctor about maintenance medications to treat those symptoms.
Can antibiotics keep you awake?
One class of antibiotics, called fluoroquinolones, is strongly linked to sleep disorders, vivid nightmares and anxiety, Dimitriu says. Examples include ciprofloxacin (Cipro), levofloxacin (Levaquin) and moxifloxacin (Avelox). Most other antibiotics aren’t known to cause insomnia, he says. But side effects such as nausea and dizziness can make it harder to sleep, as can the illness being treated.
Can medications cause sleep apnea?
Some medications can worsen sleep apnea or contribute to breathing problems during sleep, Dimitriu says. Common culprits are opioids, benzodiazepines and sleep aides such as Ambien. “Anything that has a sedating effect” or a muscle-relaxing effect can cause sleep apnea, Dimitriu says.
Opioids are especially dangerous for older adults, he says, particularly when combined with other sedatives, because they can cause respiratory issues: Breathing may get slower, shallower and less effective or even stop altogether.
Can medications cause non-REM parasomnias like sleepwalking and sleep talking?
Nonrapid eye movement (non-REM) parasomnias are actions you do during the early stages of sleep, including sleepwalking, sleep talking, sleep eating and night terrors. Though you’re not awake and may not remember them, they can disrupt your sleep.
A number of medications can cause these sleep-related disorders, including antianxiety drugs like benzodiazepines, certain antidepressants, high blood pressure medicines, antipsychotic drugs, antiseizure medications, and asthma or allergy medicines.
What drugs cause REM sleep behavior disorder?
Certain antidepressants have been linked to REM sleep behavior disorder, a condition in which 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.
Antidepressants may cause REM sleep behavior disorder by altering levels of the brain chemicals dopamine and serotonin, which play a role in REM sleep. The association has been reported with several common SSRIs, such as sertraline (Zoloft) and fluoxetine (Prozac), although researchers are still studying whether the medications directly trigger the condition or simply unmask it in people who are prone to it.
Other medications linked to the disorder include sleep medicines like zolpidem (Ambien) and eszopiclone (Lunesta).
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