Institute for Continuing Education

Medications that Interfere with Sleep

Course Objectives

Upon successful completion of this module, you will be able to:

• Describe the mechanisms by which common medication classes affect sleep architecture, sleep continuity, and circadian rhythm regulation, including effects on neurotransmitter systems, receptor binding, and sleep-wake regulatory pathways.
• Identify medications across major therapeutic categories that cause insomnia, excessive daytime sleepiness, parasomnias, sleep-disordered breathing, or circadian disruption, including prescription drugs, over-the-counter medications, and dietary supplements.
• Recognize medication-induced sleep disturbances in patients presenting to sleep laboratories, understanding how to elicit comprehensive medication histories and identify drug-related contributions to sleep complaints.
• Explain the differential effects of psychotropic medications on sleep, including antidepressants, antipsychotics, anxiolytics, and mood stabilizers, with awareness of both therapeutic sleep effects and adverse sleep consequences.
• Understand how medications used to treat medical conditions including cardiovascular disease, respiratory disorders, neurological conditions, and pain affect sleep quality and sleep disorder risk.
• Apply knowledge of medication-sleep interactions to patient education, recognizing when to recommend consultation with prescribing physicians about timing adjustments, alternative medications, or management strategies for drug-induced sleep problems.
• Integrate awareness of polypharmacy effects, drug-drug interactions, and special population considerations (elderly, pregnant, pediatric) into comprehensive assessment of medication impacts on sleep for patients undergoing sleep evaluation or treatment.

Course Information

Though medication and prescription drugs are designed to help with specific problems, they can often have negative side effects. Medicine can disrupt the normal balance of the body and lead to a disruption in sleep or insomnia. Even sleeping pills can have a negative impact on restful sleep.

Each person spends one third of his or her life asleep. It is not surprising that such a complex and pervasive cognitive state should be affected by drugs in many different ways. A philosophy that remains cogent for the CNS is that new research almost always shows this system to be more complex than previously thought. Only a few years ago, if patients complained of difficulty sleeping, they were given pills, often dangerous and addictive pills, to induce sleep no matter what the basis of the complaint might be. Sleeping pills may be safer now, and the understanding of the sleep state itself has increased rapidly. Diagnoses are still diffuse, however, and treatments are often poorly directed.