Just as our bodies and minds change throughout life, so does our ability to get the recommended seven-plus hours of good, quality sleep each night. In fact, it’s estimated that 40 to 70 percent of older adults routinely experience sleep problems, like difficulty falling asleep or staying asleep.
Insufficient sleep doesn’t just wreck your mind and mood the next day; it’s been linked to a number of chronic health conditions, including type 2 diabetes, cardiovascular disease, obesity and depression. What’s more, lack of sleep can increase your risk of accidents and falls.
Poor sleep can be traced back to a number of causes, from stress to screen time to health-related issues like heartburn. Commonly used prescription and over-the-counter medications can also contribute.
What is Insomnia?
Insomnia is a common sleep disorder, characterized by trouble falling asleep, staying asleep or getting good-quality sleep. Short-term insomnia can be caused by stress or changes in your schedule or environment; chronic insomnia occurs at least three nights a week and lasts more than three months.
Insomnia is the most common sleep problem in adults 60 and older.
Source: National Heart, Lung and Blood Institute
Here are 10 sleep-disrupting drugs commonly used by older adults.
1. Cold and allergy decongestants
Class of medications: alpha-/beta-agonist; 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 prevents sleep or deep sleep.
What to do: Because these medications can affect the heart, check with your doctor or pharmacist before reaching for one — an alternative such as a steroid nasal spray may be recommended. If you get the OK from your health care provider and find you need a decongestant for more than seven days, or if your symptoms are worsening during use, contact your doctor to make sure there’s not another issue causing your symptoms, like an infection.
2. Asthma medications
Common medications: short-acting beta 2-agonists (bronchodilators), commonly called “rescue” medications or inhalers for quick symptom relief
Common names: pirbuterol (Maxair Autohaler), albuterol (Proventil HFA, ProAir and Ventolin HFA), levalbuterol (Xopenex)
How they affect sleep: These medications have data showing that only 1 to 3.1 percent of users experience true insomnia. However, other side effects such as excitability, headache, heart palpitations and tremors may be the bigger culprits for the sleep troubles, especially with frequent use.
What to do: If you use your rescue asthma inhaler or nebulizer more than twice a week and have trouble sleeping when you do, contact your physician and consider using a preventive medication or long-acting therapy.
3. Blood pressure medications
Class of medications and common names:
- Angiotensin-converting enzyme (ACE) inhibitors: benazepril (Lotensin), enalapril (Vasotec), lisinopril (Prinivil), quinapril (Accupril), ramipril (Altace) and many others in this family
- Beta-blockers: Propranolol (Inderal), nadolol (CorGard), pindolol (Visken), labetalol (Normodyne), penbutolol (Levatol), sotalol (Betapace) and carvedilol (Coreg) are all considered nonselective for the heart and can have more associated sleep disturbances.
How they affect sleep:
- ACE inhibitors do not directly cause insomnia. However, side effects, such as a dry, persistent cough (from the buildup of an inflammation-causing protein in the body) and muscle aches (from changes in potassium), may affect sleep.
- Beta-blockers may reduce your natural levels of melatonin, which helps with your sleep cycles, and some, such as carvedilol, can cause nightmares.
What to do: Do not stop taking these without talking to your doctor. These medications are not only used for blood pressure; they may also protect your kidneys and heart from more severe problems. Your doctor may lower the dose of your medication or recommend an alternative therapy that causes fewer changes in sleep.