We use cookies. By continuing to browse you are agreeing to our use of these cookies. Click to see our cookie policy.

Prednisone and insomnia: How to sleep while taking steroids

Figuring out how to sleep while taking steroids is complicated. Drugs like Prednisone and insomnia tend to go hand-in-hand due to the adrenaline-boosting nature of the medication. However, steroids are an important part of many treatments. 

The steroids Prednisone and Dexamethasone are powerful immune-system suppressors and anti-inflammatory substances. Unfortunately, they’re also well-known to cause severe problems with sleep in 50-70% of all patients

The chances are if you’ve been offered steroids as a treatment for conditions like asthma, COPD, certain cancers, or rheumatologic diseases, you also have insomnia.

So, what exactly can you do about trouble sleeping on steroids?

Let’s explore your options.

Dexamethasone and insomnia: Does Prednisone cause insomnia?

Prednisone and Dexamethasone are both kinds of synthetic corticosteroids used to suppress the immune system and reduce inflammation. 

Insomnia is one of the most reported side effects, when taking these. So, how does Prednisone cause insomnia? Read on to learn how to sleep while taking steroids. Find the specific cause of this adverse effect, and how to reverse it. 

Corticosteroids can successfully treat various conditions, including arthritis, asthma, colitis, bronchitis, and various allergies. In some cases, these substances can also help to prevent the body from rejecting transplanted organs. 

Like all medications, Dexamethasone and Prednisone can both cause an additional range of side effects, including:

  • Weight gain
  • Fluid retention
  • High blood pressure 
  • Nausea
  • Headache
  • Potassium loss
  • Nausea
  • Vomiting
  • Muscle weakness
  • Acne
  • Skin thinning
  • Psychotic behavior
  • Personality changes

Additionally, suddenly stopping your consumption of Prednisone or Dexamethasone can also cause withdrawal symptoms, which among other side effects, can cause severe sleeping issues too. 

Problem sleeping is slightly more common with Prednisone than Dexamethasone, but both medications are notorious for interfering with sleep. Apart from medications like Adderall, designed to keep you awake and focused, they’re the among some of the worst culprits for disturbing sleep.

Due to their ability to interfere with everything from mood to blood pressure, alertness, and focus all forms of corticosteroids tend to cause insomnia to some degree.  

Prednisone and insomnia: Steroids stop you sleeping

For most people, the answer to “Does prednisone cause insomnia” will be “sometimes” or “usually.” To understand why there’s such a significant problem with steroids and sleep, you’ll need to know how steroid medications work. 

Corticosteroids like Prednisone and Dexamethasone are man-made substances which mimic the body’s natural fight-or-flight hormone, cortisol. 

Cortisol is also the substance associated with stress, focus, and concentration. When your body needs to be awake, your brain signals to stop the production of melatonin (for sleep) and begin the production of cortisol (for alertness). 

Though Prednisone isn’t a stimulant, its ability to replicate cortisol means you can feel more alert and jittery. This makes it much harder to get to sleep, or even relax at night. 

Mood issues are also common with Prednisone, and since issues like anxiety can make it harder to sleep, this makes the problem of insomnia even more likely. 

How to sleep while taking steroids?

Since the primary purpose of certain corticosteroids is to mimic the hormone responsible for alertness, insomnia and trouble sleeping are side-effects difficult to avoid. However, there are steps you may be able to take to minimize your risk. 

The right kind of steroid
The first step, as with any medication, is to speak to your doctor about your options. Getting the right kind of steroid from day one, can reduce your problems with sleeplessness. For instance, some people believe it’s easier to figure out how to sleep while taking Dexamethasone, than when taking Prednisone. 

The right dosage
Dosage is another significant factor. No form of corticosteroid is intended to be used at a high dose for long periods of time. The longer you take this kind of medication, the higher the dose, the more significant your risk of side effects and complications.

Prednisone is usually intended for short-term use, to bring inflammation caused by a disease under control. You’ll also be given the lowest possible dosage of this drug to help reduce your risk of side effects. However, for some conditions, higher doses will be needed.

Timing
Taking your corticosteroids in the morning will significantly reduce the risk of sleep problems. It takes about 8 hours for the body to metabolize Prednisone and a little longer for Dexamethasone. 

Sleeping pills 
Ensuring you keep up with regular doctor appointments should help your care provider to appropriately monitor your condition and prescribe supplementary medications. 

For instance, you might be given certain sleeping pills or melatonin to help you overcome insomnia. However, sleeping pills, like Zopiclone, should only be used for short periods of time, as there’s a risk of abuse and addiction.

What can help you sleep when on Prednisone?

In many cases, you will be able to get some sleeping tablets for a very short period of time when using a medication like Prednisone. Keep in mind, like Prednisone, most sleeping medications are not intended for long-term use. 

You will also need to speak to your doctor about how to improve your sleep routine, while on steroids for longer periods of time. It is so important to avoid seeking out your own treatment, for any insomnia issues you might have. 

Even some “natural” sleeping remedies considered harmless by most, can interact negatively with other medications you may already be taking. 

Your doctor is more likely to give you sleeping medications if you have severe sleep deprivation, or frequent waking during the night. 

If you’re having other side effects from Prednisone, which are contributing to your inability to sleep, your doctor can look into additional treatments for these. Sleep disrupting side effects could be:

Weight gain
Weight gain can often cause issues with sleep for a number of reasons. You’re more likely to be unable to find a comfortable position in bed when struggling with your weight. People suffering from obesity or those who are overweight are also more likely to suffer from issues with breathing when they sleep, which could lead to sleep apnea.Your doctor may recommend a careful diet and exercise routine to help with weight gain. 

Mood
In some cases, people taking Prednisone will suffer from issues of stress and depression. Low mood can also make it difficult to sleep, particularly if you’re feeling lethargic during the day, and have racing thoughts at night. Exercise can help to burn off some of the stress and improve your mood, by releasing endorphins. It’s also a good way to “tire your body out” in time for sleep. 

General discomfort
Prednisone and other corticosteroids can sometimes lead to problems like muscle pain, nausea, or stomach issues. If you’re having issues with general discomfort keeping you awake, your doctor may prescribe additional medication to help. 

Discussing any side effects, you’re having with your doctor when you’re taking Prednisone or Dexamethasone should reduce your risk of any longer-term problems. Your doctor can work with you to come up with a personalized solution. 

Does Prednisone cause insomnia? More on timing your doses

One of the most effective ways to reduce the risk of trouble sleeping when taking steroids, is to make sure you get your dosage timing right. Prednisone mimics the natural hormone of cortisol. This is released during times of stress, and in the morning when you’re first waking up. Therefore it might be worth taking this substance early in the day.

As you progress towards the end of the day, your brain releases melatonin, which can help you to fall asleep, while lowering the release of cortisol. Taking a medication like Prednisone too late into the day will give you a boost of alertness, which may make it difficult to fall asleep. 

Most doctors will ask you to take your full dose in the morning, so you can improve your chances of better sleep at night. You may also be asked to follow a specific routine both on a morning and on an evening, to improve your overall sleep hygiene. 

Following a schedule at night can help to relax your body and put you in the right frame of mind for sleep. This could help to counteract some of the side effects associated with taking steroids. 

Be careful with Prednisone withdrawal

Managing the sleep problems which can occur when you begin taking Prednisone regularly can be very difficult for some. Unfortunately, the issues don’t come to an end when you stop taking these medications. 

If you’ve been taking your corticosteroids for an extended period of time, or you were given a higher dose of the medication, you’ll have a higher risk of withdrawal. 

Taking corticosteroids can suppress the pituitary gland and hypothalamus, which leads to a reduced production of cortisol. This could lead to problems like fatigue, joint pain, muscle stiffness, and tenderness, which can harm your sleeping patterns further.

Withdrawal symptoms happen when your own body’s hormonal system becomes sluggish from the suppression. When you were supplementing with the steroid, your own production was down. It can take a while for it to get back to the previous good balance. 

Discussing a strategy for tapering off any medications with your doctor will reduce your risk of withdrawal-focused side effects.

How to sleep while taking steroids: Overcoming Prednisone insomnia

Steroids have a lot of value to offer in the right circumstances. They can help with the recovery from various illnesses and surgeries, and ensure our bodies are in the best possible condition again as quickly as possible. We’ve tried to give you some options to overcome Prednisone insomnia and how to sleep while taking steroids.

Discussing your treatment with your doctor at the time your steroids are prescribed and creating a plan for dealing with insomnia is a good way to reduce your risk of sleepless nights. Hopefully, Your doctor will also be able to advise you on the steps to take to eliminate bad slumber! 

Siestio. Sleep Matters.

Click here if you want to know about other medications that cause insomnia.

If you’re interested in improving your sleep generally, enjoy these posts…

Adaptogens for sleep
Essential oils for sleep
Over the counter sleep aids

Medical disclaimer
You must not rely on the information provided on our website as an alternative to medical advice from your doctor or other healthcare professionals. For more information read our full disclaimer here.

Medical Expert

Siestio is an evidence-based resource dedicated to sleep and wellbeing. Whether you’re affected directly or indirectly by sleep issues, we’re here to help. Because we believe sleep matters.

For editorial, affiliate and advertising enquiries, please drop us a line…

Email: mail@siestio.com