10 medications that can mess with your sleep

7. PAIN MEDICATIONS CLASS OF MEDICATIONS: opioid pain relievers COMMON NAMES: fentanyl (Duragesic), morphine (Avinza), hydrocodone (Norco), oxycodone (OxyContin), oxymorphone (Opana) and

tramadol (Ultram)  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 apnea, which is when breathing stops and restarts throughout the sleep

cycle. WHAT TO DO: If you were prescribed opioids for short-term pain relief, talk to your doctor about alternating the prescribed opioid with acetaminophen (Tylenol) or ibuprofen (Motrin)

to minimize the opioid use. Some prescription pain relievers already contain ibuprofen or acetaminophen, so check with your pharmacist before using multiple medications at the same time.

Additionally, lifestyle changes (like exercise and weight loss), behavioral treatment (cognitive behavioral therapy), physical therapy, complementary medicine (like acupuncture) and

alternative medicine therapies can help improve quality of life in people suffering from pain. 8. PROSTATE MEDICATIONS CLASS OF MEDICATIONS: alpha-blockers COMMON NAMES: alfuzosin

(Uroxatral), doxazosin (Cardura), prazosin (Minipress), silodosin (Rapaflo), terazosin (Hytrin) 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. WHAT TO DO: If you are using an alpha-blocking medication for the treatment of prostate symptoms and are experiencing sleep problems including insomnia, talk to

your doctor about using the lowest effective dose or changing to another family of drugs, such as a 5-alpha-reductase inhibitor like dutasteride (Avodart) or finasteride (Proscar). These are

safer and generally better tolerated by older adults.   9. STIMULANTS CLASS OF MEDICATIONS: Stimulants work in the central nervous system and increase alertness, attention and energy.

Although commonly used for 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 (Concerta), dextroamphetamine (Dexedrine), dexmethylphenidate (Focalin), methylphenidate (Ritalin),

lisdexamfetamine (Vyvanse) 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. WHAT TO DO: Talk to your doctor about the benefits and drawbacks of using a stimulant medication. Ask about

adjusting the dose or changing the time you take it to improve your sleep. Additionally, non-stimulants — such as atomoxetine (Strattera), clonidine (Kapvay), viloxazine (Qelbree) and

guanfacine (Intuniv) — could be effective, depending on the condition being treated.   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), methyl-prednisolone (Medrol), dexamethasone (Decadron) 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; however,

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.    HOW DO YOU KNOW WHETHER YOUR MEDICINE, OR SOMETHING ELSE, IS

DISRUPTING YOUR SLEEP? Timing is everything, experts say. “It helps to look at when the sleep trouble began and see if it correlates with the start of a particular medication,” Dimitriu

says. You might also try taking your medicine in the morning rather than at night to see if that makes a difference. If you’re having trouble sleeping and are taking any of these

medications, it’s important that you don’t stop taking them. Talk to your health care provider, who may be able to adjust your dose or recommend a different medication that can achieve the

same results. There are also lifestyle changes that can help improve underlying conditions, as well as cognitive behavioral therapy, which is the first-line treatment for insomnia.

_Editor's note: This story, originally published April 8, 2013, has been updated to reflect new information and a new author._