Steroid therapy is used to treat a wide variety of medical conditions, from inflammatory bowel disease (IBD), ulcerative colitis, and Crohn’s disease, to poison ivy, rheumatoid arthritis, and allergic reactions. Steroid medications such as cortisone, prednisone, and methylprednisolone can be life-saving in critically ill patients. But there’s a catch. Taking prednisone and other steroids can cause a host of side effects. These can range from being mildly annoying to intolerable. One of the potential side effects of commonly prescribed steroids like prednisone is sleep disturbances such as insomnia. 

Continue reading to learn more about why prednisone may prevent you from getting a good night’s sleep. Also, find out how you can minimize or eliminate prednisone side effects like insomnia.

What is prednisone?

Prednisone is a corticosteroid medication. It is a strong anti-inflammatory drug and works by suppressing the immune system. Prednisone is often described as a jack-of-all-trades because it can be effective in treating a wide variety of medical conditions. This steroid drug mimics the hormone cortisol that is naturally produced by the adrenal glands on signals from the pituitary gland in the brain. Cortisol hormone is responsible for many critical body functions, including the fight or flight response (sympathetic response) and keeping inflammation under control. 

However, prednisone can cause many side effects such as sleep disruption and insomnia (difficulty falling asleep or staying asleep). Other side effects of prednisone include fluid retention, weight gain, mood swings, acne, increased hair growth, fragile skin, increased urine flow, decreased libido, heartburn, depression, high blood pressure, high blood sugar. Chronic use of prednisone can lead to long-term side effects such as decreased bone mass, and increased risk of bone fractures.

Typically, the adverse effects of prednisone and other steroid drugs are minor, but they can increase with higher doses or long-term use.

Does prednisone make it hard to fall asleep?

Prednisone is not a stimulant; at a lower dose and for short-term therapy, prednisone typically does not cause sleep disruption in most patients. However, steroids can make you jittery or more alert. Some patients find that prednisone keeps them awake and leads to sleep deprivation, especially at higher dosages. 

Does steroid therapy for rheumatoid arthritis affect sleep patterns?

Steroids at low doses can effectively provide an anti-inflammatory effect to suppress the inflammation associated with rheumatoid arthritis, thus reducing joint pain. Corticosteroids like prednisone are also prescribed to treat inflammation of the muscles and blood vessels in conditions like lupus, gout, Sjogren’s syndrome, and other autoimmune disorders. So to answer the above question, any type of steroid that is used to treat any type of condition can potentially cause sleep disturbance, especially insomnia. However, you can work with your doctor and practice self-care and sleep hygiene to reduce or even eliminate this bothersome side effect of prednisone.

Why do steroids keep you awake at night?

Cortisol, a natural hormone in the body, is responsible for the body’s fight or flight response; it keeps the mind alert and stimulated. Corticosteroid medications like prednisone can mimic the action and produce the same desired effects and side effects as cortisol to varying degrees in different patients. Since cortisol is responsible for the fight-or-flight response, prednisone, along with other steroid medications, produces the same stimulatory effects, which can lead to a disruption of the normal sleep-wake cycle. This is the reason why steroids can potentially cause sleep disturbance, especially insomnia. 

Can I take a sleep aid while on prednisone?

There are no known interactions between commonly prescribed sleep aids and prednisone. However, this does not mean that drug interactions do not exist. Please be sure to consult a healthcare provider before taking a sleep aid while on prednisone therapy. 

Experts recommend taking a mild and safe over-the-counter sleep aid such as melatonin or chamomile if prednisone is causing sleep disruption or sleep deprivation. Many patients find that this helps to reset their sleep patterns and relieves insomnia.

It is also a good idea to practice good sleep hygiene. This means having a fixed sleeping and wake-up time every day, prioritizing sleep, and making gradual adjustments in sleep timings. Regular exercise during the day can also benefit sleep by making you tired and helping you fall asleep. However, vigorous exercise just before bedtime can have the opposite effect by increasing your level of alertness.

What is the best time of day to take prednisone?

Steroids can cause sleep disruption, especially when they are taken in the evening. If this is the case with you, talk to your doctor about taking your entire dose of prednisone in the morning. This may help prevent sleep deprivation. With a morning dose, any alertness that prednisone causes should dissipate by the time you’re ready to go to bed and make it easier for you to fall asleep. 

References:

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7357890/

2. https://health.clevelandclinic.org/8-prednisone-side-effects-how-to-minimize-them/amp/