Drugs: substances that have a physiological effect when ingested or otherwise introduced into the body. Many drugs impact our level of consciousness whether or not they are used to promote sleep or wakefulness. Even over-the-counter (OTC) drugs, nutritional supplements and legally accepted recreational drugs such as alcohol and caffeine can be a detriment to good sleep if used improperly. Whenever possible, sleep disorders should be managed through the use of good sleep hygiene and behavioral modifications. When medication becomes necessary, the proper use of drugs will most effectively contribute to healthy sleep.

Drugs that Promote Wakefulness
A wakefulness-promoting drug improves alertness, thereby reducing the need for sleep at inappropriate times. Drugs that promote wakefulness are most often used to treat hypersomnias such as narcolepsy and idiopathic hypersomnia. Traditionally, amphetamine-type stimulants were used to treat daytime sleepiness by acting on the entire nervous system. They still are used in some cases. In recent years the analeptic drug modafinil has successfully promoted wakefulness in a more precise manner.

Modafinil:
an analeptic drug
TRADE NAMES: Provigil, Nuvigil
DISORDERS TREATED: Narcolepsy, Idiopathic Hypersomnia, Obstructive Sleep Apnea

Methylpheniate:
an amphetamine drug
TRADE NAMES: Ritalin, Concerta, Metadate, Methyln, Daytrana (transdermal patch)
DISORDERS TREATED: Narcolepsy, Idiopathic Hypersomnia


Dextroamphetamine Sulfate:
a poweful amphetamine
TRADE NAMES: Dexedrine, Dexedrine SR, Dextrostat
DISORDERS TREATED: Narcolepsy, Idiopathic Hypersomnia


Methamphetamine HCL:
a powerful amphetamine
TRADE NAMES: Dexosyn
DISORDERS TREATED: Narcolepsy, Idiopathic Hypersomnia

Drugs that Treat Cataplexy
Cataplexy, a hallmark feature of Narcolepsy, is characterized by episodic losses of muscle tone for a few seconds to several minutes or more. Cataplexy involves the intrusion of REM or dream sleep into wakefulness. Drugs that treat cataplexy include certain antidepressants or nervous system depressants that supress REM sleep.

Selective Serotonin Reuptake Inhibitors (SSRIs) and Norepinephrine Reuptake Inhibitors (SNRIs):
an antidepressant drug
SPECIFIC DRUGS: atomoxetine (Strattera), fluoxetine (Prozac, Sarafem), venlafaxine (Effexor)
DISORDERS TREATED: Cataplexy associated with Narcolepsy


Sodium Oxybate:
a very powerful and complex central nervous system depressant
TRADE NAME: Xyrem
DISORDERS TREATED: Severe cataplexy associated with Narcolepsy

Tricyclic Antidepressants: an “older” type of antidepressant
SPECIFIC DRUGS: protryptyline (Vivactyl), imipramine (Tofranil)
DISORDERS TREATED: Cataplexy associated with Narcolepsy


Drugs that Promote Sleep or Muscle Relaxation
A sleep-promoting drug reduces alertness, making it easier to sleep at appropriate times. Drugs that induce relaxation are used to treat insomnia or any disorder that prevents sleep. Psychophysiological insomnia and restless legs syndrome are examples of sleep disorders that interfere with sleep. A hypnotic/sedative is a type of drug that acts on the central nervous system to increase drowsiness. A tranquilizer makes a person more relaxed by will not necessarily cause sleepiness. Other drugs promote sleep by affecting brain chemicals such as dopamine.

Clonazepam:
a sedative/hypnotic drug
TRADE NAMES: Cebercion, Klonopin, Klonipin Wafer, Valpax
DISORDERS TREATED: Restless Legs Syndrome
, REM Sleep Behavior Disorder, Insomnia related to severe panic attacks

Eszopiclone:
a sedative/hypnotic drug
TRADE NAMES: Lunesta
DISORDERS TREATED: Restless Legs Syndrome, severe insomnia

Pramipexole: a sleep-promoting drug that affects dopamine levels
TRADE NAMES: Mirapex
DISORDERS TREATED: Restless Legs Syndrome


Ramelteon: a new class of sleep-promoting drug that affects different brain chemicals than traditional sedative/hypnotics
TRADE NAMES: Rozerem
DISORDERS TREATED: Insomnia, Delayed Sleep Phase Syndrome


Ropinirole: a sleep-promoting drug that affects dopamine levels
TRADE NAMES: Requip
DISORDERS TREATED: Restless Legs Syndrome

Zaleplon: a hypnotic drug
TRADE NAMES: Sonata
DISORDERS TREATED: Idiopathic Insomnia, Psychophysiological Insomnia


Zolpidem:
a sedative-hypnotic drug
TRADE NAMES: Ambien, Ambien CR
DISORDERS TREATED: Idiopathic Insomnia, Psychophysiological Insomnia


Medical Drugs that Impact Sleep
Even when used to treat physical illnesses or non-sleep disorders, side effects can alter sleep.The following list, though not comprehensive, briefly describes common sleep-related side-effects of drugs used to treat physical or mental illness:

Drugs that Treat Physical Illness

Anti-arrhythmic Drugs:
sleep disturbance, daytime tiredness
Antihistamines: daytime drowsiness
Asthma Drugs:
sleep disturbance, daytime drowsiness
Beta Blockers: drowsiness
Chemotherapy Drugs: sleep disturbance
Corticosteriods: Insomnia
Diet Pills: sleep disturbance, insomnia
Diuretics: sleep disturbance, insomnia, nighttime leg pain
Hormones: sleep disturbance, insomnia, daytime drowsiness
Nausea Medications:
drowsiness
Nicotine Replacement Drugs: insomnia, disurbing dreams
Pain Medications:
drowsiness
Parkinson’s Disease Medications: sleep disturbance
Thyroid Stimulating Hormone: sleep disturbance, insomnia

Drugs that Treat Mental Illness

Antiolytics: daytime drowsiness
Antidepressants:
daytime drowsiness, insomnia
Antipsychotic Medications:
daytime drowsiness
Tricyclic Antidepressants: daytime drowsiness

Recreational Drugs & Sleep

Caffeine:
sleep disturbance, insomnia
Alcohol: daytime drowsiness, sleep disturbance, insomnia
Marijuana: daytime drowsiness
Illegal Drugs: sleep disturbance, insomnia, daytime drowsiness, circadian disturbance

Nutritional Supplements & Sleep

5-HTP:
nightmares, sleep disturbance, insomnia, daytime tiredness
Ginseng: sleep disturbance or insomnia
L-Tryptophan: daytime sleepiness at high doses
Niacin: sleep disturbance or insomnia at high doses
Valerian: daytime drowsiness if taken during the day

Suggested Downlaods

SleepIssues:
Sleep & Health
Sane Sleep
SleepCaptions:
Drugs and Sleep