Could your medication be affecting your sleep?

When we're trying to work out why we're tired, or why we're not sleeping well, medication probably isn't the first thing we think about.

We might look at how much sleep we're getting, whether we're waking during the night, how much caffeine we're drinking, or whether stress is keeping us awake. And all of those things can be a factor.

But there is another part of the picture that we don't always think about ~ the chemistry of the brain. Our brains use different chemical messengers to help regulate things like alertness, sleep, memory and attention. And some of the medications we take can influence these systems too.

There are a couple that are really interesting when we look at the connection between brain chemistry and sleep = histamine and oxybutynin.

Histamine isn't just about allergies

Most of us probably think of histamine as something to do with allergies. Hay fever, itchy eyes, a runny nose ~ that's where we normally hear about it.

But histamine has another job that is really relevant to sleep. It's one of the chemical systems our brain uses to help keep us awake.

This is why some antihistamines can make you sleepy. When you take an antihistamine, you're blocking histamine, and some can also get into the brain and affect the histamine system that's helping keep you alert.

You see, histamine isn't only involved in wakefulness. The brain's histamine system also has a role in things like learning, memory and cognition. So when we're regularly using medications that interfere with these chemical systems in the brain, there can potentially be more going on than just feeling a little sleepy.

Some of the older antihistamines also have strong anticholinergic effects, meaning they interfere with acetylcholine, another chemical messenger that's important for memory, learning and attention.

A 2015 study published in JAMA Internal Medicine looked at the cumulative use of strong anticholinergic medications and found that higher long-term exposure was associated with an increased risk of developing dementia.

So if you're someone who takes an antihistamine occasionally because you've been mowing the grass and your nose won't stop running, that's very different from taking one every night.

But if you've started taking an antihistamine every night because it makes you sleepy and helps you get to sleep, that's something I'd be having a conversation about with your doctor.

Because making you drowsy isn't necessarily the same thing as giving you good quality sleep. And if you're taking something regularly that affects the chemical systems in your brain, it's worth understanding what else it might be doing.

That's not me saying you should stop taking your medication. It's about knowing what you're taking, why you're taking it, and whether there might be a better option for you in the long term.

And then there's oxybutynin

Oxybutynin is a completely different type of medication. It's commonly prescribed for an overactive bladder, which can be incredibly disruptive to sleep in its own right.

If you're getting up several times a night to go to the toilet, you can appreciate why treating that problem could actually help your sleep. Every time you wake up, you're potentially disrupting your sleep, so reducing those overnight trips to the bathroom can obviously be helpful.

But oxybutynin also has strong anticholinergic effects, which means it blocks some of the effects of acetylcholine. And as we've just seen, acetylcholine is important in the brain. It's involved in things like memory, learning and attention.

So you have a medication that can be doing a very useful job for your bladder, while also having effects elsewhere in the body and brain.

So again, this isn't me saying, "Don't take oxybutynin."

It's about knowing what you're taking and understanding that a medication can be helping one part of your body while potentially affecting another.

So what does all of this have to do with sleep?

Quite a lot, actually.

Because when you're trying to work out why you're tired, it's easy to focus on the obvious things. But sometimes there are things going on in the background that you haven't considered.

Maybe you're waking several times a night because of your bladder. Maybe you're taking something for allergies that's making you drowsy during the day. Maybe you're taking something every night to help you sleep without realising that it is affecting your brain in other ways.

It doesn't mean your medication is the problem.

It doesn't mean you should stop taking anything.

It means it's another piece of information that can help us understand what's going on.

And this is why I don't think there is a one-size-fits-all answer when it comes to sleep. Your sleep is influenced by a lot of different things, and sometimes we need to look a little deeper than "go to bed earlier" or "put your phone away".

If you're taking medication regularly and you're struggling with your sleep, feeling excessively tired during the day, or relying on something to make you sleepy at night, have a conversation with your doctor or pharmacist about whether your medication could be playing a role.

Don't just stop a prescribed medication because you've read something on the internet (or in my article!).

But don't assume that because something makes you sleepy, it's automatically helping you sleep either. Sometimes, getting better sleep starts with understanding what's already happening in your body.

~ Nina

Sleep Consultant & CPAP Specialist

Positively Rested

Is poor sleep affecting your life?

If poor sleep is affecting more than just how you feel in the morning. If you’re struggling to concentrate, losing motivation, feeling constantly exhausted, becoming more irritable, withdrawing from the things you enjoy or simply not feeling like yourself anymore - it’s time to take it seriously.

You shouldn’t have to organise your life around being tired or just accept that this is how things are now.

If poor sleep is getting in the way of the life you want to live, I can help. Book your free call to discuss what’s happening with your sleep and whether I can help you get things moving in the right direction.