If you're having frequent disturbing dreams with no obvious connection to what's happening in your waking life, it might be time to check your first aid kit. Many people are unaware that common medications can have a negative impact on their dreams.
Some antidepressants, beta blockers to treat high blood pressure, statins to treat cholesterol disorders, psychostimulants to treat attention deficit hyperactivity disorder, dopamine agonists to treat Parkinson's disease, and acetylcholinesterase inhibitors to treat neurodegenerative diseases such as Alzheimer's and Parkinson's are among the drugs that have been connected cause or worsen disturbing dreams.
Unusually vivid dreams and nightmares are also recognized side effects of other prescription medications and even some over-the-counter medications, such as sedating antihistamines.
“There are many medications that can cause nightmares or bad dreams,” says Dr. Clete Kushida, chief of staff and medical director of the Stanford Sleep Medicine Institute. “Even melatonin and medications used for short-term insomnia, such as Ambien, Sonata and Lunesta, may cause more bad dreams, but we don’t know the mechanisms.” The newer GLP-1 drugs Kushida adds that (such as Ozempic and Munjaro), which are used to treat type 2 diabetes or promote weight loss, are also associated with disturbing dream content.
Why do some medications affect dreams?
When medications are associated with an increase in bad dreams or nightmares, the cause is not always clear. For some drugs, such as selective serotonin reuptake inhibitor (SSRI) antidepressants, they can change the levels of neurotransmitters such as serotonin in the brain, which can affect dreams and nightmares. “SSRIs inhibit the reuptake of serotonin, a neurotransmitter that is involved in regulating sleep, so more serotonin moves around the body. [in the brain]- Kushida said.
Research found that while older tricyclic antidepressants “induce more positive feelings in sleep,” use of SSRIs and serotonin norepinephrine reuptake inhibitors (SNRIs) was associated with more intense dreams and the possibility of more frequent nightmares. Withdrawal from tricyclic antidepressants can also lead to nightmares, while withdrawal from SSRIs and SNRIs increases dreams.
Instead, “dopamine agonists are thought to directly influence nightmares through their effects on dopamine receptors,” explains Dr. Shweta Gogineni, a sleep specialist and pulmonologist at UCLA Health.
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Other drugs may have a more direct effect on sleep architecture, the structure of the different stages of sleep at night. For example, medications used to treat Alzheimer's disease (such as Aricept) can lead to REM sleep behavior disorder, which can cause intense, often bad dreams and even cause people to act out their dreams, Kushida says.
Meanwhile, beta blockers tend to reduce REM sleep, during which most dreaming occurs. research found that they were associated with an increase in nightmares. Using some fluoroquinolone antibioticssuch as ciprofloxacin and levofloxacin are also associated with a higher risk of nightmares.
Sometimes it's not entirely clear what causes bad dreams. For example, a major sleep disorder such as sleep apnea can affect someone's dreams when they take a drug that affects dreams, such as an antidepressant. “Many people with depression suffer from disturbing dreams,” says Dr. Barry Krakow, a sleep medicine specialist in Savannah, Georgia, who runs a sleep health coaching service. “Many people with depression need a sleep study because they have a sleep disorder called sleep apnea.” Obstructive sleep apnea itself is connected with increased nightmares; Its treatment with continuous positive airway pressure (CPAP) has been shown to reduce the number of bad dreams.
How to Deal with Horrible Side Effects
When people experience dream-related side effects from medications, their reactions can vary significantly. Some people simply notice that their dreams become more intense and ignore them. “Others report sleep fragmentation, palpitations, and a feeling of panic when waking up,” says Gogineni. “Some people can develop insomnia due to fears regarding sleep and nightmares. For some, nightmares may affect their ability to function at work or in other social situations.”
So what should you do if you suspect your medication is ruining your dreams? The first step is to discuss your symptoms and concerns with your healthcare provider. “Nightmares can have a significant impact on someone’s sleep and overall quality of life,” says Gogineni. “It is very important that [your] the doctor knows if this is happening.”
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It is important not to stop taking medications without first consulting your doctor, as this may have a negative impact on the health condition being treated. Additionally, “abruptly stopping these medications can sometimes cause nightmares to worsen,” Gogineni says.
Depending on your medical condition and medication, several solutions may help. “Your doctor may suggest changing the dose or timing of your medication,” says Kushida.
“In some cases, your doctor may suggest trying a different drug in the same class or a different type of drug altogether to treat your health condition,” says Gogineni.
This is an important conversation to start with your healthcare provider, and if that isn't helpful enough, a sleep specialist. The quality of your rest, including your sleep, can affect how you feel day and night, so it's worth taking steps to ensure you get restful sleep.
