By Kathleen Yount

Paul Peterson, MD, of Duke Neurology of Raleigh, says there’s now a great body of evidence that routine medications we’ve been using for years may have effects on sleep. Drugs that seem sleep-benign, such as prednisone, can cause insomnia in some patients.

Moreover, many patients can unwittingly trigger a sleep disruption when they take matters -- or, more specifically, medications -- in their own hands. A patient with restless leg syndrome, for example, may start taking her medication in the afternoon, and then have trouble sleeping at night without realizing why.

Even antidepressants can interfere with the body’s sleep system. “When some patients are given an SSRI (selective serotonin reuptake inhibitors), we may actually give them a sleep disorder,” says Peterson. In these cases, a balancing act is in order: while not withholding important medications such as antidepressants, a physician must prescribe wisely to avoid a sleep-disrupting domino effect.

Whether the patient complaint is insomnia, restless legs, or another sleep disorder, combing through the tangles of medications and health conditions that may be disrupting a patient’s sleep begins with a good history, according to Peterson.

“A good history can obviate an expensive sleep study, in many cases,” he says, noting that the results of a sleep study can be confounded by the medications that the patient is on. “When I see a patient for the first time, it’s important for me to know exactly what that patient is taking, and exactly when they take it.”