Steroid-induced insomnia

Steroid-induced insomnia is a common and frustrating side effect of corticosteroid medications like prednisolone, dexamethasone, or hydrocortisone — especially when taken for conditions like aspergillosis, adrenal insufficiency, or inflammatory diseases.

Why it Happens

Corticosteroids affect the brain’s sleep-wake cycle and increase levels of cortisol-like hormones, which can make you feel:

• Wired or overstimulated

• Restless or anxious

• Unable to fall asleep or stay asleep

Even low-to-moderate doses can affect sensitive sleepers, especially when taken in the afternoon or evening.

Tips to Manage It

1. Take Steroids in the Morning (if possible – discuss with your doctor)

Mimics the body’s natural cortisol rhythm and reduces sleep disruption.

2. Create a Wind-Down Routine

Try calming activities in the evening — reading, gentle music, warm bath, breathing exercises.

3. Avoid Stimulants After 2 PM

That includes caffeine, nicotine, and even long naps.

4. Sleep Hygiene Helps

• Keep your room cool and dark

• Avoid screens at least an hour before bed

• Stick to a regular sleep schedule

5. Melatonin (with caution)

Some doctors may suggest melatonin to reset sleep patterns — but always ask first, especially if you’re on multiple meds.

Medical Support

If insomnia is severe or long-lasting:

• Your doctor might adjust your steroid dose or timing

• A short course of sleep aids may be prescribed if needed

• Sometimes adding a mood stabilizer or sedating medication at night (like mirtazapine or a low-dose antihistamine) is helpful