Steroids can disrupt your sleep, causing insomnia and worsening conditions like sleep apnea.

Steroids are a class of compounds that include both hormones and synthetic medications. They treat various conditions from inflammation and autoimmune disorders to hormone imbalances and muscle growth.

While many steroids are legally prescribed for medical purposes, others are illicitly used for performance enhancement or muscle building.

Many of these steroids, regardless of their legal status, can disrupt sleep patterns and worsen sleep-related conditions.

Steroids can cause insomnia and other sleep disturbances, depending on the type of steroid, the dosage, and the duration of use.

Here’s how different types of steroids may affect sleep:

Corticosteroids

Healthcare professionals commonly prescribe corticosteroids, including glucocorticoids like prednisone and dexamethasone, to reduce inflammation in conditions such as asthma, autoimmune disorders, and various chronic diseases. Insomnia is a common side effect of these medications.

Corticosteroids mimic the hormone cortisol, which is naturally produced by the adrenal glands and helps regulate the body’s sleep-wake cycle.

Typically, cortisol levels drop at night to promote sleep, but corticosteroids can raise these levels, leading to increased brain activity, restlessness, and difficulty falling or staying asleep.

Higher doses, especially when taken late in the day, can intensify these effects, sometimes causing vivid dreams or nighttime awakenings.

People on long-term corticosteroid therapy may experience chronic sleep issues that disrupt their overall well-being.

Illicit steroid use

Anabolic androgenic steroids (AAS), such as testosterone and methandrostenolone (Dianabol), are sometimes misused by athletes and bodybuilders to enhance muscle growth and performance.

One study found that AAS can significantly disrupt sleep quality when misused, with users reporting lower quality sleep compared to non-users. Sleep quality was even worse during withdrawal from AAS compared to when using the steroids.

Anabolic steroid misuse may also increase the risk of developing obstructive sleep apnea (OSA), a condition in which breathing stops temporarily during sleep due to muscle growth around the neck and throat.

Misuse of anabolic steroids is also linked to changes in mood, anxiety, and irritability, commonly referred to as “roid rage,” which can further disrupt sleep patterns.

Androgenic steroids

Androgenic steroids, including testosterone, are used in hormone replacement therapy to treat certain medical conditions. Unlike anabolic androgenic steroids used for performance enhancement, these steroids are administered at much lower doses under medical supervision.

In some cases, individuals may experience mild insomnia or mood changes that interfere with their ability to fall or stay asleep.

Some studies suggest that testosterone replacement therapy may also worsen OSA symptoms. However, the evidence is mixed and more studies are necessary.

Understanding all of insomnia’s symptoms

Even mild insomnia can cause a variety of other mental health symptoms that you may not expect. These can include:

The duration of sleeplessness caused by steroid use can vary depending on several factors, including the type of steroid, dosage, duration of use, and individual response.

  • Short-term use: For those taking steroids for a short period, sleep disturbances may occur during the time of use and can persist for a few days to weeks after discontinuation.
  • Long-term use: For individuals on long-term steroid therapy, sleep issues might continue as long as the medication is taken, and potentially for some time after stopping, depending on how long the body takes to readjust.
  • Withdrawal: If steroids are discontinued abruptly after prolonged use, sleep disturbances may be prolonged due to withdrawal effects, lasting weeks as the body adjusts.

Managing insomnia caused by steroid use requires a mix of strategies to handle the side effects and improve sleep quality.

Here are some approaches:

  • Talk with your doctor: Discuss your sleep issues with your healthcare professional, who may adjust your dosage or timing to reduce side effects. Reducing these factors can help lessen the risk of sleep disturbances and other adverse effects. Don’t stop or adjust medication without talking with them first.
  • Adjust timing of medication: Take steroids in the morning to align with the body’s natural cortisol rhythm and reduce the effect on sleep. Avoid taking them late in the day or before bedtime.
  • Gradual dose reduction: If possible, work with a healthcare professional to gradually reduce the steroid dose rather than stopping abruptly. This can help reduce withdrawal symptoms, including sleep disturbances.
  • Sleep hygiene: Improve sleep quality by establishing a consistent sleep schedule, creating a restful sleep environment, and avoiding stimulants like caffeine or electronics before bedtime.
  • Relaxation techniques: Practices such as deep breathing exercises, progressive muscle relaxation, or mindfulness meditation can help reduce anxiety and improve sleep.
  • Therapy: Seeing a therapist can help you manage insomnia as well as chronic pain.
  • Medication: In some cases, short-term use of sleep aids or medications prescribed by a healthcare professional may be necessary to manage severe insomnia, though these should be used cautiously and under medical supervision.

Can I take melatonin with steroids?

No. Melatonin isn’t typically recommended for use with corticosteroids or other immunosuppressive drugs.

Melatonin’s immune-modulating effects could interfere with how well corticosteroids weaken immune activity, possibly reducing their effectiveness. Always check with a healthcare professional before combining melatonin with these medications.

They will likely have a safer medication or other sleep aid for you to try.

Steroids can disrupt the sleep-wake cycle, worsen conditions like sleep apnea, and contribute to changes in mood, all of which can negatively affect sleep quality.

If you’re using any type of steroid and experiencing sleep problems, it’s important to consult your healthcare professional for management and adjustments to your treatment.