Antidepressants and Sleep: How Do They Affect You?

People who are experiencing depression often notice disruptions to their sleep patterns. While some people with depression find that they sleep much more than normal, others find that they have difficulty sleeping and suffer from insomnia. 

Taking antidepressant medications can cause changes to your sleep patterns, but when it comes to antidepressants and sleep, how do they affect you?

How does depression affect sleeping patterns?

Depression is a mental health condition and mood disorder that is characterized by mental, physical, and emotional symptoms including feelings of intense sadness, feelings of guilt or worthlessness, and a loss of interest in things the patient once enjoyed doing. Depression is one of the most common mental health issues in the United States, and about seven percent of the adult population suffers from a major depressive episode each year. 

Physical symptoms caused by depression include disrupted sleep patterns, changes in appetite, and low energy levels. Depression impacts people’s sleeping habits in different ways, but the disruption is so common that sleep issues are listed as one of the primary symptoms of depression. 

Some people who are experiencing depression find that they sleep much more than normal, while others find that they struggle with insomnia and are not able to fall asleep easily or get a restful night’s sleep. These disruptions to normal sleeping patterns can exacerbate symptoms of depression in some patients, causing them to feel worse. 

Antidepressant medications are commonly prescribed to patients suffering from depression, and they can also cause changes to sleep patterns.

How do antidepressants impact sleeping patterns?

Antidepressant medications can be very effective for controlling depression symptoms for some people, but they do have a number of side effects, including the tendency to impact sleeping patterns. 

There are five major types of antidepressants that are commonly taken by patients with depression:

• Selective serotonin reuptake inhibitors (SSRIs)
• Serotonin-norepinephrine reuptake inhibitors (SNRIs)
• Tricyclic antidepressants (TCAs)
• MAOIs
• Atypical antidepressants

Each type of medication has a different way of affecting sleep. SSRIs are one of the most commonly prescribed types of antidepressants and include popular medications like Lexapro and Prozac. These medications work by moderating serotonin absorption in the brain; serotonin has been found to impact sleep and wakefulness stages. 

SSRIs have a different impact on everyone, so some patients taking these drugs will experience insomnia, while others may experience daytime drowsiness. However, the most common impact to sleep caused by SSRIs is an increased number of nighttime awakenings and a suppression of REM sleep, or deep sleep. SNRIs act on serotonin and norepinephrine in the brain and have been found to have effects on sleep that are similar to those caused by SSRIs.

Some TCAs, called “activating” TCAs, have been found to boost energy levels and can be effective at treating patients who experience daytime lethargy in conjunction with their depression symptoms. However, TCAs most frequently have the opposite effect and are disruptive to REM sleep, causing a decrease in sleep efficiency. 

People taking TCAs are likely to have their sleep disrupted and may not feel well rested even after getting a full night’s sleep. TCAs that have been found to have a reduced impact on REM sleep and are thereby said to be less disruptive to a patient’s sleeping habits include trimipramine, nefazodone, mirtazapine, trazodone, and bupropion.

MAOIs are no longer commonly used to treat depression and are generally only prescribed to patients who have not experienced symptom relief from other antidepressants. Some MAOIs, such as tranylcypromine, have been found to be disruptive to REM sleep and are associated with insomnia, while others are more sedating. However, MAOIs in general are associated with REM disruption. Atypical antidepressants all work differently and have a variety of impacts on sleep. However, they are less likely to suppress REM sleep in general.

Is it possible to prevent sleep disruption caused by antidepressants?

The effects of antidepressants on sleep depend on the class of the medication, the dosage, and the time of day that the medication is taken. It is recommended that patients who experience insomnia as a result of their antidepressant talk to their doctor about taking their medication in the morning instead of at night. Patients who experience drowsiness from their antidepressant medication should consider taking their medication at bedtime with their doctor’s permission. 

Sources:

https://www.webmd.com/depression/sleep-problems-and-depression#1 

https://pubmed.ncbi.nlm.nih.gov/15892588/ 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5548844/