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Does Dexamethasone Cause Insomnia

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How To Sleep While Taking Steroids

Dexamethasone (Does dexamethasone work against COVID-19?) | Overview | Dosage | Side Effects

Since the primary purpose of certain corticosteroids is to mimic the hormone responsible for alertness, insomnia and trouble sleeping are side-effects difficult to avoid. However, there are steps you may be able to take to minimize your risk.

The right kind of steroidThe first step, as with any medication, is to speak to your doctor about your options. Getting the right kind of steroid from day one, can reduce your problems with sleeplessness. For instance, some people believe its easier to figure out how to sleep while taking Dexamethasone, than when taking Prednisone.

The right dosageDosage is another significant factor. No form of corticosteroid is intended to be used at a high dose for long periods of time. The longer you take this kind of medication, the higher the dose, the more significant your risk of side effects and complications.

Prednisone is usually intended for short-term use, to bring inflammation caused by a disease under control. Youll also be given the lowest possible dosage of this drug to help reduce your risk of side effects. However, for some conditions, higher doses will be needed.

TimingTaking your corticosteroids in the morning will significantly reduce the risk of sleep problems. It takes about 8 hours for the body to metabolize Prednisone and a little longer for Dexamethasone.

Dexamethasone And Insomnia: Does Prednisone Cause Insomnia

Prednisone and Dexamethasone are both kinds of synthetic corticosteroids used to suppress the immune system and reduce inflammation.

Insomnia is one of the most reported side effects, when taking these. So, how does Prednisone cause insomnia? Read on to learn how to sleep while taking steroids. Find the specific cause of this adverse effect, and how to reverse it.

Corticosteroids can successfully treat various conditions, including arthritis, asthma, colitis, bronchitis, and various allergies. In some cases, these substances can also help to prevent the body from rejecting transplanted organs.

Like all medications, Dexamethasone and Prednisone can both cause an additional range of side effects, including:

  • Weight gain
  • Psychotic behavior
  • Personality changes

Additionally, suddenly stopping your consumption of Prednisone or Dexamethasone can also cause withdrawal symptoms, which among other side effects, can cause severe sleeping issues too.

Problem sleeping is slightly more common with Prednisone than Dexamethasone, but both medications are notorious for interfering with sleep. Apart from medications like Adderall, designed to keep you awake and focused, theyre the among some of the worst culprits for disturbing sleep.

Due to their ability to interfere with everything from mood to blood pressure, alertness, and focus all forms of corticosteroids tend to cause insomnia to some degree.

How To Take It

There is currently no recommended dose for melatonin supplements. Different people will have different responses to its effects. Lower doses appear to work better in people who are especially sensitive. Higher doses may cause anxiety and irritability.

The best approach for any condition is to begin with very low doses of melatonin. Keep the dose close to the amount that our bodies normally produce . You should only use the lowest amount possible to achieve the desired effect. Your doctor can help you determine the most appropriate dose for your situation, including how to increase the amount, if needed.

Pediatric

  • Always ask your child’s doctor before giving melatonin to a child. In fact, doses between 1 to 5 mg may cause seizures in this age group.

Adult

  • You should work with your doctor to find the safest and most effective dose for you. The right dose for you should produce restful sleep with no daytime irritability or fatigue.
  • Jet lag: 0.5 to 5 mg of melatonin 1 hour prior to bedtime at final destination has been used in several studies. Another approach that has been used is 1 to 5 mg 1 hour before bedtime for 2 days prior to departure and for 2 to 3 days upon arrival at final destination.

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For Children And Teenagers

If your child takes dexamethasone for several months, their height and weight need to be monitored carefully. This is to make sure the steroid is not affecting their growth. Talk to their doctor if you’re worried. They will be able to explain the benefits and risks of giving your child dexamethasone.

Do not stop taking dexamethasone suddenly, especially if you have been on a high dose for a long time.

Your health condition may flare up again. You may also get extra side effects including:

  • severe tiredness
  • body aches
  • joint pain

Your doctor will probably want to reduce your dose gradually over several weeks to prevent these side effects.

Correlation Between Items Of The Dsq

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In order for the DSQ to be a useful clinical instrument, it should demonstrate correlation between items that one would expect to be correlated, and to discriminate between items that are expected to be relatively independent. Table 4 indicates Spearman rank correlation co-efficients between items of the DSQ. As expected, nausea and vomiting , and increased appetite and weight gain were strongly correlated. Items such as insomnia and acne showed, as expected, a low coefficient of correlation . The nausea/vomiting subscore was positively associated with the dexamethasone side-effect subscore however, this association was not statistically significant .

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How Should This Medicine Be Used

Dexamethasone comes as a tablet and a solution to take by mouth. Your doctor will prescribe a dosing schedule that is best for you. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take dexamethasone exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.

Do not stop taking dexamethasone without talking to your doctor. Stopping the drug abruptly can cause loss of appetite, upset stomach, vomiting, drowsiness, confusion, headache, fever, joint and muscle pain, peeling skin, and weight loss. If you take large doses for a long time, your doctor probably will decrease your dose gradually to allow your body to adjust before stopping the drug completely. Watch for these side effects if you are gradually decreasing your dose and after you stop taking the tablets or oral liquid, even if you switch to an inhalation corticosteroid medication. If these problems occur, call your doctor immediately. You may need to increase your dose of tablets or liquid temporarily or start taking them again.

Sleep Comparison Between Steroid Groups

Average daily values of total sleep time, sleep onset latency, sleep quality, night awakenings, and nap frequency by steroid group are presented in Figs. 2 and and3.3. During the steroid week, children taking prednisone experienced better sleep quality and fewer night awakenings than children taking dexamethasone . There were no differences between total sleep time, sleep onset latency, and napping between the groups during the steroid week.

Night awakenings and daily naps by steroid. Vertical dotted line at day 7 indicates end of steroid period

For the time off steroids, children taking prednisone continued to experience significantly better sleep quality than children taking dexamethasone . There were no differences on night awakenings, total sleep time, sleep onset latency, and napping between the groups during the weeks off steroids.

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How Long Do Dexamethasone Side Effects Last

With a half-life of four hours , a 20 mg dose is eliminated from the body in about 24 hours. Many of the temporary side effects of dexamethasone, such as mood changes or anxiety, will wear off by that time.

Dexamethasone is not applied directly to skin, but long-term use can affect the skin. These side effects may take longer to clear up after the medication is discontinued. Some such responses, like skin thinning, can be treated. Pigment changes or stretch marks, though, may be permanent.

More severe side effects may take longer to resolve. Peptic ulcers, perforation, bone fractures, tendon rupture, cataracts, and glaucoma are longer-lasting and will often require medical treatment. Adrenal insufficiency caused by prolonged use of dexamethasone could take months to resolve. Some of the most serious side effects, such as congestive heart failure, can be lifelong.

Dexamethasone Contraindications & Warnings

Dexamethasone Side Effects

Dexamethasone is used for a wide range of medical conditions, some quite serious. However, a doctor or healthcare provider may need to avoid using dexamethasone in people with certain pre-existing conditions.

Dexamethasone is never used in people with:

  • Systemic fungal infections
  • Torn or ruptured posterior lens capsule

Dexamethasone ear drops are never given to people with:

  • Perforation of the drum membrane
  • Fungal infections of the ear

People with other conditions may encounter problems when taking dexamethasone. These include:

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Urgent Advice: Contact A Doctor Urgently If:

  • you’re feeling depressed
  • you’re thinking about harming yourself
  • you have strange or frightening thoughts

Taking dexamethasone makes you more likely to catch infections such as flu, the common cold and chest infections.

Keep away from people with an infectious disease, especially measles, chickenpox or shingles. If you get any of these illnesses they could make you very ill.

Yes, you can drink alcohol while taking dexamethasone.

No, you can eat and drink normally while taking dexamethasone.

There’s no clear evidence to suggest that taking dexamethasone will reduce fertility in either men or women.

However, speak to a pharmacist or your doctor if you’re trying to get pregnant.

Predictors Of Hrql And Fatigue

Step-wise regression models were run entering demographic variables in step 1, medical variables in step 2, and sleep variables in step 3 to predict HRQL and fatigue in the weeks on and off steroids. Model 1 predicting HRQL during the steroid week was not significant . Model 2 predicting HRQL during the last week of the month was significant . Models 3 and 4 predicting fatigue were also significant during the steroid week and the last week of the month . With the exception of HRQL during steroids , the addition of the sleep variables was responsible for a significant change in the percentage of the variance explained .

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Tell The Doctor About All Medical Conditions And Medications

Because of the risk of side effects, inform the healthcare professional prescribing or dispensing dexamethasone about all medical conditions and medications, including:

  • Any current or past medical conditions, especially
  • Any fungal infection
  • Tuberculosis, malaria, or herpes eye infection
  • Any current or recent infection
  • Exposure to measles or chickenpox
  • Mental illness
  • Gastrointestinal problems, particularly stomach ulcers, ulcerative colitis, diverticulitis, or recent intestinal surgery
  • Osteoporosis
  • Myasthenia gravis
  • Thyroid problems
  • All medications, over-the-counter medications, and supplements currently being taken, especially antibiotics, antifungals, NSAIDs, or birth control pills
  • Any recent vaccinations
  • What Other Information Should I Know

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    Keep all appointments with your doctor and the laboratory. Your doctor will order certain lab tests to check your response to dexamethasone. Checkups are especially important for children because dexamethasone can slow bone growth.

    If your condition worsens, call your doctor. Your dose may need to be adjusted.

    Carry an identification card that indicates that you may need to take supplementary doses of dexamethasone during periods of stress . Ask your pharmacist or doctor how to obtain this card. List your name, medical problems, drugs and dosages, and doctor’s name and telephone number on the card.

    This drug makes you more susceptible to illnesses. If you are exposed to chicken pox, measles, or tuberculosis while taking dexamethasone, call your doctor. Do not have a vaccination, other immunization, or any skin test while you are taking dexamethasone unless your doctor tells you that you may.

    Report any injuries or signs of infection that occur during treatment.

    Your doctor may instruct you to weigh yourself every day. Report any unusual weight gain.

    If your sputum thickens or changes color from clear white to yellow, green, or gray, call your doctor these changes may be signs of an infection.

    Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription.

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    Side Effects Not Requiring Immediate Medical Attention

    Some side effects of dexamethasone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

    Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

    More common

    • lightening of normal skin color
    • red face
    • reddish purple lines on the arms, face, legs, trunk, or groin
    • swelling of the stomach area
    • thinning of the scalp hair

    A Few Tips To Fight Insomnia Caused By Prednisone Use

    Dear Dr. Roach:

    I have a medical condition that currently requires me to take 60 mg of prednisone per day, resulting in insomnia. I get approximately five hours of sleep per night. Sometimes Im able to take a one-hour nap in the afternoon. Is there anything I can do to reduce the insomnia? M.H.S.

    Dr. Roach: Prednisone is a powerful anti-inflammatory and immune-system suppressor that is used for many conditions. It can cause some degree of insomnia in 50 to 70 percent of those who take it, but the higher the dose, the more likely the insomnia.

    It sounds like crazy advice, but many of my patients have had luck following my recommendation to take the prednisone immediately before bedtime. Prednisone takes time to work, and some people are able to fall asleep before the effects of the medicine kick in.

    Unfortunately, others have medical conditions that require them to take prednisone twice daily. This is more effective, but its more likely to cause side effects, including insomnia.

    Dear Dr. Roach: I have never had shingles, nor chickenpox. I could find no record of it, even in my baby book. Do I need to have the shingles shot? I am over 70. C.S.

    Dr. Roach: Most people did have chickenpox, but occasionally the case is not recognized, especially in very young children. In any case, the shingles vaccine is recommended for most adults over 60, whether or not you have had evidence of shingles or chickenpox in the past.

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    Prednisone And Insomnia: Steroids Stop You Sleeping

    For most people, the answer to Does prednisone cause insomnia will be sometimes or usually. To understand why theres such a significant problem with steroids and sleep, youll need to know how steroid medications work.

    Corticosteroids like Prednisone and Dexamethasone are man-made substances which mimic the bodys natural fight-or-flight hormone, cortisol.

    Cortisol is also the substance associated with stress, focus, and concentration. When your body needs to be awake, your brain signals to stop the production of melatonin and begin the production of cortisol .

    Though Prednisone isnt a stimulant, its ability to replicate cortisol means you can feel more alert and jittery. This makes it much harder to get to sleep, or even relax at night.

    Mood issues are also common with Prednisone, and since issues like anxiety can make it harder to sleep, this makes the problem of insomnia even more likely.

    Nasal Decongestants Or Oral Decongestants

    Dexamethasone for Covid-19 patients #dexamethasoneforcovid

    Decongestants can come in handy when youre suffering from a stuffy nose. They can be taken as a nasal spray, like , or as an oral decongestant, like . But one downside is that decongestants can cause insomnia.

    If youre using a decongestant, its probably just for a short period of time, so you may decide to push through the nighttime annoyance until you dont need it anymore. You could also consider an alternative, drug-free option like a saline nasal spray or an antihistamine nasal spray like .

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    More Common Side Effects

    The more common side effects that can occur with dexamethasone oral tablets include:

    • nausea
  • rapid heartbeat
  • Osteoporosis
  • Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.

    Increased Doses Needed For Physical Stress

    Steroid use for over two weeks can decrease the ability of your body to respond to physical stress. A higher dose of steroid may be needed at times of major stress, such as surgery or very extensive dental work or serious infection. This could be needed for as long as a year after you have stopped steroids.

    Self-care tips:

    • Discuss this possibility with the surgeon or dentist, etc. who is taking care of you at the time. Your physician or surgeon may not feel you need to take the extra steroid at the time of surgery, but if they know you have been on corticosteroids they can watch you more carefully after surgery.

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    Take Dexamethasone As Scheduled

    Some people will receive dexamethasone injections from a healthcare provider. They may be given once or on a schedule. Make sure to keep all appointments for injections.

    For other forms of dexamethasone, a healthcare provider will furnish a dosing schedule. For tablets or oral solutions, doses are usually taken once or twice a day. Dexamethasone eye drops have an initial dosing schedule of once per hour that eventually might fall to three or four doses a day. Ear drops will have a schedule of three or four doses a day. These can be complex dosing schedules, so use an alarm, medication diary, or smartphone app to be sure not to miss a dose.

    Talk to a doctor, pharmacist, or other healthcare professional for medical advice about what to do for a missed dose.

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