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Q: I am wondering if one of my medications is interfering with my sleep. Which types of drugs are more likely to do that?

A: Medications that affect sleep can be prescription drugs or over-the-counter remedies. Here are some common culprits:

Antidepressants. Antidepressants are typically prescribed to treat depression or anxiety, and they have varying side effects, even within the same drug class. For example, among selective serotonin reuptake inhibitors (SSRIs), fluoxetine (Prozac) can be stimulating and may make it hard to fall or stay asleep.

Beta blockers. Beta blockers such as metoprolol (Lopressor, Toprol XL) and atenolol (Tenormin) are used primarily to treat high blood pressure or an irregular heartbeat. These medications can sometimes decrease the body’s natural levels of melatonin, a hormone that helps regulate your sleep-wake cycle.

Decongestants. Oral decongestants such as pseudoephedrine help shrink swollen membranes in the nasal passages, allowing more air to pass through them. But they can be stimulating. They can raise your blood pressure and heart rate, and may cause insomnia in some people.

Diuretics. Diuretics such as furosemide (Lasix), torsemide (Demadex), and hydrochlorothiazide reduce the amount of sodium and water in the body. They’re prescribed to treat high blood pressure, kidney disorders, liver disease, and fluid retention caused by heart failure. Diuretics don’t affect sleep directly, but they can interrupt sleep if they make you go to the bathroom during the night.

Smoking-cessation drugs. Over-the-counter nicotine replacement medications such as nicotine patches, gum, or lozenges can cause someone to have unusual dreams or nightmares and wake them up. The prescription drug varenicline (Chantix) also can cause nightmares.

Steroids. Oral steroids such as prednisone are used to reduce inflammation inside the body. Prednisone stimulates the production of the stress hormone cortisol and mimics what stress does to the body, which can make it hard to fall asleep and disrupt the sleep cycle.

What to do about it

There are a number of things you can do if you think your sleep problems could be related to one of your medications.

Practice good sleep hygiene. Go to bed and wake up at the same time each day; avoid caffeine after lunch; don’t drink alcohol or eat close to bedtime; turn off electronic screens an hour before bed; and sleep in a cool, dark, comfortable spot.

Take the medication during the day. This applies to drugs that make it hard to fall or stay asleep, cause nightmares, or make you get up and go to the bathroom.

Take a lower dose. Ask your doctor if lowering your medication dose will help you get better sleep.

Switch to a new medication. If you’ve tried everything and sleep problems are becoming distressing, ask your doctor if you can switch to a medication that won’t affect your sleep.

Howard LeWine, M.D., is an internist at Brigham and Women’s Hospital in Boston and assistant professor at Harvard Medical School. For additional consumer health information, visit health.harvard.edu.

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