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Inhaled steroids and insomnia
Hi, all.
I have been taking inhaled steroids for bronchiectasis since 2012, with the occasional infammation requiring prednisone. For the last year, though, my sleep has been getting worse, to the point I often do not get more than four hours every night. Sometimes coughing is waking me up, but otherwise it is the usual aches and pains I have had for years. The problem is I cannot get back to sleep, nor can I nap for more than a few minutes at a time. I have been treated with increasingly powerful sleep meds, but the problem just gets worse, and I am wondering if the steroids are at the root of my inability to get back to sleep. Has anyone been told that their long-term use of inhaled steroids might be the cause of their bad sleep?
Thank you.
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After a lot of experimentation, I've concluded that, for me at least, taking nothing is the best sleep remedy. Instead, I've focused on improving my sleep hygiene. I still keep a prescription for zolpidem on hand for travel, but in general I've found that training my body to associate bed with sleep, not tossing and turning, has been the most effective approach.
My routine is simple: no phone before bed, just reading a paper book. I dim the lights, try to maintain a consistent sleep schedule, wear an eye mask, and keep the bedroom cool and very dark.
I've also tried full spectrum CBD oil. It helps me fall asleep, but I consistently woke up two to three hours before I was ready to start my day, so it wasn't a good long term solution.
More recently, TMJ pain began interfering with my sleep. A mouth guard and baclofen, a muscle relaxant, have both helped, and Tylenol is useful on nights when aches and pains are likely to be an issue.
Getting enough movement during the day also seems important. On a recent trip, I slept remarkably well without taking anything. The hotel room was dark, quiet, and free of distracting lights, and I was walking at least 15,000 steps a day. Timing airway clearance has also helped. I try to do it at least two hours before bed so the saline isn't rattling around in my lungs during the night.
Despite all of this, my sleep app still records "full awakenings" on several nights, usually because of coughing. Brinsupri has dramatically reduced my daytime cough, but nighttime coughing remains unpredictable. Some days I clear more mucus, some days less, and I've stopped trying to find a pattern. At this point, I just accept it as part of the variability of living with this condition.
PS - editing to add that I take symbicort 2 puffs 2x day for asthma. I cannot take the p.m. dose too close to bedtime or it will keep me awake. I have not been on oral steroids for some time but when I was they definitely interfered with sleep.