Can Zoloft (Sertraline) Cause Insomnia?
Depression, anxiety, and other mental health conditions are major causes of insomnia. Unfortunately, some of the treatments for these conditions can also make it more difficult to get a good night’s sleep. Certain types of antidepressants, including Zoloft, lead to insomnia in nearly one out of five people.
Does Zoloft Cause Insomnia?
Zoloft is an antidepressant that belongs to a category of drugs called selective serotonin reuptake inhibitors (SSRIs). Zoloft, which also goes by the generic name sertraline, can help treat depression as well as other mental health conditions.
Zoloft may cause insomnia, making it harder to fall asleep or stay asleep. For some people, the insomnia caused by Zoloft is temporary. For others, it may be ongoing — lingering for several months or more — requiring further treatment.
SSRIs and Insomnia
Insomnia is the most common sleep disorder and, according to the Cleveland Clinic, it affects around 70% of Americans every year. Insomnia can be transient (lasts a few days or weeks) or acute (lasts more than three months).
For around 15% of the population, insomnia is chronic, and for many, it is a struggle that can last for years. Contrary to popular belief, having insomnia doesn’t just mean you don’t get enough sleep. You can meet your sleeping quota, but if you have trouble falling asleep or staying asleep, or feeling rested during the day, these sleep challenges also fall under the category of insomnia.
Insomnia can be caused by many factors, some better known, such as stress, anxiety, or an uncomfortable sleeping environment, and others, lesser known. For example, insomnia can also appear as a side effect of antidepressants, which frequently interfere with sleep physiology.
Insomnia Caused by Antidepressants
Unlike some other treatments for mental health conditions, Zoloft is not a sedative and doesn’t often make you sleepier, although it can occasionally cause fatigue as a side effect.
SSRIs work by increasing serotonin levels in the brain. Serotonin is a neurotransmitter (brain chemical) that affects mood and sleep-wake regulation. Zoloft can also change the levels of other neurotransmitters. These changes in brain chemistry may be why antidepressants cause insomnia.
Various clinical studies have shown that SSRIs can:
- Increase the amount of time it takes to fall asleep
- Make you more likely to wake up in the middle of the night
- Lead to less rapid eye movement (REM) sleep — the sleep stage in which most of your dreaming occurs
In many cases, Zoloft and other drugs that affect serotonin may successfully improve the symptoms of depression or other mental health conditions but exacerbate insomnia. It’s essential to discuss side effects with your doctor when determining the best course of action for treatment.
Zoloft Recommended Dosage
When you first begin treatment, your doctor will likely recommend taking a low dose of Zoloft. The common starting dose for depression is 50 mg once per day. The standard Zoloft dose for anxiety disorders is 25 mg per day.
Your doctor will assess how well the drug is working and whether you experience any side effects. They may recommend increasing the dose and then reassessing. You may go through this process a couple of times until you find a dosage that works for you.
Zoloft should be taken at the same time each day, in the morning or evening. The best time to take Zoloft for sleep depends on how the drug affects you. If this medication increases insomnia, taking it in the morning may help. If Zoloft makes you drowsy, your doctor may recommend taking it in the evening.
If you miss a dose of Zoloft, you should generally take it as soon as possible once you remember. However, you should avoid taking a double dose. If you remember a missed dose right before it’s time for your next dose, just skip the missed dose and take one dose of Zoloft as usual.
Can You Drink While Taking Zoloft?
The drug’s label says that you should avoid mixing Zoloft and alcohol. These two substances can interact, exacerbating Zoloft’s negative side effects and reducing its positive effects.
You should also avoid skipping Zoloft to drink alcohol. If you don’t take this medication consistently, your depression or anxiety can worsen.
Zoloft Side Effects
Besides insomnia, Zoloft can also lead to several other side effects, including:
- Nausea or vomiting
- Diarrhea or constipation
- Loss of appetite or weight changes
- Dry mouth
- A low sex drive
This medication may also cause specific problems for males or females. In men, Zoloft can lead to problems getting an erection or difficulty achieving ejaculation. Zoloft's side effects for women include trouble having an orgasm. Zoloft may not be a good choice for women who are pregnant, as this medication can lead to birth defects.
Zoloft’s side effects may appear within the first week of taking the drug. Certain problems such as nausea and drowsiness are more likely to appear early on. These effects may also emerge or worsen if your dosage is increased. The initial side effects of Zoloft may also wear off over time.
In rare cases, this medication may also lead to more serious side effects. Zoloft can cause hallucinations, seizures, bleeding problems, and rashes. If you notice any of these health problems while taking Zoloft, contact your doctor right away.
Zoloft and Night Sweats
Zoloft can also cause night sweats. About 22% of people taking antidepressants experience episodes of extreme sweating while sleeping and may wake up to find that their bedsheets or pajamas are soaked through. Zoloft is one of the antidepressants most likely to cause this side effect.
Does Zoloft Help With Anxiety?
Although this drug is an antidepressant, Zoloft can also treat anxiety and other mental health conditions. In the U.S., the Food and Drug Administration (FDA) has approved Zoloft for the treatment of multiple anxiety disorders and related conditions, including social anxiety disorder, panic disorder, obsessive-compulsive disorder (OCD), and post-traumatic stress disorder (PTSD). It is also used off-label to treat generalized anxiety disorder.
Studies show that Zoloft works quickly to treat anxiety — symptoms often improve within the first six weeks of taking the drug. Zoloft helps with anxiety even more quickly than it helps with depression.
Healthy Ways to Treat Insomnia Caused by Zoloft
Although many people believe that insomnia can only be cured with drugs, the truth is that there are effective non-pharmacological methods for treating insomnia. In fact, guidelines from the American Academy of Sleep Medicine and the American College of Physicians recommend non-pharmacological treatments as first-line interventions.
- Exercising — studies have shown that exercising regularly works just as well as sleeping pills but without the side effects. What’s more, 83% of people who exercise regularly report sleeping better. Exercise is also an excellent way to manage depression.
- Meditation and yoga help reduce stress, which is one of the leading factors behind insomnia. According to a 2019 study, those who do yoga and other mind-body practices such as meditation, tai chi, and qigong have better sleep quality. Studies have shown that mindfulness is also an effective intervention for insomnia.
- Improving your sleeping habits can also promote healthy sleep patterns. The more you provide a stable routine for your sleep, the more optimal your sleep will be over time. When sleep becomes more reliable, you will decrease the links between sleep and negative emotions, and thus reduce and eventually avoid hyperarousal.
If you struggle with depression and insomnia, be sure to discuss these concerns with your physician to determine the potential cause and the best course of action for treatment.
Why CBT-I May Be the Best Cure for Insomnia
Curing insomnia doesn’t have to involve drugs that create dependency and cause unwanted side effects. Cognitive behavioral therapy for insomnia (CBT-I) is a scientific, evidence-based approach to treating insomnia. CBT-I is based on the principles of Cognitive Behavioral Therapy — a form of talking therapy that focuses on the connection between our thoughts, emotions, and habits.
CBT-I is recommended by the American Academy for Sleep Medicine, the American College of Physicians, and the European Sleep Research Society.
Utilizing the principles of CBT-I, Dawn is completely safe and, unlike sleep medications, it does not cause side effects or create dependency. In clinical trials, 80% of people who underwent CBT-I reported better sleep patterns, and Dawn success stories show that CBT-I can help you fall asleep effortlessly without pills.
To learn more about how to effectively treat your insomnia and why Dawn is the right choice for you, please fill out this form to start your journey to a restful night’s sleep!
For more resources on insomnia and to discover how CBT-I can help, visit Dawn.health.
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Dr. Colleen Ehrnstrom is a licensed clinical psychologist with a specialty practice in Acceptance and Commitment Therapy (ACT). Areas of expertise include insomnia and other sleep disorders, anxiety, and depression.
Dr. Ehrnstrom is not a medical provider and is not providing any recommendations regarding medications. Rather, she is sharing and reviewing the research as it relates to education when learning how best to treat insomnia.