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Many prescription and over-the-counter drugs can affect sleep quality and are associated with sleep disorders ranging from insomnia (difficulty falling asleep or maintaining sleep) to excessive daytime sleepiness.[1] In the March 2023 issue of Worst Pills, Best Pills News, we discussed drugs that cause or exacerbate insomnia.[2] This article discusses drug-induced excessive daytime sleepiness. In a future issue, we will discuss drugs associated with sleep apnea and sleep-related movement...
Many prescription and over-the-counter drugs can affect sleep quality and are associated with sleep disorders ranging from insomnia (difficulty falling asleep or maintaining sleep) to excessive daytime sleepiness.[1] In the March 2023 issue of Worst Pills, Best Pills News, we discussed drugs that cause or exacerbate insomnia.[2] This article discusses drug-induced excessive daytime sleepiness. In a future issue, we will discuss drugs associated with sleep apnea and sleep-related movement disorders, including sleepwalking.
Most people from time to time feel sleepy or very sleepy during the day. Feeling sleepy (somnolence), fatigued or drowsy during waking hours is usually due to missing sleep during the night.[3] In contrast, excessive daytime sleepiness (hypersomnia) manifests itself through excessive napping and falling asleep during the day at inappropriate times, sometimes regardless of whether a person had adequate sleep during the night.[4]
Feeling excessively sleepy during the day is a common symptom of several medical conditions.[5] Examples include multiple sclerosis, epilepsy, Parkinson’s disease, hypothyroidism, chronic liver disease and kidney failure. In addition, many prescription and over-the counter drugs can cause daytime sleepiness either directly or indirectly by worsening nighttime sleep quality. Daytime sleepiness and hypersomnia can severely diminish quality of life and lead to serious accidents.
Any medication that can cross the blood-brain barrier and interfere with neurotransmitters and receptors involved in the regulation of sleep and wakefulness may affect sleep quality.[6]
Drugs may directly induce sleepiness, or they may interrupt sleep, leading to daytime drowsiness.[7] Moreover, it is often difficult to discern whether sleepiness is the effect of a drug or of an underlying condition.[8] For example, sleepiness is a common adverse effect of both Parkinson’s disease and epilepsy, as well as of medications that treat these conditions. Generally older adults and those with multiple medical conditions have a higher risk of drug-induced hypersomnia.
Although many drug classes are associated with sleep disruption, approximately 20% of those drugs lack U.S. label warnings about such adverse effects. Moreover, most pharmacovigilance studies are small studies that do not compare sleep effects between drugs.[9] Drug classes that are commonly associated with daytime sleepiness are described below.
Antipsychotics can directly affect sleep and promote drowsiness.[10] Examples of these antipsychotics include clozapine (CLOZARIL, VERSACLOZ and generics), haloperidol (generic only), olanzapine (ZYPREXA and generics), risperidone (RISPERDAL and generics) and ziprasidone (GEODON and generics). After a few weeks of treatment, some patients may develop tolerance to the drug’s daytime effects and be less likely to be drowsy.
Long-term use of opioids, such as oxycodone (OXYCONTIN, ROXICODONE, ROXYBOND, XTAMPZA ER and generics), hydrocodone (HYSINGLA ER and generics) and tramadol (CONZIP and generics) can negatively affect daytime function in a number of ways, including promoting excessive sleepiness and fatigue.[11],[12] Opioid use also increases the risk of disrupted breathing during sleep. Importantly, the use of opioids in combination with other products that have sedating effects (including benzodiazepines, first-generation antihistamines and alcohol) can increase the sedating effects.
Certain sedative-hypnotic drugs can lead to excessive sleepiness and potentially dangerous sleep-related behaviors such as driving when not fully awake.[13] These drugs include benzodiazepines, such as alprazolam (XANAX and generics), chlordiazepoxide (LIBRIUM and generics) and diazepam (DIAZEPAM INTENSOL, VALIUM and generics). In fact, these drugs are also used to induce or maintain sleep and to treat acute anxiety.
And another class of hypnotics — often called Z-drugs — are approved for short-term relief of insomnia and have similar but shorter-acting effects than benzodiazepines. Common Z-drugs include eszopiclone (LUNESTA and generics), zaleplon (generic only) and zolpidem (AMBIEN, EDLUAR and generics). Because of the serious risks associated with these drugs, including abuse and addiction, Public Citizen’s Health Research Group classifies all benzodiazepines (except for alprazolam, which can be used to treat panic disorder) and Z-drugs as Do Not Use.[14]
Table. Examples of Other Oral Drug Classes Associated With Daytime Sleepiness[16],[17],[18]
| Drug Class | Generic Name | Brand Name(s)† |
|---|---|---|
| Blood pressure drug | propranolol | HEMANGEOL, INDERAL LA, INNOPRAN XL and generics |
| Epilepsy drugs | gabapentin | GRALISE, NEURONTIN, RELGAABI and generics |
| pregabalin* | LYRICA and generics | |
| valproic acid | generic only | |
| Parkinson’s disease drugs | pramipexole* | generic only |
| ropinirole* | generic only | |
| Tricyclic antidepressant | doxepin** | SILENOR and generics |
†Brand-name combination products that contain other active ingredients are not included.
*Designated as Limited Use by Public Citizen’s Health Research Group.
** Designated as Do Not Use by Public Citizen’s Health Research Group.
Additional prescription drug classes are associated with excessive daytime sleepiness.[15] These include antidepressants, especially tricyclic antidepressants, such as amitriptyline (generic only); drugs for high blood pressure, such as clonidine (JAVADIN, NEXICLON XR, ONYDA XR, QLONILIK and generics); migraine drugs, including zolmitriptan (generic only); antihistamines, such as hydroxyzine (generic only); epilepsy drugs, including phenytoin (DILANTIN, PHENYTEK and generics); and Parkinson’s disease drugs containing levodopa (CREXONT, DHIVY, RYTARY, SINEMET, STALEVO and generics). The Table, above, has additional examples of oral drugs that are associated with daytime sleepiness; not all drugs and drug classes are listed.
What You Can Do
If you experience unexplained excessive daytime sleepiness, review all your prescription and over-the-counter medications with your clinician to determine whether any of them may be contributing to your symptoms. Make sure that any relevant medical conditions are ruled out.
Although drug-induced sleepiness is often resolved if the drug is discontinued, this may not always be an option.[19] Instead, your clinician may suggest an alternative drug or nighttime dosing to minimize a drug’s effects on daytime sleepiness. Do not stop taking any prescription medication without first talking to your clinician. Be aware that other drugs not listed in this article can cause excessive daytime sleepiness.
References
[1] Jain, K.K., 2021. Drug-induced sleep disorders. In Drug-induced neurological disorders (pp. 295-308). Cham: Springer International Publishing.
[2] Drug-induced insomnia. Worst Pills, Best Pills News. March 2023. https://www.worstpills.org/newsletters/view/1522. Accessed September 1, 2026.
[3] Murray BJ. Excessive daytime sleepiness due to medical disorders and medications. UpToDate. Updated September 4, 2025.
[4] National Health Service. Excessive daytime sleepiness (hypersomnia). June 23, 2023.
https://www.nhs.uk/conditions/excessive-daytime-sleepiness-hypersomnia/. Accessed September 9, 2026.
[5] Murray BJ. Excessive daytime sleepiness due to medical disorders and medications. UpToDate. Updated September 4, 2025.
[6] Jain, K.K., 2021. Drug-induced sleep disorders. In Drug-induced neurological disorders (pp. 295-308). Cham: Springer International Publishing.
[7] Van Gastel A. Drug-induced insomnia and excessive sleepiness. Sleep Med Clin. 2022;17(3):471-484.
[8] Murray BJ. Excessive daytime sleepiness due to medical disorders and medications. UpToDate. Updated September 4, 2025.
[9] Zhang M, Li J, Huang S, et al. Not always a good night's sleep: A global pharmacovigilance risk profiling of drug-induced sleep disorders. Sleep Med. 2026 Nov;147:109161.
[10] Van Gastel A. Drug-induced insomnia and excessive sleepiness. Sleep Med Clin. 2022;17(3):471-484.
[11] Cao M, Javaheri S. Effects of chronic opioid use on sleep and wake. Sleep Med Clin. 2018;13(2):271-281.
[12] Van Gastel A. Drug-induced insomnia and excessive sleepiness. Sleep Med Clin. 2022;17(3):471-484.
[13] Ibid.
[14] Jain, K.K., 2021. Drug-induced sleep disorders. In Drug-induced neurological disorders (pp. 295-308). Cham: Springer International Publishing.
[15] Van Gastel A. Drug-induced insomnia and excessive sleepiness. Sleep Med Clin. 2022;17(3):471-484.
[16] Ibid.
[17] Jain, K.K., 2021. Drug-induced sleep disorders. In Drug-induced neurological disorders (pp. 295-308). Cham: Springer International Publishing.
[18] Murray BJ. Excessive daytime sleepiness due to medical disorders and medications. UpToDate. Updated September 4, 2025.
[19] Jain, K.K., 2021. Drug-induced sleep disorders. In Drug-induced neurological disorders (pp. 295-308). Cham: Springer International Publishing.
