Somnera
Getting help

Does prednisone cause insomnia? Steroids and sleep

Lying awake wired on prednisone is one of the best-known steroid side effects. Why it happens, how long it tends to last, and what to raise with your prescriber.

5 min read

Last reviewed November 11, 2026

Share

Yes. Insomnia is one of the best-known side effects of prednisone and other corticosteroids, and it is listed in the prescribing information. Many people feel wired, restless or unable to switch off at night. With a short course it usually settles soon after the course ends. Do not stop or change a steroid on your own; tell your prescriber how you are sleeping, and ask about timing.

Why steroids keep you awake

Prednisone is a synthetic version of cortisol, a hormone your body already makes. Cortisol has a daily rhythm: it is low around bedtime and rises toward morning, helping you wake up and feel alert. Taking a steroid adds a large amount of cortisol-like signal on top of that rhythm.

The result, for many people, is the feeling of morning arriving at the wrong time. Your heart may feel quicker, your thoughts busier, and your body less ready to wind down. Some people also notice more hunger, more trips to the bathroom, or night sweats, all of which can break up sleep.

How much it affects you depends on the drug, the dose, how long you take it, and you. Two people on the same course can have very different nights.

What about a steroid shot?

Steroid injections, whether into a joint, a muscle, or the spine, are often given for pain or inflammation in one place. Some of the medicine still reaches the rest of the body, and some people notice a few nights of poor sleep, flushing or a lift in energy afterward.

For most people this passes. If it goes on longer than you were told to expect, or comes with mood changes, high blood sugar if you have diabetes, or anything that worries you, call the clinic that gave the injection.

Steroid inhalers, creams and drops

Not every steroid acts on the whole body in the same way. Inhalers for asthma, nasal sprays, skin creams and eye drops deliver the medicine mostly where it is needed, so much less of it reaches the rest of the body than with tablets or an injection. Sleep trouble is less commonly linked to these forms, but it is not impossible, especially with higher strengths or long use.

If you notice your sleep changed after starting any steroid, in any form, it is still worth mentioning. Bring the actual inhaler, cream or box to your appointment, so your prescriber or pharmacist knows exactly what you are using and how often.

Steroid insomnia vs ongoing insomnia

Steroid-relatedInsomnia as its own pattern
When it startedWithin days of starting the course or the shotBefore, or it carried on long after
How it feelsWired, energized, restless bodyTired but unable to switch off; worry about sleep
CourseOften settles soon after a short course endsThree nights a week or more, for three months or more
What helpsYour prescriber looking at the plan; patienceCBT-I, the recommended first treatment

A short run of bad nights on prednisone is not chronic insomnia. But the habits people pick up to cope, like going to bed earlier, lying in bed longer or watching the clock, can stick around after the steroid is gone. That is one way short-term sleeplessness turns into chronic insomnia.

Mood changes at night are worth reporting

Steroids can affect mood as well as sleep. Some people feel irritable, anxious, unusually high or very low. Rarely, people become confused or lose touch with reality. These effects are listed in the prescribing information, and they tend to be more likely at higher doses.

Sleeplessness and mood feed each other, so the night is often when these changes show up first. If you or someone close to you notices a real change in how you are thinking or feeling, call your prescriber promptly. If you ever have thoughts of harming yourself, call or text 988 in the US.

What to bring up with your prescriber

  1. That you are not sleeping, how many nights, and what it feels like.
  2. What time of day you take the steroid, and whether that timing matters for sleep. Ask; do not change it yourself.
  3. How long the course is expected to last, and when sleep should settle.
  4. Any mood changes, however small, especially ones you or others have noticed at night.
  5. Other medications and supplements, including anything you have started for sleep.
  6. Whether there is anything they would like you to watch for, such as blood sugar.

Steroids should never be stopped suddenly unless your prescriber tells you to, especially after longer courses, because the body needs time to restart its own cortisol. For the appointment itself, see how to talk to your doctor about insomnia.

Getting through the nights

While you are on the course, keep your rising time steady, even after a bad night. Do not add hours in bed to make up for lost sleep; that tends to make the nights longer, not better. If you are lying awake and restless, get up and do something quiet in dim light until you feel sleepy, then go back. Getting out of bed feels backwards, but it protects the link between your bed and sleep. Skip naps if you can, and go easy on caffeine.

If your sleep has not recovered a few weeks after the course ends, it may have become insomnia in its own right, and CBT-I is the treatment the guidelines recommend first.

Somnera is a self-guided education program built on CBT-I. It is not a diagnosis and does not replace care from your own clinician. The assessment is free and gives you a real score.

Citations

  • Prednisone tablets prescribing information, FDA label.
  • Edinger JD, et al. Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2021;17(2):255–262. doi:10.5664/jcsm.8986
  • Qaseem A, et al. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–133. doi:10.7326/M15-2175

Frequently asked questions

Yes. Insomnia is a well-known, listed side effect of prednisone and other corticosteroids taken by mouth. Many people describe feeling wired or restless at night while taking it.

It can. Steroid injections can have effects through the whole body, and some people sleep badly for a few nights afterward. If it lasts or worries you, call the clinic that gave the shot.

With a short course, sleep often settles within days of finishing. With longer treatment it can continue, which is a reason to raise it with your prescriber rather than wait it out.

It can, and that is exactly the kind of question to ask your prescriber. Do not change how or when you take it on your own.

Call promptly if sleeplessness comes with big mood changes, agitation, confusion, feeling unusually high or very low, or seeing or believing things that are not real. If you have thoughts of harming yourself, call or text 988 in the US.

More in Getting help

Related posts