The Effect of Metoprolol on Sleep

The CDC recommends that adults get between 7 and 9 hours of sleep per night. Unfortunately, 1 in 3 adults aren’t getting adequate sleep. A myriad of issues can interrupt sleep patterns and put you at risk of developing chronic insomnia. Stress, anxiety, and underlying health issues are some of the most common triggers. Certain medications can also reduce your sleep quality, leaving you fatigued and irritable.

One such medication is metoprolol. A common beta-blocker used to treat high blood pressure, heart attacks, and stroke, metoprolol can have adverse effects on sleep architecture. Here we’ll take a closer look at how metoprolol and other beta-blockers work, how it can impact your sleep, and ways to combat these effects.


Check out our video on Metoprolol & sleep!

What is Metoprolol?

As previously mentioned, metoprolol is a beta-blocker used to treat high blood pressure and certain heart conditions. Beta-blockers work by slowing down your heart rate and lowering blood pressure. By doing so, they affect your body’s adrenaline levels. Adrenaline is a hormone secreted from the adrenal glands. It’s responsible for controlling stress, blood circulation, and breathing. Metorpolol’s effect on adrenaline levels is one reason this beta blocker can trigger insomnia.

Metoprolol may also be prescribed to treat migraines, tremors, angina, and certain types of glaucoma.

Metoprolol and Insomnia

As beneficial as metoprolol and other beta-blockers may be for treating certain heart conditions and high blood pressure, they can wreak havoc on your sleep quality. In addition to spiking adrenaline levels, metoprolol may also inhibit your brian’s secretion of the sleep-inducing hormone melatonin.

Melatonin plays an important role in maintaining your circadian rhythm, or internal sleep-wake clock. As night falls and you get ready for bed, your body also goes through a certain preparation process by releasing melatonin. Unfortunately, beta-blockers like metoprolol can inhibit your body’s ability to produce and release this important hormone. Low levels of melatonin can cause both chronic and acute insomnia

Reducing melatonin levels isn’t the only way that metoprolol can negatively impact your sleep. To understand better why this happens, we need to dive deeper into the scientific side of things. One reason metoprolol impacts sleep is that beta-blockers have the ability to cross the blood-brain barrier (BBB). By passing this barrier, metoprolol increases how often you wake up throughout the night and how long it takes you to fall back asleep. In some cases, metoprolol has been linked with insomnia, hallucinations, nightmares, and excessive daytime sleepiness.

It’s also reported that metoprolol may suppress REM sleep. The rapid eye movement sleep cycle occurs about 90 minutes after you fall asleep. During this time, your brain activity increases, as does your breathing, pulse, and blood pressure. Your eyes dart around quickly, though closed, and your muscles are in a state of paralysis. REM sleep is also when you experience the most dreams. This sleep cycle is essential for increased learning and memory retention. Reduced REM sleep may result in fitful dreams involving kicking, punching, or jumping out of bed. You may also talk, laugh, or shout in response to your dreams. This is known as REM sleep behavior disorder.

Other Side Effects of Metoprolol

In addition to insomnia, metoprolol can cause a variety of other, sometimes unpleasant, side effects. These include:

  • Dizziness
  • Constipation/diarrhea
  • Rash
  • Low libido (sex drive)
  • Bradycardia (slow heart rate)
  • Difficulty breathing, shortness of breath, and cough
  • Excess fatigue
  • Headache
  • Cold hands and feet 

Because metoprolol can cause both fatigue and dizziness, many patients take it at night. Unfortunately, this can cause sleep disturbances in some people. Most symptoms are mild and only last short-term. 

More serious side effects include lung complications, swelling of the legs or ankles, irregular heartbeat, fever, confusion, and liver problems. If you exhibit any of these symptoms it may be time to speak with your doctor about an alternative treatment method.

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Key Facts About Metoprolol

As with any medication, a healthcare professional can advise you on the proper dosage of metoprolol and how long to take it. Most patients take this beta-blocker once or twice a day, while others need it as many as 4 times per day. The tablet form is available in both slow and standard releases. Standard release metoprolol releases quickly, whereas the slow release tablet doesn’t take effect right away and may only be needed once daily. Metoprolol also comes in an injection form known as Betaloc.

Metoprolol isn’t the best medication option for everyone. If you have any of the following conditions, let your doctor know before taking this beta-blocker.

  • Low blood pressure
  • Lung disease or asthma
  • Overactive thyroid
  • Blood circulation problems
  • Metabolic acidosis 
  • Liver problems
  • An allergic reaction to any medications

Ways to Overcome Metoprolol Sleep Disturbances

If you suffer from high blood pressure or a heart condition that requires you to take metoprolol, you may be concerned about how it will impact your sleep. And rightfully slow. Beta-blockers such as metoprolol can interrupt your sleep patterns, reduce REM sleep, and cause violent nightmares.

The good news is, insomnia treatment at home is possible. Here are a few ways to combat these sleep disturbances so that you can enjoy the benefits of metoprolol without the negative side effects. 

Set a Sleep Schedule

One way that metoprolol can negatively impact your sleep is by disturbing your sleep-wake cycle. Over time, your body naturally prepares for sleep as the sun sets and wakes up feeling rested as the sun rises. Unfortunately, a lot of external factors can interfere and disrupt this routine, including beta-blockers like metoprolol

The best way to combat these effects is to establish a consistent sleep schedule. Try going to bed at the same time each night and waking up at the same time every morning, even on weekends. By doing so, your body will naturally adjust and you’ll start getting tired at the same time every evening and naturally awake every morning, even without an alarm. 

Adopt a Healthy Nighttime Routine

While timing is everything in some respects, establishing healthy sleep patterns takes more than just setting a bedtime. Try performing the same routine behaviors every night like taking a walk, having a cup of tea, or writing in your journal. Unplug all digital devices and screens about 2 hours before bed to avoid overstimulation. Performing these same rituals is another way to signal your brain and body that it’s time for sleep. Doing so can also trigger your brain to start releasing melatonin. 

Avoid Napping

Daytime sleepiness caused by metoprolol can make napping seem very appealing. While in some cases, a short nap can take the edge off your exhaustion and leave you feeling invigorated, it usually has adverse effects. Regardless of how tempted, you are to nap, resist the urge to get some shuteye mid-day. Doing so will make it more difficult to fall asleep at night and may interfere with your circadian rhythm. 

Create a Sleep Oasis

Your bedroom should be a space for sleep and sex only. Avoid bringing your work, phone, or food into bed. Doing so confuses your brain into thinking you should be awake and active. Instead, reserve your bed for quiet, relaxing activities. In addition to removing these distractions, don’t be afraid to add relaxing and welcoming features like dim lighting, an essential oil diffuser, or a sound machine. 

If you find yourself lying awake for longer than 20 minutes fighting sleep, get up and perform a relaxing activity outside the bedroom. Take a short walk, perform meditation, or enjoy a soothing cup of tea. Avoid stimulating activities that involve screens like turning on the TV or scrolling through social media. Once you feel tired enough for sleep, return to your bed. This solidifies the connection between your brain and the bedroom as an oasis for sleep.

Don’t Let Metoprolol Rob You of Your Sleep

When used as directed, metoprolol is a very effective treatment for high blood pressure, certain heart conditions, and other ailments. As with any prescription medication, metoprolol isn’t without side effects — one of which is insomnia and related sleep disturbances. If you need this beta-blocker to treat a serious health issue but worry about the adverse side effects, Somnus can help.

At Somnus Therapy we provide professional advice and several treatment and therapy options to help you overcome insomnia and finally achieve the blissful night’s sleep you need and deserve. Through a mix of CBT for insomnia, mindfulness, cognitive restructuring, and other forms of therapy, we get to the root of your sleep issue and help you make long-lasting lifestyle changes.

Click here to start your journey today.

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“Thanks to Somnus Therapy I now sleep well each night without medication! This was a huge milestone for me – so thank you.”

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