Insomnia is a common side effect of Zoloft, affecting up to 21%¹ of users. However, others may find that Zoloft helps them relax, calm down, and sleep better.
Insomnia doesn’t mean that you don’t sleep at all. You could still be meeting your sleep quota but finding it very hard to fall or stay asleep. While Zoloft may be effective in reducing panic attacks, unwanted thoughts, and depression, it can also cause insomnia.
You might experience insomnia symptoms for the first few days, weeks, or months of taking Zoloft until your body gets used to it. However, insomnia and other side effects go away on their own with time.
Here is what you should know about Zoloft insomnia and what you can do about it.
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Zoloft is an effective antidepressant that helps reduce symptoms of psychiatric health problems such as anxiety disorder and depression. It is a selective serotonin reuptake inhibitor (SSRI), meaning it works by increasing levels of the hormone serotonin in the brain.
Studies² show that reduced serotonin activity is linked to mental health problems such as depression and anxiety disorder. SSRI antidepressants restore the balance of chemical “messengers” in the brain, such as serotonin, to induce relaxation, calmness, and happiness.
By reducing anxiety, fear, intrusive thoughts, and panic attacks, some Zoloft users report better sleep. For others, the change in the chemical balance in their brains causes insomnia. Since it is an SSRI, Zoloft interferes with the brain’s chemistry, which may affect the sleep/wake cycle.
Taking Zoloft in the morning is one of the best ways to deal with its side effects. Sertraline, the main ingredient in Zoloft, takes 4–10 hours to be fully absorbed and reach peak concentration in the blood. Side effects start showing up earlier.
Since Zoloft is taken once a day, you will have a lower concentration of it in the blood by the time you go to sleep at night, which will help reduce insomnia. If taking Zoloft at night causes side effects, try taking it in the morning instead.
Your doctor will start you off with a low dose of Zoloft to minimize side effects. The standard starting dose is 25-50mg daily, but this dosage depends on the reason for administration.
If this dosage still causes significant side effects, talk to your doctor about switching to a different medication. There are many other options for treating depression and anxiety, including the following:
Mirtazapine and trazodone are antidepressants used to treat insomnia. Trazodone is especially effective at inducing sleep (an off-label effect).
Wellbutrin (bupropion) is a norepinephrine and dopamine reuptake inhibitor (NDRI) used to treat depression and anxiety. Although it is stimulating in the daytime, it doesn’t cause insomnia and can even promote sleep at night.
Tricyclic antidepressants are even better than SSRIs when treating depression, but they may have more side effects than SSRIs. For example, amitriptyline and doxepin have a sedating effect that can help users sleep better.
Sleep hygiene means healthy habits and an environment conducive to sleep. More specifically, it is a method used to treat insomnia and is based on the fact that insomnia may sometimes be due to poor sleeping habits reinforced over the years.
Some ways to observe good sleep hygiene include:
Listen to your body’s natural clock: go to bed and wake up at the same time every day.
Go to bed when you’re tired and don’t get in bed if you’re not tired.
Get some early morning sunshine to reset your internal clock.
Maintain a healthy sleeping environment: set the temperature at 73.4F³ and maintain darkness and silence.
Invest in a comfortable mattress and pillow.
Don’t use your bedroom for anything else but sleeping and intimacy. For example, don’t watch TV there.
Keep phones, laptops, and all other sources of blue light out of your bedroom. Blue light suppresses melatonin, the sleep hormone, and can disrupt your ability to fall asleep.
Avoid stimulating substances such as soda, tea, tobacco, and caffeine in the afternoon and evening hours. These disrupt your body's internal clock and cause difficulty falling asleep later in the evening.
One study⁴ found that consuming caffeinated beverages after 2 PM can disrupt sleep even when consumed 12 hours before bedtime.
Also, avoid going to bed immediately after a large meal. As a rule of thumb, give yourself three hours after eating before you go to bed.
Although alcohol is a depressant and will make it easier to sleep, it reduces sleep quality and duration, especially when alcohol is consumed in excess. Alcohol may help you sleep faster, but overall it disrupts sleep, particularly the dream stage (REM stage) of sleep.
Alcohol can also worsen other symptoms of depression, leading to more insomnia.
If you need to drink alcohol, do so in moderation and only on the weekend. Don’t drink alcohol right before bedtime (as a nightcap).
In addition to reducing your dosage of Zoloft, you may also want to try taking a melatonin supplement. You can purchase melatonin over the counter, and it's relatively inexpensive.
Melatonin is not addictive or habit-forming like other sleep aids, although its long-term use has yet to be studied in humans. If you use melatonin and notice any adverse effects on your health (such as memory loss), talk with your doctor.
Exercise can be a great way to help you sleep. It's been shown that those who exercise regularly get more sleep than those who don't. Workouts release endorphins, which may help you feel relaxed and ready for bedtime, but there are other reasons too.
Your body feels better and boosts your overall mood after some physical activity. So if you're feeling down or anxious from insomnia, consider getting some exercise in the morning or during the day. However, avoid vigorous activity at least one hour before bed.
With CBT-I, you learn to manage your insomnia by changing your thoughts and feelings about sleep. You can learn how to relax and fall asleep more efficiently and change the way you think about sleep in general. This means that even when you aren't taking medication for depression anymore, CBT-I will help you continue to get a good night's rest.
Zoloft is an antidepressant, and it may be the cause of your insomnia. If you're experiencing insomnia as a side effect of Zoloft, don't feel alone.
Several possible remedies include changing the medication, sticking to a routine, and trying cognitive behavioral therapy. Your doctor should be able to help you find solutions that work for your situation and needs.
Sertraline side effects | Drugs.com
Selective serotonin reuptake inhibitors | Drugs.com
Sertraline (Rx) | Medscape
Mirtazapine vs. trazodone: Which is the best for sleep? | Arete Recovery
Sleep problems can guide antidepressant selection | Psychiatric Times
Blue light has a dark side | Harvard Health Publishing
Alcohol and sleep | Sleep Foundation
Does exercising at night affect sleep? | Harvard Health Publishing