Does Albuterol Keep You Awake at Night?

Albuterol is commonly prescribed for COPD and other respiratory issues, but one side effect is that it may affect your sleep.

When it comes to short-term solutions for chronic obstructive pulmonary disease (COPD) symptoms, albuterol is often used to treat coughing, chest tightness, shortness of breath, and wheezing.

Like any medication, albuterol comes with possible side effects. Insomnia isn’t listed as one of the main ones by the National Library of Medicine, but it could be sabotaging your sleep quality anyway.

Why? Because the type of side effects reported most often tend to interfere with sleep. Here’s what you should know if you have COPD and take albuterol regularly:

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How albuterol works

Albuterol is part of a family of medications known as adrenergic bronchodilators. The medication targets muscles in the respiratory system and makes them relax.

According to the National Library of Medicine, albuterol comes as a tablet, syrup, or extended-release pill that can be taken orally. It’s also available as a liquid solution or powder that can be inhaled using a nebulizer or inhaler that turns the medication into a mist.

Most often, it’s used in a rescue inhaler to address sudden respiratory symptoms, says Sami Hossri, MD, assistant professor of critical care and pulmonary medicine and director of the asthma program at UTHealth Houston.

In any of these forms, albuterol has side effects that can indirectly keep you awake at night. The most common are:

• uncontrollable shaking of a part of the body
• nervousness
• headache
• nausea
• vomiting
• cough
• throat irritation
• muscle, bone, or back pain

“Any of these would make it difficult to fall asleep and enjoy an uninterrupted stretch of slumber, particularly feelings of agitation and hyperactivity that come with nervousness as a side effect,” Hossri says.

Why does sleep matter?

Obviously, being able to breathe is more important than clocking 7–9 hours of uninterrupted sleep every night, so if albuterol is recommended for reducing COPD issues, it’s important to follow that advice from your physician, according to Margarita Oks, MD, a pulmonologist at Northwell Lenox Hill Hospital in New York.

“Staying on top of COPD flares and everyday symptoms is crucial for managing this disease more effectively,” she says. “Medications often work quickly, and that can reduce the duration and intensity of your symptoms.”

However, that doesn’t mean you have to put up with sleep problems as a result — especially given how important sleep is to your overall health and your COPD management.

For example, in a 2022 study, the risk of COPD flare-ups was up to 95% higher in people who had poor sleep compared to good quality sleep. Because of these findings, researchers said that poor sleep may predict COPD flare-ups better than a history of smoking.

Sleep also plays a key role in the mental health aspects of managing COPD.

Poor sleep quality was linked with depression and anxiety among people living with COPD and asthma, according to 2023 research.

How to get sleep and manage symptoms

The importance of both quality sleep and managing symptoms creates a tricky balance: How can you use albuterol to relieve COPD symptoms while managing the potential impact on your sleep?

A good first step is talking with a healthcare professional, Dr. Oks says.

Switch medications

“In some cases, you may be able to switch to another medication that may not affect your sleep as much and is just as effective for you as albuterol,” Oks says.

For example, you may be able to transition from albuterol to levalbuterol, which has similar benefits but may come with fewer side effects.

“Albuterol is made up of two compounds, called S-albuterol and R-albuterol, while levalbuterol contains only R-albuterol,” Hossri says. “For some people, that means they get the relief of albuterol but without some of the notable side effects such as nervousness or shaking.”

Take medication at different times

You can also ask your doctor about taking albuterol on a different schedule or in a different form. For example, if it causes nervousness and high energy but not enough to negatively affect your daily activities, it might be better to use it in the morning rather than in the afternoon.

Or you may find that albuterol taken orally instead of through an inhaler gives you just as much relief but doesn’t make you so jittery that it’s tough to fall asleep.

Check for other causes

There could be other drug interactions that are intensifying albuterol’s side effects. Medications that might interact with albuterol include those prescribed for depression, high blood pressure, cardiovascular issues, and other medical conditions.

For example, a 2018 review of research found that when albuterol is taken with tricyclic antidepressants, it increases the risk of an increased or skipped heart rate and shortness of breath. These issues might have an effect on sleep.

“COPD management often has to be adjusted, and that includes use of medications like albuterol,” Hossri says. “Definitely have a discussion with your doctor if your sleep is affected, and particularly if that problem is getting worse over time.”