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Q. Is it likely that Rhinocort would cause sleep issues?

Answered by
Dr. Sadaf Mustafa
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Apr 19, 2017 and last reviewed on: Aug 26, 2021

Hi doctor,

I am stress-free and moderately active person. I play sports two to three times a week and have no other major health problem such as hypertension, hyperthyroidism, high cholesterol, etc. I have been using Rhinocort Aqua once a day on each nostril for four years and recently I have experienced issue of sleeplessness and insomnia. I just got to know that Rhinocort is a type of cortisol medication and it was understood that elevated cortisol can lead to sleeping problems. Is it likely that Rhinocort is behind my recent sleeping issue?

#

Hi,

Welcome to icliniq.com.

  • Indeed it has low dose steroid, but the systemic absorption is very less. I would suggest reducing the dose to once daily and avoid using caffeinated beverage, exercise and stressful activities before nap time.
  • If this does not work, then consider discontinuing it gradually and watch your sleep pattern.
  • Although you have mentioned that you do not have hyperthyroidism, it would be good to know other related symptoms. When was the last time your TSH (thyroid stimulating hormone) checked?

The Probable causes:

Drug induced insomnia.

Investigations to be done:

Check TSH.

Differential diagnosis:

Hyperthyroidism and caffeine induced insomnia.

Treatment plan:

1. Tapering of the nasal spray and watching sleep pattern.
2. Discontinuation of any caffeine two to three hours before bedtime and no alcohol during that time as well.

Regarding follow up:

Revert back after three to four weeks to an internal medicine physician online.---> https://www.icliniq.com/ask-a-doctor-online/internal-medicine-physician


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