Does trazodone make it hard to wake up? (+3 factors)

In this article, we will discuss whether trazodone makes it hard to wake up. We will also share evidence from the literature, contributing factors, and other information related to this topic. 

Does trazodone make it hard to wake up? 

Yes, trazodone makes it hard to wake up due to its sedating properties. Trazodone belongs to the class of anti-depressants called serotonin antagonists and reuptake inhibitors (SARIs). It is primarily used to treat major depressive disorder (1). 

Trazodone, along with anti-depressant activity, also has sedating properties. At low doses, it is a commonly used hypnotic for individuals with sleep disruptions. It is also beneficial for individuals with depression who have insomnia (1). 

Due to its sedating properties, one of its frequently reported side effects is drowsiness. Thus, it is possible that while you are taking trazodone, you find it difficult to wake up in the morning. 

How does trazodone affect morning wakefulness? 

Trazodone affects morning wakefulness due to its sedative properties. Trazodone has a multifaceted mechanism of action. It blocks serotonin reuptake and increases serotonin levels in the brain (1). 

Trazodone also blocks some serotonin receptors, histamine (H1) receptors, and alpha-1 adrenergic receptors. These receptors play a role in wakefulness. The antagonist effect of trazodone on these receptors induces sedation (1). 

The effects of trazodone on sleep are well established. Trazodone is known to improve overall sleep duration and cause a quicker onset of sleep. It also reduces instances of waking up during sleep and increases the delta sleep (2). 

Thus, the sedative effects of trazodone may linger and make it difficult for you to wake up in the morning. It is more likely to happen in the initial phase of treatment when you are taking higher doses. 

What does research suggest?

The occurrence of drowsiness with high doses of trazodone is widely reported. Drowsiness is an officially documented side effect of trazodone. This drowsiness may occur when you wake up and persist throughout the day. 

During a clinical trial of trazodone, 24% of the total 142 inpatients, and 41% of the total 157 outpatients reported experiencing drowsiness (3). This drowsiness may cause a strong desire to sleep and make waking up more challenging. 

Several studies have reported drowsiness as an adverse effect of trazodone. It is commonly associated with higher doses (4). A systematic review recommends using trazodone with caution due to daytime drowsiness (5). 

What factors contribute to trazodone-associated drowsiness?

Different factors contribute to drowsiness caused by trazodone which makes it hard to wake up in the morning. 

Dosage:

Higher doses of trazodone are associated with drowsiness. Trazodone for sleep issues is prescribed at low doses of 25-100mg. At these doses, it does not exert an anti-depressant effect (1). 

Studies indicate that trazodone in the dose of 25-100mg induces sedation but does not cause drowsiness during the day as trazodone has a short half-life (4). Thus, if you are taking trazodone at these doses, you are likely to wake up easily. 

However, trazodone is prescribed at higher doses for depression and other conditions it is known to treat. Studies have shown that higher doses of trazodone result in drowsiness in the morning (4). 

Thus, taking higher doses of trazodone may make it difficult for you to wake up in the morning as the drowsiness increases the urge to sleep. 

Timing: 

High doses of trazodone should not be taken in the morning due to its sedative properties. Trazodone is taken in divided doses where a major portion of the dose can be taken at night as it helps with sleep (3). 

However, if you take trazodone very late at night or too close to your intended wake-up time, it will result in daytime drowsiness and difficulty waking up in the morning.

Interactions with other medications:

Taking trazodone with other medications or supplements that also induce sedation can increase the sedative effect and make it challenging for you to wake up. Taking trazodone with first-generation antihistamines like doxylamine can increase this risk. 

Taking trazodone and melatonin together also enhances the sedative effect as melatonin supports natural sleep. Thus, caution is required while using these together. 

Health conditions: 

Different health conditions may affect the metabolism of trazodone in the body which can influence its sedative effects. Conditions like hypersomnia also increase the risk of daytime sleepiness while taking trazodone. 

How to manage trazodone’s effect on morning wakefulness?

Trazodone results in daytime symptoms like grogginess and drowsiness which is also called trazodone hangover. This hangover may resolve within a day or last for a few weeks if you are taking higher doses. 

Trazodone is taken at night to make its sedative effects beneficial for sleep. To avoid struggling to wake up in the morning you can take trazodone an hour before the bed time. This provides you with enough time to sleep and wake up fresh. 

Do not take the medication early in the morning or late at night. Maintain a consistent sleep schedule so your body can regulate the sleep-wake cycle. Avoid rushing while waking up and give your body time to gently wake up. 

Include some light exercises in the morning in your schedule to promote wakefulness. Maintain hydration and consume a healthy breakfast to boost your energy levels in the morning. 

Avoid the use of caffeine before bedtime as it can interfere with your sleep. Do not take medications that promote sedation with trazodone without the guidance of your healthcare provider. 

If you feel drowsy, avoid driving and operating heavy machinery while taking trazodone. If you experience extreme drowsiness, communicate with your healthcare provider for dose adjustments. 

In my perspective, trazodone makes it hard to wake up due to its sedating effects. The sedation may persist in the morning and an individual may struggle to wake up. Daytime drowsiness is a frequently reported side effect of trazodone. 

Trazodone induces sedation due to its antagonist effects on different receptors. Higher doses of trazodone make it more difficult for an individual to wake up in the morning.

Taking trazodone late at night or with medications that also promote sleep further increases the challenge of waking up. Therefore it is recommended to take trazodone an hour before sleep and maintain a consistent sleep schedule. 

If you feel drowsy in the morning you should avoid driving. Communicate with your healthcare provider if you experience excessive sleepiness during the day. 

References