What Causes Sleeplessness, Tiredness And Depression In A Type 2 Diabetic Patient?

Posted on Thu, 30 Jul 2015

Question: Hello. I am a 61 year old male and I have been having trouble sleeping well for several months. I go to sleep easily but wake up repeatedly throughout the night. Often lie awake for an hour or more before going back to sleep. I do not have sleep apnea. I feel tired and depressed during the day. I have no other physical symptoms. My only condition is mild type 2 diabetes treated with 500 mg metformin 2 x daily, simvastatin 40 mg daily for chloresterol, and fenofibrate 54 mg once a day for triglycerides. Been on these meds for 5 years. Why am I not sleeping properly? Could any of my meds be causing this problem? OTC sleep meds do not work well.

Answered by Dr. Praveen Jeyapathy (37 minutes later)

Brief Answer:
Drugs can cause it.

Detailed Answer:
Hello Mr. XXXXXXX
Thanks for writing to HCM. I am Dr Praveen and I will be answering your query today. Noted the contents of your query.

I would like to know if you have these symptoms since the time you have been on simvastatin and fenofibrate or has it started recently? Have you been treated for depression in the past?

To answer your question if drugs can be the culprit, yes. Both simvastatin and fenofibrate can cause insomnia. Simvastatin has a higher chance of causing it though. Metformin will not cause insomnia.

I presume you had a sleep study done and ruled out OSA. In that case two common causes would be drug induced or depression. Removing the offending agent is ideal but medications for diabetes and high cholesterol are given weighing the risk-benefit ratio. As per guidelines, you need to be on a statin but if the present scenario is very troublesome you will need to stop it.

Take care. Regards.
Dr Praveen

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Praveen Jeyapathy (47 minutes later)

Thank you very much. Are other statins available that may not cause sleep issues? I used to take Lipitor and I don't remember sleep problems. What are my options to fenofibrate? Lower dose? Take dose at different time of day?

Answered by Dr. Praveen Jeyapathy (12 minutes later)

Brief Answer:
Substitutes available

Detailed Answer:
Hello,
Well, you can try changing fenofibrate to gemfibrozil. Gemfibrozil is not known to cause insomnia. The usual dose is 600 mg twice a day but since you are on a very low dose of fenofibrate you can take it once a day and check your values after 3 months or so.

As per the literature lipitor (atorvastatin) can also cause insomnia but if it has agreed well with you, you should try that. You can take 20 mg lipitor and monitor the LDL levels with the triglycerides after 3 months. Another statin that has virtually very weak side effects relating to sleep is pravastatin but its considered weak and not appropriate for risk reduction in diabetics of your age.

Warm regards
Dr Praveen

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj