A cortisone shot is an injection of a corticosteroid medication, such as triamcinolone or methylprednisolone, administered to reduce inflammation and pain in a targeted area like a joint, tendon, or bursa. These injections are potent anti-inflammatory treatments used for conditions like arthritis, bursitis, and tendonitis. While patients often find significant relief from pain and swelling, the introduction of this medication can sometimes lead to temporary, systemic side effects. Insomnia is a known potential side effect of receiving a cortisone shot, ranging from feeling restless to difficulty falling or staying asleep.
Is Insomnia a Recognized Side Effect?
Insomnia is a recognized adverse effect associated with corticosteroid use. While it does not affect every patient, many individuals report experiencing sleep issues following the injection. Studies indicate that people receiving steroid injections often report a higher prevalence of sleep problems compared to control groups.
The severity of insomnia is variable, sometimes manifesting as difficulty initiating sleep or frequent waking. This sleep disruption is generally temporary. Higher doses of the corticosteroid tend to increase the incidence and severity of sleep disturbance, suggesting a dose-dependent relationship, though individual sensitivity also plays a role.
The Physiological Link Between Cortisone and Wakefulness
Cortisone shots interfere with sleep because their chemical structure mimics cortisol, a natural stress hormone. Cortisol is produced by the adrenal glands and regulates the body’s stress response. Normally, cortisol levels follow a distinct daily rhythm, peaking in the morning to promote wakefulness and dropping near midnight to allow for sleep.
When a synthetic corticosteroid is injected, it temporarily elevates circulating “cortisol-like” hormones. This sudden flood disrupts the body’s natural circadian rhythm, signaling to the brain that it is a high-alert, daytime state. The central nervous system is stimulated, leading to increased alertness, energy, and sometimes anxiety, which prevents the relaxed state necessary for sleep.
Duration and Strategies for Sleep Management
Insomnia following a cortisone shot is typically short-lived, correlating with the period when the medication’s systemic concentration is highest. Most people find that sleep patterns normalize within 24 to 72 hours following the injection. Depending on the specific corticosteroid and dosage, the sleep disturbance can occasionally last up to one or two weeks.
To manage temporary sleep disruption, patients should focus on practicing good sleep hygiene:
- Maintain a consistent bedtime and wake-up time, even on weekends, to reinforce the body’s natural sleep cycle.
- Create an optimal sleep environment by ensuring the bedroom is dark, quiet, and kept at a cool temperature.
- Avoid stimulants such as caffeine and nicotine, especially in the afternoon and evening, as these can worsen hyper-alertness.
- Use relaxation techniques, such as deep breathing exercises or gentle stretching before bed, to help calm the central nervous system.
If insomnia is severe or persists beyond one week, contact a healthcare provider, who may recommend short-term sleep aids.