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HomeAddictionPrescription DrugsBenzodiazepineDoes Xanax Make You Sleepy
Does Xanax Make You Sleepy

11 Minutes

Edited & medically reviewed by THE BALANCE Team
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Xanax, also known as Alprazolam, is a medication that belongs to a class of drugs known as benzodiazepines. It is commonly prescribed for the treatment of anxiety and panic disorders and, at times, insomnia. Drowsiness is one of its most frequently reported side effects, raising questions about how this medicine causes such a response and how to keep it under control.

The connection between Xanax and sleepiness involves understanding its effects on the central nervous system. This article will examine the reasons behind Xanax’s sedative effects, accentuating its pharmacological action and its implications in therapeutic and non-medical settings. Understanding these effects is crucial for those using Xanax, whether under medical supervision or otherwise, to maintain personal safety.

Xanax acts as a central nervous system depressant by enhancing the impact of gamma-aminobutyric acid (GABA), a neurotransmitter responsible for calming the brain. The medication works by binding to specific receptors in the brain, increasing GABA’s efficacy at decreasing neural activity. The process can be divided into three categories:

Enhancing GABA Activity

GABA is integral to managing anxiety by blocking excessive neural activity. By binding to the GABA-A receptors, Xanax adds to the overall relaxing effect. As a result, the general brain activity slows down, causing the individual to experience calm.

Targeting Brain Regions

The GABA-A receptors targeted by Xanax are present in several brain areas, such as the limbic system, thalamus, and hypothalamus. These regions regulate emotions, alertness, and responses to stress. By increasing GABA’s blocking effect in these areas, Alprazolam reduces feelings of anxiety and stress. This impact also makes Alprazolam highly effective for the treatment of issues like anxiety disorders and panic attacks.

Rapid Action

When taken orally, alprazolam is quickly absorbed into the bloodstream and reaches peak levels within two hours. Its lipophilic nature helps it cross the blood-brain barrier and interact with GABA receptors quickly. The quick action causes a rapid reduction in brain activity, relieving anxiety and causing drowsiness simultaneously.

According to research, [1] drowsiness is one of the most common side effects reported by many individuals using Alprazolam. Several factors contribute to the degree of sleepiness caused by Xanax, such as the following:

Dosage and Frequency

  • Higher Dosage: The sedative effects of Xanax are dose-dependent. Higher doses increase GABA activity, causing more significant CNS depression and drowsiness.
  • Frequency of Use: This medication’s daily use causes cumulative effects in the body, gradually enhancing its sedative impact. Frequent usage, specifically at a higher amount, can lead to consistent sleepiness throughout the day.

Individual Sensitivity and Metabolism

  • Metabolic Rate: The body’s ability to metabolize Alprazolam varies among people. Individuals with slower metabolic rates may experience prolonged drowsiness as the medicine remains active in their system longer.
  • Age and Health Status: Older adults or individuals with liver or kidney issues metabolize Xanax slowly, increasing the intensity of its sedative effects. Moreover, individuals with certain medical conditions may also be more sensitive to the drug’s CNS-depressant impacts.
  • Body Weight: Body mass can affect how quickly Alprazolam is absorbed and eliminated from the body. Those with lower body weight may have comparatively more severe effects.

Interaction with Other Substances

  • Alcohol: Drinking alcohol while taking Xanax can add to the drug’s sedative effects, causing increased sleepiness.
  • Other Medications: Co-administration with other medications, which are also CNS depressants, can add to the sleepiness caused by Alprazolam. Some medicines can also influence Xanax’s absorption and metabolism, possibly intensifying its soothing properties.

Duration of Action

  • Half-Life of the Drug: Alprazolam does not stay in the body for eleven to sixteen hours, but its metabolites may persist for longer. Hence, even if the immediate effects may go away within a few hours, the residual sleepiness can remain, specifically with repeated doses.
  • Immediate vs. Extended-Release Formulations: Xanax is available in immediate-release and extended-release formulations. Extended-release versions are given to maintain a steady concentration in the body and can cause drowsiness for longer.

Time of Administration

Timing: The time of day Xanax is taken can influence the extent of drowsiness. Taking it during the evening or night may improve the natural sleep cycle. However, taking it during the day can disrupt everyday activities, causing unintended daytime drowsiness.

Genetic Factors

Genetic Polymorphisms: Research [2] shows that variations in genes that affect enzymes responsible for metabolizing Alprazolam can cause differences in drug processing. Individuals with specific genetic variants may metabolize the drug either more quickly or slowly, which, in turn, influences the duration and intensity of drowsiness caused by Alprazolam.

Excessive drowsiness caused by Xanax can lead to several side effects and issues in daily life, including the following:

Cognitive and Motor Function Issues

Excessive sleepiness can significantly decrease alertness and ability to focus, making it difficult to perform tasks that need focus, such as driving or working. Lack of focus can delay reaction times, making it challenging to respond quickly in situations that require rapid decision-making. Furthermore, studies show [3] that high doses of Alprazolam can impact short-term memory and coordination, elevating the risk of mishaps.

Elevated Risk of Accidents

The soothing properties of Alprazolam come with a particular risk of accidents while engaging in activities that can be life-threatening without focus. For instance, Xanax use has been associated with higher chances of having car accidents because of slowed reaction times. In older adults or those with mobility issues, excessive sleepiness can increase the risk of falls and associated injuries by negatively impacting balance and coordination.

Increased Effects with Other Substances

The risks of excessive sleepiness and impairments are further increased when Alprazolam is taken with other substances. For example, alcohol [4] can amplify the drug’s depressant effects, increasing drowsiness even more. Similarly, the concurrent use of other central nervous system depressants, such as opioids or sedatives, can lead to severe respiratory depression.

Risk of Overdose

Taking high doses of Xanax, especially without medical supervision, increases the risk of excessive sedation and overdose. Symptoms of overdose include issues in motor function, extreme drowsiness, confusion, and, in severe cases, respiratory depression and coma. Accidental overdose is also a concern when individuals take more doses to manage consistent anxiety without understanding that the residual sedative effects may still be present. Research [5] has shown that Xanax overdose can be dangerous and potentially cause several side effects.

Impact on Daily Life

Consistent drowsiness can interfere with everyday activities, affecting an individual’s ability to function at work, participate in social interactions, and maintain the quality of life. These impairments may cause various adverse outcomes, such as loss of employment, strained relationships, and social isolation. Additionally, the cognitive and physical issues resulting from excessive Alprazolam use can worsen existing mental health conditions.

Sleepiness from Alprazolam can interfere with daily activities and increase the risk of many issues. Hence, managing it on time is crucial to limit damage. Treating drowsiness due to Alprazolam requires several steps, including the following:

Managing Sleepiness Through Lifestyle Adjustments

Lifestyle changes are integral to managing the drowsiness induced by Xanax. Some strategies include:

  • Timing of Dosage: Take Alprazolam in the evening rather than during the day so that its sedative effects occur during the natural rest periods. This can decrease the drug’s interference with daytime activities.
  • Physical Activity: Add regular exercise into daily routines to elevate energy levels and counteract sleepiness. However, avoid high-intensity activities right after taking the medication because of the risk of impaired coordination.
  • Strict Sleep Schedule: Maintain a strict sleep routine that fixes specific times for rest to decrease the body’s need for sleep during the day.
  • Dietary Considerations: Limit caffeine intake, specifically late in the day, and avoid alcohol, as it can add to Xanax’s drowsiness.

Seeking Medical Advice for Drowsiness Management

If lifestyle changes and careful dosing are not working, consulting a healthcare professional may be needed. Medical guidance may include the following:

  • Medication Adjustments: A doctor may suggest altering the dosage, switching to a different medicine, or changing the timing of doses to decrease sleepiness.
  • Alternative Medications: If excessive sleepiness remains, a healthcare provider might suggest an alternative treatment option with a lower risk of sedation.
  • Regular Monitoring: Plan follow-up appointments to evaluate the medication’s effects and make necessary adjustments as needed with time.
  • Safety Precautions: Never change the prescribed dose or discontinue Alprazolam without asking a medical professional to prevent withdrawal symptoms and the reoccurrence of anxiety, depression, or panic symptoms.

For individuals new to Alprazolam or restarting after a break, managing the drowsiness can be difficult. However, some ways can help reduce this side effect, such as:

  • Titrating Doses: Rather than beginning at a standard dose, consider a slow titration under the guidance of a healthcare professional. These gradual increments can help the body get used to the medicine more safely while decreasing the risk of intense drowsiness, especially during the initial days of treatment.
  • Hydration: Proper hydration can impact how the body processes medicines, including Alprazolam. Dehydration may worsen feelings of laziness or fatigue. Therefore, it is crucial to stay well-hydrated throughout the day when taking the medication. Include electrolytes via balanced nutrition or supplements, as it can counteract extreme drowsiness.
  • Maintaining an Active Morning Routine: For new users, establishing an active morning routine can assist in combating the initial sleepiness associated with Xanax use. Experts recommend participating in light stretching, brisk walking, and yoga activities. Exposure to natural sunlight can also be helpful in mitigating sleepiness. An active morning routine can signal to the body that it is time to wake up and can offset the soothing properties of the medicine.
  • Short Naps Instead of Long Resting Time: If sleepiness remains consistent, short naps can be better than long rest periods. Limit naps to 20–30 minutes to recharge without falling into a deep sleep state, which can make a person feel groggy upon waking. Short naps provide energy without disrupting the general sleep schedule.
  • Low-Impact Activities during the Adjustment Phase: In the first few days of starting Alprazolam, plan the daily schedule to include low-impact activities that do not require intense focus or physical coordination. Light reading, organizing, or engaging in easy hobbies can help individuals stay active without requiring a lot of attention. Slowly increase the complexity of daily activities as the body becomes used to the medication’s effects.

While drowsiness is a well-documented side effect of Xanax, continuous or excessive sleepiness can be an early indicator of developing dependency. Recognizing the sign can be particularly helpful in avoiding any further complications. Following are some of the indicators:

Persistent Drowsiness and Tolerance

When taken over for a long time, the body can develop a tolerance to Alprazolam and users may require higher doses to get the same effects. However, as the dosage increases, so do the adverse impacts, including sleepiness. If drowsiness becomes worse while maintaining the same dose, it may be a sign that the body is becoming dependent on the medicine. This tolerance and resulting sleepiness can show that the medicine is no longer working for its intended purpose.

Drowsiness Linked to Increased Dosage

A clear indicator of dependency is the need to increase the dosage to manage anxiety or panic symptoms, which causes increased drowsiness. As individuals increase their intake, they find that daytime sleepiness becomes more severe and begins to interfere with daily activities. Increasing the dose and experiencing more sleepiness highlights a growing dependency on the drug.

Sleepiness and Withdrawal Symptoms

When dependency develops, decreasing the dose or skipping a dose can result in withdrawal symptoms, such as rebound anxiety and insomnia. Paradoxically, the need to improve these symptoms can cause increased Alprazolam use, leading to the development of dependency. Excessive sleepiness during regular use, combined with restlessness or irritation when the impacts diminish, should be considered a severe warning sign of developing a reliance on Xanax.

When to Get Help

Recognizing sleepiness as a potential sign of dependency is vital. If drowsiness is persistent, worsening, or associated with an increased dosage, it is essential to talk to a healthcare professional. Early treatment can avoid further complications and support safe management or discontinuation of the drug. A healthcare provider can examine the situation, provide alternatives, and oversee a safe tapering procedure if needed to cut down withdrawal risks.

Xanax, while effective for managing anxiety and panic disorders, often comes with drowsiness as a side effect. Though manageable for some, its sedative properties may become problematic, affecting everyday activities and general health. Recognizing the different aspects of drowsiness linked to Alprazolam, whether as an expected reaction, a sign of needing adjustment, or a warning sign of dependency, is necessary for the safe use of the medicine. By implementing strategies to manage sleepiness, noticing changes in its intensity, and getting medical help when needed, individuals can deal with the complexities of Xanax treatment safely. In doing so, they can ensure that the benefits of the drug are delivered without adverse impacts on alertness, quality of life, or long-term health.

[1] Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A review of alprazolam use, misuse, and withdrawal. J Addict Med. 2018;12(1):4-10.

[2] Zhao J, Liu S, Wolf CA, Wolber G, Parr MK, Bureik M. Changes in alprazolam metabolism by CYP3A43 mutants. Biomedicines. 2022;10(12):3022.

[3] Chowdhury ZS, Morshed MM, Shahriar M, Bhuiyan MA, Islam SM, Bin Sayeed MS. The effect of chronic alprazolam intake on memory, attention, and psychomotor performance in healthy human male volunteers. Behav Neurol. 2016;2016:3730940.

[4] Aitken B, Hayley AC, Ford TC, Geier L, Shiferaw BA, Downey LA. Acute administration of alprazolam, alcohol and their combination on cognitive performance and mood: A randomized, double-blind, placebo-controlled study. J Psychopharmacol. 2023;37(12):1227-1237.

[5] Isbister GK, O’Regan L, Sibbritt D, Whyte IM. Alprazolam is relatively more toxic than other benzodiazepines in overdose. Br J Clin Pharmacol. 2004;58(1):88-95.

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