Dexamethasone is a type of medication called a corticosteroid. Doctors can use it to treat a variety of conditions, including allergic reactions, asthma, medical conditions related to inflammation, and certain cancers.
One of the most common side effects includes difficulty sleeping, which can lead you to feel sleepy during waking hours and cause fatigue.
What is dexamethasone?

Dexamethasone (Decadron) is a prescription corticosteroid that comes in various forms, including oral tablets, topical creams, inhalers, and injections.
Administered in lower doses, it decreases inflammation in the body. At higher doses, it lowers your immune system function. It is commonly used as a short-term treatment for allergic reactions, asthma flare-ups, and inflammation issues within the body.
It is also used long term for treating cancers like leukemias and lymphomas, multiple sclerosis, endocrine disorders, and long-term inflammatory diseases such as arthritis, Crohn’s disease, and certain skin conditions.
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Does it make you sleepy?
Drowsiness is not a listed side effect of dexamethasone. But difficulty sleeping and insomnia are common effects of steroid medications like this one. If you have trouble sleeping, it can cause you to feel tired and sleepy during the day.
This can range from an annoying but persistent yawn to a dramatic effect on your ability to concentrate and perform daily duties.
Having a healthy bedtime ritual can help promote a good night’s sleep. If you’re still not getting enough rest, you may also consider trying natural sleep aids like melatonin or chamomile, or you can speak with a healthcare professional to discuss prescription sleep aids.
Always consult a doctor to discuss possible interactions between medications and herbal supplements.
Other side effects
Common side effects you may notice when you start taking dexamethasone include:
- upset stomach
- weight gain, including in the face
- changes in eyesight or blurred vision
- headache
- increased appetite
- dizziness
- muscle cramps or muscle weakness
Other, more severe side effects can occur and are more common with higher doses of dexamethasone or if you are on a long-term therapy program. You should seek immediate medical attention, call 911, or go to your nearest emergency room if you experience any of the following:
- chest pain
- irregular or fluttering heartbeat
- difficulty breathing
- swelling or numbness in the arms or legs
- trouble thinking, speaking, or walking
How to manage sleepiness
If you’re experiencing insomnia or sleepiness due to dexamethasone, there are several strategies you can try to help.

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Get free cardSleep hygiene
Good sleep hygiene is essential and can significantly improve the quality of your sleep. The Centers for Disease Control and Prevention (CDC) suggests following these tips to help get a restful sleep and feel more rested:
- create a bedtime routine
- make sure your room is quiet, dark, relaxing, and at a comfortable temperature
- remove electronic devices such as cell phones, laptops, and TVs
- avoid large meals, caffeine, and alcohol before bedtime
- get some exercise during the day
Schedule medications earlier in the day
Corticosteroids commonly cause insomnia, or the inability to sleep. Some people find that it helps to take these types of medications when they wake up, if possible. This works in alignment with your natural circadian rhythm to raise cortisol levels and lower them toward the end of your day.
Because of the potential increase in alertness or restlessness, this gives your body time to adjust to the medication and be more ready for sleep by the end of the day.
Avoid caffeine and alcohol
Caffeine is a stimulant that reduces your body’s ability to go to sleep and stay asleep. Studies show that people should consume caffeine at least 8 hours before bedtime, as it takes that long for the effects to wear off.
Alcohol disrupts the sleep cycle and reduces the amount of REM (rapid eye movement) sleep you get. REM sleep is the cycle responsible for cognitive function, memory consolidation, and emotional processing.
Talk with your doctor about medications
If you experience persistent insomnia, a doctor might prescribe some medications to help you fall asleep and stay asleep. These include:
- doxepin (Silenor)
- temazepam (Restoril)
- eszopiclone (Lunesta)
- ramelteon (Rozerem)
Summary
It may take some time for your body to adjust when starting a new medication. Difficulty sleeping is one of the most common side effects of dexamethasone, and it can significantly affect your mental clarity and alertness during the daytime.
To help decrease this effect, try taking your dexamethasone when you wake up. If it continues and becomes disruptive to your daily activities, contact your doctor. They may be able to discuss herbal supplements or prescription sleep aids to help you rest better.
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