What is Finasteride and How Does it Work for Treating Hair Loss?

Finasteride is a prescribed medication used to treat male pattern hair loss (also known as androgenetic alopecia).

Male pattern baldness is caused by dihydrotestosterone (DHT), a variety of testosterone. In individuals that are sensitive to DHT, their hair follicles undergo miniaturization. Hair shortens, which leads to weaker, thinner hairs that aren't able to push through the scalp. The result is poor or reduced hair growth.

Treatment with finasteride affects DHT production by blocking the enzyme responsible for creating it: 5-alpha-reductase.

Lowering DHT levels helps promote healthy hair growth and avoid further hair loss. Not only that, finasteride can help regrow hair - many men notice improvements in hair growth around the hairline and vertex scalp.

Unfortunately, as with any medication, there can be side effects. Alongside issues with ejaculation and erectile dysfunction, some men taking finasteride reported developing insomnia.

What is Insomnia?

Insomnia is a sleep disorder characterised by:

  • Difficulty falling asleep

  • Difficult staying asleep

  • Poor sleep quality

There are two main types of insomnia: acute and chronic. Acute insomnia is short-term and can last from a few days to a few weeks. It's usually triggered by your mental or emotional state, with stress or adverse events being the most common cause.

If your sleep patterns are significantly affected at least three nights a week for three months or more, this would be classified as chronic insomnia.

Insomnia can significantly impact your mental and physical health. Sleep disturbances are linked to an increased risk of developing a mental health disorder, such as depression and anxiety.

Bad sleep at night can lead to daytime sleepiness. This can negatively affect your ability to concentrate, which in turn may affect your job, education, and home life.

Sleep disturbances can be caused by various factors, including stress, medical conditions, lifestyle habits such as caffeine and alcohol, and medications, maybe even including finasteride.

So, Can Finasteride Cause Insomnia?

The evidence on whether finasteride can cause insomnia is mixed. Some studies have not found any high-quality scientific evidence that finasteride causes insomnia.

However, other studies have found associations between finasteride use and sleep apnoea, sleep disorders, and other sleep-related issues.

Individual factors are involved in the development of insomnia, so it's likely that the sleep-related side effects of finasteride vary from person to person.

Unfortunately, the current evidence is not definitive. More research is needed to fully understand the relationship between finasteride and sleep problems.

However, there are some theories as to how finasteride can lead to sleep issues.

Potential Reasons Finasteride Could Cause Sleep Disturbances

Let's discuss a few theories on how finasteride can lead to poor sleep.

  1. Affecting your mental state
    There is some evidence that finasteride can cause changes in your mood, and even depression. Both anxiety and depression could indirectly influence sleep patterns and may cause you to develop sleep problems.

  2. Hormone fluctuation
    As your body gets used to you taking finasteride, there will be fluctuations in your hormone levels. This may lead to sleep disturbances. Luckily, hormonal changes usually level out with time.

  3. Anxiety about side effects
    Anxiety or the anticipation of negative side effects is known as the nocebo effect. This could contribute to sleep disturbances in some individuals taking finasteride.

  4. Withdrawal effects if stopped suddenly
    Abruptly stopping finasteride treatment may lead to withdrawal effects, which could potentially impact your sleep schedule.

    Officially, finasteride is safe to stop "cold turkey", but if you're experiencing negative effects when trying to stop, ask a medical professional for advice.

  5. Interactions with other medications
    Finasteride may interact with other medications, leading to reduced sleep quality. Luckily, specific interactions seem to be very rare, with none formally mentioned in the official drug information.

Tips to Prevent Insomnia While Taking Finasteride

A healthy sleep routine is helpful for everyone, but it can be particularly helpful if you're worried finasteride is affecting your sleep.

Sleep Hygiene

Establish a consistent sleep schedule and create a relaxing bedtime routine. This means avoiding screens in the hour before bed, as they can interfere with the body's natural sleep-wake cycle.

Environment

A dark, cool, quiet room is generally the best environment for sleep. However, some people find music or guided meditation helpful before bed.

Caffeine

Try to limit your caffeine consumption, especially in the afternoons and evenings - it's a surprisingly powerful stimulant.

Exercise and Meditation

By staying active during the day, you'll sleep better at night. Try to get at least 30 minutes of exercise that raises your heart rate every day. Activities like yoga and meditation are also good to include in your day as they can help reduce stress levels.

If you're experiencing persistent or severe insomnia, it's important to consult a healthcare professional rather than assuming it's a side effect of finasteride. They can help get to the bottom of what's causing it, and rule out something more serious.

Signs Finasteride May Be Contributing to Poor Sleep

There are some signs to look out for if you think finasteride could be linked to your sleep disturbances.

  1. You developed insomnia after starting finasteride
    If you had no problems with sleep before you started taking finasteride, this makes it much more likely it could be causing the problem.

  2. You're still struggling to fall asleep despite good sleep hygiene
    Are you cutting out stimulants, staying active during the day, and practising good sleep hygiene at night? If so, the cause of your disrupted sleep is more likely to be an external factor like finasteride.

  3. Sleep improves after stopping finasteride
    If your sleep suddenly improves after stopping finasteride, it is likely part of the problem.

When to Seek Medical Advice

It's important to seek medical advice if you experience side effects of finasteride that are significantly impacting your quality of life, persist longer than a few weeks, or if you're worried.

A healthcare professional can evaluate your symptoms and give you specific advice based on your individual circumstances.

Summary

So, can finasteride cause insomnia? While some men may report sleep issues while taking finasteride as a hair loss treatment, there's no high-quality scientific evidence to support a direct link.

It's important to maintain good sleep habits and speak to a healthcare professional if you're struggling with ongoing insomnia - they can help you determine the underlying cause.

Many men take finasteride for treating hair loss and don't develop sleep issues. It's important to balance both its positive effects on hair loss and any negative effects, like sexual dysfunction when considering starting finasteride. A healthcare professional can help.

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FAQs

Is it bad to take Finasteride before bed?

That entirely depends on you. It's important to take finasteride every day for it to work effectively. But as long as you try to take it at the same time every day, it doesn't matter when that is.

Some people find taking finasteride before bed helps with certain side effects, including sexual issues. However, if you're struggling to fall asleep, it may be worth taking it in the morning.

Does Finasteride mess with mood?

Some studies have found a link between finasteride and low mood, and depression is listed as a medication side effect. However, many men take finasteride without any issues.

If you're worried about your mood, speak to a healthcare professional.

When is it too late to take Finasteride?

If you've missed a dose of finasteride and it's been fewer than 6 hours since you were meant to take it, then take it now. If it's been more than 6 hours, skip the dose and just take the next one as normal.

Does Finasteride affect energy levels?

We know that naturally low testosterone can lead to reduced energy levels, but there's no clear evidence that finasteride affects energy. It's not a commonly recognised side effect of this hair loss medication, although some men may report it.

Does Finasteride cause mental fog?

Finasteride can cause mood changes, such as anxiety and depression. However, slow thoughts or "mental fog" is not an officially recognised side effect of finasteride.

However, it's possible some men may experience mental fog as a side effect. If you're worried, please seek professional medical advice.


Written by

Reviewed by

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Aliysha Parveen

Pharmacist Independent Prescriber

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