How long does clonidine make you sleepy?

In this article:

• Clonidine sleepiness
• How long does clonidine make you sleepy?
• Factors that influence the effect
• Managing sleepiness
• When to see your doctor

In this article

• Clonidine sleepiness
• How long does clonidine make you sleepy?
• Factors that influence the effect
• Managing sleepiness
• When to see your doctor

Clonidine is a generic prescription medication that helps calm the nervous system, relax blood vessels, and slow the heart rate. Brand names include Catapres, Javadin, and Kapvay. While it’s FDA approved to treat high blood pressure, medical providers may also prescribe it off-label for ADHD, anxiety, tics caused by Tourette’s syndrome, menopausal symptoms, and sleep disorders. The medication’s relaxing effects can be helpful for certain health conditions, but they can also cause drowsiness for several hours after your dose and even into the next morning—disrupting daily activities like work, driving, and everyday responsibilities.

How does clonidine induce sleepiness?

Clonidine works to induce sleepiness by blocking the release of norepinephrine, a chemical that helps keep the body alert, says Jordan Spencer, DO, a psychiatrist at Barrier Islands Psychiatry in Charleston, South Carolina. “It lowers your ‘fight or flight’ response to induce a calming effect.”

Think of clonidine as a “volume knob” for the nervous system, says Linda Khoshaba, NMD, founder of Natural Endocrinology Specialists in Scottsdale, Ariz. “When that chemical level drops, your heart rate slows down, and your brain gets a very loud message that it’s time to take a nap,” Khoshaba explains. “It’s basically like flipping a switch from go mode to rest mode.”

How long does clonidine make you sleepy?

Many people will notice sleepiness within about 30 or 60 minutes after taking an immediate-release dose, with the strongest effect within one to four hours, says Austin Traasdahl, DO, a family medicine provider with Alexander Medicine in the Phoenix, Arizona, suburbs. How long sleepiness lasts varies, however, depending on the dose of clonidine and the patient. “Some feel it for a few hours, while others can feel drowsy into the next morning,” Trassdahl says.

The half-life—or the time it takes for half of the medication to leave a person’s bloodstream—is between 12 and 16 hours. “Because it stays in your system for a while, you might still feel a little bit of a hangover or lingering grogginess even the next morning,” Khoshaba says.

Yet everyone’s body metabolizes drugs differently. “If your system runs a bit slower, or if your genetics make you more sensitive to nervous system changes, that sleepy feeling is going to stick around much longer than it might for someone else,” Dr. Khoshaba said. 

Factors that influence clonidine’s sedative effects

Several variables affect how quickly the sleepy feeling passes after taking clonidine tablets.

• Dosage: A patient’s dose is the biggest factor that influences clonidine’s sedative effects, Dr. Khoshaba says, with higher doses increasing the risk of sleepiness. Especially at higher doses, side effects of clonidine, like sleepiness, may be more pronounced, studies show.
• Formulation: Clonidine is available in several formulations, including short-acting tablets, extended-release tablets, and an extended-release clonidine patch. While extended-release tablets are taken once a day, short-acting tablets are taken twice a day in the morning and at bedtime. “A patch releases it slowly, while a pill hits all at once,” Khoshaba says. Immediate-release tablets may cause the greatest sleepiness.
• Kidney health: The kidneys are responsible for removing about 50% of clonidine from the body, Dr. Spencer says. If a person is experiencing decreased kidney function due to age, illness, or kidney disease, the medicine may be cleared more slowly and remain in the body longer. “This means the sedation window shifts from a 12-hour to 24-hour cycle, causing a persistent hangover effect,” Dr. Spencer adds.
• Food interactions: “If you’re mixing it with a glass of wine, an allergy pill, or even some calming herbal teas, those can team up with the clonidine to make you feel twice as tired,” Khoshaba notes.
• Drug interactions: Taking clonidine with other medications like isocarboxazid, a monoamine oxidase inhibitor (MAOI) commonly used to treat depression, can significantly increase the risk of low blood pressure and drowsiness. 

“People should talk to their provider if clonidine makes them too sleepy to function normally or if it affects driving, work, or school,” Dr. Traasdahl said. “Seek medical advice promptly if there’s fainting, severe dizziness, confusion, or unusual weakness.”

Practical strategies for managing clonidine-induced sleepiness

Managing clonidine-induced sleepiness often involves small adjustments that help balance symptom relief. One of the simplest strategies is adjusting medication timing. “For example, taking clonidine in the evening can reduce daytime drowsiness while improving insomnia,” Dr. Traasdahl says.

When patients report that they feel a little “fuzzy” in the morning, Dr. Spencer says he tells patients if they feel like they’re moving through water or that they’re in a fog, not to drive and adjust the time of day when they take clonidine. “We often solve this problem by moving the dose earlier in the evening so that we know sedation wears away before their morning commute,” Dr. Spencer adds.

Other practical strategies for managing clonidine-induced sleepiness include:

• Don’t drink alcohol: Drinking while taking clonidine can not only increase drowsiness, but also raise the risk of other mild and serious side effects. A study published in Hypertension also showed alcohol may even block the blood-pressure-lowering effects of clonidine.  
• Gradually increase your dosage: “It helps to start low and go slow, meaning you increase your dose very gradually over several weeks to let your brain get used to the new ‘quiet’ level,” Khoshaba notes. Fatigue is also more noticeable when doses are increased too quickly, Dr. Traasdahl agrees.
• Maintain consistent sleeping habits: This is the foundation for good health, Dr. Traasdahl says. Maintaining a consistent sleep schedule can also help you better understand how clonidine affects you, providing a clearer picture of any side effects related to sleepiness.
• Stay hydrated: The kidneys are the workhorse in eliminating clonidine from the body, so it’s important to help them function effectively by staying hydrated. Drinking fluids while taking clonidine can also help prevent dehydration, which can cause fatigue and sleepiness on its own.  

Patients experiencing sleep disturbances, daytime sleepiness, or other clonidine side effects (like constipation and dry mouth) should avoid abruptly stopping the medication, Dr. Traasdahl says. This can cause withdrawal symptoms like tremors and headaches or a rebound rise in blood pressure.

Serious side effects that warrant consulting a healthcare professional include:

• Low blood pressure (hypotension), including signs like dizziness and lightheadedness or feeling faint
• Signs of an allergic reaction, such as a skin rash, itching, hives, or swelling of the face, lips, tongue, or throat
• Changes in heartbeat, including a slow heart rate or irregular heartbeat

If you’re taking over-the-counter or prescription drugs, consult with a healthcare provider about possible drug interactions. Clonidine should be stored at room temperature, and always keep medications out of the reach of children. In case of a missed dose, don’t double-dose. Take the medication as soon as you remember, or if it’s closer to your next dose, take it then.

When to talk to your healthcare provider

While clonidine can be an important tool in lowering blood pressure and alleviating insomnia, the drug can cause midday fatigue or untimely sleepiness if not managed properly. “We need to know if you’re too sedated during the day or experiencing rebound insomnia so we can adjust the timing to match your natural sleep cycle,” Dr. Spencer says.

If you’re still feeling like a zombie after two weeks, or if the sleepiness is so severe that you’re worried about driving or doing your job, it’s time to give your healthcare provider a call. “You shouldn’t have to trade your quality of life just to stay on a medication,” Khoshaba agrees. “There’s usually a way to adjust the dose or the timing to make it work better for you.”