From the Guidelines
Atorvastatin is not commonly associated with insomnia, and most patients taking atorvastatin do not experience sleep problems, as evidenced by the lack of direct mention in recent studies such as 1. The relationship between statins, including atorvastatin, and sleep disturbances is not fully understood but may involve changes in hormone production or neurotransmitter activity. If insomnia persists in patients taking atorvastatin, practicing good sleep hygiene (maintaining a regular sleep schedule, avoiding caffeine and electronics before bedtime) might help manage this side effect while continuing to receive the cardiovascular benefits of atorvastatin, as suggested by general principles of sleep management 1. It's essential for patients to discuss any sleep disturbances with their healthcare provider, who might consider adjusting the dose or switching to a different statin medication if necessary. The most recent and highest quality study, 1, focuses on the cardiovascular benefits of statins, including atorvastatin, highlighting their importance in stroke risk management and the reduction of cerebro- and cardiovascular events, which takes precedence over potential, though uncommon, side effects like insomnia in terms of morbidity, mortality, and quality of life. Key points to consider include:
- Atorvastatin's primary role in reducing cardiovascular risk, as shown in 1.
- The potential, though not commonly significant, impact on sleep.
- The importance of good sleep hygiene practices.
- The need for healthcare provider guidance if sleep disturbances occur.
From the FDA Drug Label
Insomnia2.92.81.15.32.83.0 Insomnia is reported as an adverse reaction in patients treated with atorvastatin calcium, with an incidence of 2.9% to 3.0% in the atorvastatin calcium group, which is greater than the placebo group.
- The incidence of insomnia varies by dose, with the highest incidence (5.3%) reported in the 40 mg group. 2
From the Research
Atorvastatin and Insomnia
- The relationship between atorvastatin, a type of statin, and insomnia is complex and has been studied in various research papers 3, 4, 5, 6, 7.
- A study published in 2014 found that statin use is associated with an increased risk for sleep disturbances, including insomnia 3.
- However, a systematic review and meta-analysis published in 2015 found that statin therapy had no significant effect on total sleep duration, sleep efficiency, or latency to stage I sleep, but significantly reduced wake time and number of awakenings 4.
- A cross-sectional cohort study published in 2021 found that statin users had an increased risk of insomnia compared to controls, with an odds ratio of 1.07 (95% CI: 1.03-1.11) 5.
- Another review published in 2025 found that statins appear to have minimal impact on sleep, although rare cases of insomnia or nightmares are reported 6.
- The impact of statins on sleep quality is still not fully understood and may be influenced by various factors, including the ability of statins to cross the blood-brain barrier and alter serum levels of blood-borne factors such as glucose 7.
Key Findings
- Statin use is associated with an increased risk for sleep disturbances, including insomnia 3, 5.
- Atorvastatin, a type of statin, may have a similar effect on sleep quality as other statins 3, 4, 5.
- The relationship between atorvastatin and insomnia is complex and may be influenced by various factors, including genetic predisposition and individual responses to the medication 5.
- More research is needed to fully understand the impact of atorvastatin on sleep quality and to determine the underlying mechanisms of any potential effects 3, 4, 5, 6, 7.