Can lisinopril (angiotensin-converting enzyme inhibitor) cause hypersomnolence?

Lisinopril and Hypersomnolence

Lisinopril is not known to cause hypersomnolence as a side effect. Based on the available evidence, there is no documented association between lisinopril (an angiotensin-converting enzyme inhibitor) and hypersomnolence.

Side Effect Profile of Lisinopril

• The most common side effects of lisinopril documented in clinical trials include headache, dizziness, cough, and diarrhea 1.
• In comprehensive safety and tolerability studies involving 1,476 patients, somnolence or hypersomnolence was not reported as an adverse effect of lisinopril 1.
• Clinical pharmacology reviews of lisinopril do not list hypersomnolence or excessive daytime sleepiness among its known side effects 2, 3.
• Long-term safety studies of lisinopril in patients with congestive heart failure also do not mention hypersomnolence as a reported adverse event 4.

Medications Known to Cause Hypersomnolence

• Central disorders of hypersomnolence are typically treated with medications like modafinil, armodafinil, and sodium oxybate, indicating these conditions are not typically associated with ACE inhibitors 5.
• When hypersomnolence occurs as a medication side effect, it is typically associated with sedating medications rather than cardiovascular medications like ACE inhibitors 5.
• The American Academy of Sleep Medicine guidelines on hypersomnolence do not list ACE inhibitors or specifically lisinopril as causes of medication-induced hypersomnolence 5.

Clinical Approach to Hypersomnolence in Patients on Lisinopril

• If a patient on lisinopril presents with hypersomnolence, clinicians should consider other more common causes including:

  • Other medications with known sedating properties 5
  • Underlying sleep disorders such as sleep apnea 5
  • Medical conditions that can cause excessive daytime sleepiness (e.g., Parkinson's disease, dementia with Lewy bodies) 5
  • Insufficient sleep or poor sleep hygiene 6

• For patients experiencing unexplained hypersomnolence while on lisinopril:

  • A comprehensive sleep evaluation including polysomnography and multiple sleep latency testing may be warranted to identify the true cause 5
  • Consider consultation with a sleep specialist if symptoms persist 5

Important Considerations

• When evaluating medication side effects, it's important to distinguish between documented effects and coincidental symptoms 7.
• If hypersomnolence develops in a patient taking lisinopril, consider other medications the patient may be taking concurrently that have known sedating properties 5.
• In elderly patients particularly, multiple factors often contribute to hypersomnolence, including polypharmacy, medical conditions, and age-related changes in sleep architecture 5.

In conclusion, based on the available evidence, lisinopril has not been documented to cause hypersomnolence, and if a patient on lisinopril experiences excessive daytime sleepiness, other causes should be investigated.