Can Sleeping Pills Raise Cholesterol? Exploring the Link

October 12, 2025 •

4 min read

With approximately 30% of adults reporting one or more symptoms of insomnia, sleeping pills are widely used [1.9.2]. However, research has uncovered a potential link and asks the question: can sleeping pills raise cholesterol? [1.2.2]

Quick Summary

Studies suggest an association between the use of sleeping pills for insomnia and elevated levels of LDL ('bad') cholesterol [1.2.4]. The relationship is complex, with some medications showing more impact than others.

Key Points

Direct Association: A major study found that people with insomnia who use sleeping pills are 118% more likely to have elevated LDL ('bad') cholesterol [1.4.3].
Insomnia Itself: Poor sleep quality, independent of medication, can disrupt hormones that regulate appetite and metabolism, indirectly affecting cholesterol levels [1.8.2].
Benzodiazepines & Triglycerides: Some studies show male users of benzodiazepines may have higher triglycerides and lower HDL ('good') cholesterol [1.3.5].
Indirect Effects: Some medications, like certain sedating antidepressants or antipsychotics, may contribute to weight gain, which is a risk factor for high cholesterol [1.4.1].
Management is Key: If a medication is believed to be raising cholesterol, doctors may suggest an alternative, monitor lipid levels, or recommend lifestyle changes and cholesterol-lowering drugs [1.10.1, 1.10.3].

The Crossroads of Sleep Aids and Lipid Health

Insomnia is a prevalent condition, with estimates suggesting that 10% of adults experience chronic insomnia disorder [1.9.5]. To combat sleeplessness, many turn to sedative medications. Simultaneously, managing cholesterol levels is a cornerstone of cardiovascular health. This raises a critical question for millions of people: can the medications used to improve sleep have a detrimental effect on cholesterol?

One large, population-based study found that while insomnia symptoms themselves were generally not associated with dyslipidemia (abnormal cholesterol levels), individuals with insomnia who took sleeping pills had significantly increased odds of elevated LDL-C (low-density lipoprotein cholesterol), often called 'bad' cholesterol [1.2.4]. People with insomnia using these aids were 118% more likely to have high LDL cholesterol [1.4.3]. This suggests that the medication, rather than just the poor sleep, might be a contributing factor, though researchers note this is an association, not definitive proof of cause-and-effect [1.2.2].

Indirect Connections: Sleep Quality and Cholesterol

Beyond the direct effects of medication, the quality of sleep itself plays a role in cholesterol regulation. Poor sleep can disrupt the balance of key hormones like cortisol (stress hormone), ghrelin (appetite-inducer), and leptin (regulates body weight) [1.8.2]. This hormonal imbalance can, in turn, upset cholesterol balance [1.8.2]. Studies have shown that prolonged sleep restriction can decrease the expression of genes responsible for cholesterol transport [1.8.1]. Inadequate sleep is linked to higher triglycerides and lower levels of HDL ('good') cholesterol, while a full eight hours of sleep is associated with the highest HDL levels [1.8.2]. Therefore, the severe insomnia that necessitates sleeping pill use might itself be a confounding factor in elevated cholesterol [1.2.1].

A Closer Look at Different Sleeping Pill Classes

The term 'sleeping pill' covers a wide range of medications with different mechanisms. Their impact on cholesterol is not uniform.

Benzodiazepines

This class includes drugs like diazepam and lorazepam. Research on their effects has yielded mixed results. One study on male benzodiazepine users noted significantly higher plasma triglyceride levels and, by one analysis, lower HDL cholesterol levels, with no significant differences in total or LDL cholesterol [1.3.5]. However, another study in rats found that prolonged, high-dose use of diazepam led to a significant increase in total cholesterol and LDL cholesterol [1.3.4]. In vitro studies suggest diazepam can inhibit enzymes involved in cholesterol esterification, a process central to cholesterol transport and metabolism [1.3.3].

'Z-Drugs' (Nonbenzodiazepine Hypnotics)

Z-drugs like zolpidem (Ambien) are chemically different from benzodiazepines but act on similar brain pathways [1.6.3]. While specific studies linking Z-drugs directly to cholesterol changes are limited, they fall under the general umbrella of 'sedative medications' that were associated with elevated LDL in the large-scale NHANES study [1.2.4, 1.4.2]. More research is needed to isolate the specific effects of this class [1.4.2].

Antidepressants Used for Sleep

Some antidepressants, like Trazodone, Doxepin, and Mirtazapine, are prescribed off-label for insomnia due to their sedating effects [1.6.1, 1.6.2]. The impact of these drugs on cholesterol may be more related to the broader effects of antidepressants and weight changes. For example, some atypical antipsychotics, which can also be used for sleep, are associated with a higher risk of high cholesterol, possibly linked to medication-induced weight gain [1.4.1].

Orexin Receptor Antagonists

This newer class of drugs, including suvorexant (Belsomra), lemborexant (Dayvigo), and daridorexant (Quviviq), works by selectively blocking orexin, a neurotransmitter that promotes wakefulness [1.5.1, 1.5.4]. Currently, there is limited publicly available research directly linking this specific class to significant changes in cholesterol profiles. They are metabolized by the hepatic CYP3A system, and drug levels can be higher in women and obese individuals [1.5.5].

Over-the-Counter (OTC) Antihistamines

Common OTC sleep aids often contain antihistamines like diphenhydramine or doxylamine [1.6.2]. A 2010 study found that while antihistamine use was linked to an increased likelihood of being overweight, the medications were not linked to higher odds of elevated cholesterol [1.7.1]. However, another study found that histamine plays a complex role in lipoprotein metabolism, suggesting more research is needed [1.7.4].

Comparison of Sleeping Aids and Potential Cholesterol Impact


Medication Class	Examples	Potential Impact on Cholesterol	Citation
Benzodiazepines	Diazepam, Lorazepam	May increase triglycerides and lower HDL in men; prolonged high doses may increase total and LDL cholesterol.	[1.3.4, 1.3.5]
'Z-Drugs'	Zolpidem (Ambien)	Included in broad sedative studies showing association with higher LDL; specific data is limited.	[1.2.4, 1.4.2]
Sedating Antidepressants	Trazodone, Doxepin	Impact may be indirect, related to weight gain; some related psychiatric drugs are linked to high cholesterol.	[1.4.1]
Orexin Receptor Antagonists	Suvorexant (Belsomra)	Currently, limited data suggests a direct link to cholesterol changes.	[1.5.1, 1.5.5]
OTC Antihistamines	Diphenhydramine	Studies have not found a direct link to elevated cholesterol, but have linked them to weight gain.	[1.7.1]

Managing Your Health: A Holistic Approach

If you take sleeping pills and are concerned about your cholesterol, open communication with your doctor is key. If a medication is suspected of causing dyslipidemia, a physician might consider replacing it with an alternative [1.10.1]. Regular monitoring of serum lipid levels is important for anyone on long-term medication [1.10.1, 1.10.3]. Lifestyle interventions, such as a healthy diet, regular exercise, and achieving a target body weight, remain the foundation for managing cholesterol [1.4.4]. If lifestyle changes are insufficient, your doctor may prescribe cholesterol-lowering medicines like statins [1.10.4].

Conclusion

The evidence points to a noteworthy association between the use of sleeping pills and higher levels of 'bad' LDL cholesterol [1.2.4]. While poor sleep itself can negatively affect lipid profiles, certain medications, particularly older classes like benzodiazepines, may also play a direct or indirect role. The link is not a simple cause-and-effect relationship and can be influenced by the type of medication, dosage, duration of use, and individual health factors. Patients using sleep aids should engage in regular check-ups with their healthcare provider to monitor their cardiovascular health, including their cholesterol levels, and discuss the most appropriate strategies for managing both sleep and heart health.

For more information on cholesterol management, you can visit the CDC's page on Cholesterol-Lowering Medicines. [1.10.4]

Frequently Asked Questions

Not necessarily. Studies show an association between general 'sleeping pill' use and high LDL cholesterol, but the effects vary by drug class. For instance, some benzodiazepines have been linked to changes in triglycerides and HDL, while the direct impact of newer classes like orexin receptor antagonists is less clear [1.3.5, 1.2.4, 1.5.5].

It's complicated and likely both. Poor sleep quality itself can negatively impact cholesterol by altering hormones [1.8.2]. However, one major study found that after adjusting for covariates, the use of sleeping pills in people with insomnia was significantly associated with high LDL, suggesting the pills themselves are a factor [1.2.4].

Existing research has not found a direct link between common OTC antihistamine sleep aids and elevated cholesterol. One study did note a link between antihistamine use and increased odds of being overweight, which is a risk factor for high cholesterol [1.7.1].

LDL stands for low-density lipoprotein. It is often called 'bad' cholesterol because high levels can lead to the buildup of plaque in your arteries, increasing your risk for heart disease and stroke [1.2.4, 1.3.4].

You should speak with your healthcare provider. They can assess your overall health, monitor your lipid levels, and determine if your medication is a contributing factor. Management options include lifestyle changes, switching medications, or adding a cholesterol-lowering drug if necessary [1.10.1, 1.10.3].

Specific data focusing only on zolpidem is limited. However, it falls into the broader category of 'sedative-hypnotics' which, in a large study, were associated with an increased likelihood of high LDL cholesterol among users with insomnia [1.2.4, 1.4.2].

If your medication was a contributing factor, stopping or changing it might help improve your lipid profile, but this should only be done under the guidance of a doctor. Since poor sleep also affects cholesterol, it's crucial to have an effective insomnia management plan in place [1.8.2, 1.10.1].