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Insomnia From Beta Blockers


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Hi everybody! Well once again, I'm having a horrible time with this new beta blocker, Metoprolol. I have severe insomnia, like no sleep, which makes all my other symptoms flare badly. I don't think I'll be able to keep taking it, yet it seemed to really help my tachycardia for the one day I took it. How in the world can I give it a chance if I can't sleep at all when I take it. I'm just not sure what to do as I'm afraid my doctor won't feel I'm giving it a chance, but I deperately need some sleep. I took a very small dose, so not possible to take a lower dose either. I tried to take a tylenol PM and usually that helps a lot, but it didn't even take any effect last night :o Any advice?

- Tammy

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Hi Tammy,

Sorry you are having such trouble. I have been taking metoprolol for a couple of years. When I first started, I had lots of trouble sleeping, but I loved how it helped slow my tachy. The docs couldn't do much about the insomnia except add benzos which I didn't want to do, so I asked the pharmacist.

She suggested I divide the dose in two and take half just before going to bed and the other half 12 hours later. That way, I would be asleep when it was strongest. That helped a lot.

Eventually I was able to reduce the dose somewhat which has helped the most. I tweak the dose depending on need (and with the doctor's blessing), but still take half just before bedtime.

Taking Toprol to even out the dose was a disaster as it wore off too soon and I would rebound with tachy and still have insomnia.

Good luck. For me, it was worth trying different things. I am grateful for it.


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Thanks for the input. I did divide the dose in half and took a half before bed time. The dose at bedtime kicked in later on, but the dose from the morning was still in my system so I couldn't fall asleep and than as the night time dose kicked in, it really made the insomnia set in. Any other ideas? Thanks :)

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I switched from splitting my Metroprolol dose to twice a day to Toprol XL (which is extended release metroprolol) for this reason. I was told to take my Toprol in the morning or before bed, but I found that taking it at about 1-2pm works best for me. I didn't have a problem sleeping, and it was still working in the morning, which is my worst time of day. Taking it later than 6pm gives me very vivid dreams that are often unpleasant.

Just my own personal experience, and I know everyone is different, but I was severely compromised before I started on Toprol XL, and I have now lived an almost completely normal life for the 22 months I have been on it. Tachycardia was my main symptom. I had given up on the Metroprolol and was only taking it when I had serious episodes of resting tachy.

I would say that it took about 3 weeks before I was totally used to the drug. My PCP had suggested I take Ativan or Xanax (I take a quarter tablet of the lowest dose possible because I am very med sensitive) to help me sleep every other night at first. I really didn't need it, though.

Best of Luck to you! That "wired but so tired" feeling is the worst! All I can say is that getting my tachycardia under control changed my life!


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I started to sleep much better once I reduced my dose of BB. I would not be surprised if insomnia is a side effect. How long have you been taking a BB? It takes a while to adjust to it. The first weeks is the absolute worst and it continues to get better after that. After taking it for months/years, the side effects really started to go away. I would encourage you to stick with it if you can. Most POTS meds seem to have an adjustment period - believe it or not many are even worse than the BBs! It could be worth it if you can manage to hang in there.

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