Does Paxlovid Cause Insomnia? Understanding Sleep Disturbances and Side Effects

Does Paxlovid directly cause insomnia, or are sleep problems related to COVID-19 itself? Explore side effects, expert insight, and tips for better rest.

By Medha deb

Created on Sep 25, 2025

Does Paxlovid directly cause insomnia, or are sleep problems related to COVID-19 itself? Explore side effects, expert insight, and tips for better rest.

Does Paxlovid Cause Insomnia?

Paxlovid is a widely prescribed oral antiviral medication used for treating COVID-19, especially in individuals at risk of severe illness. As patients increasingly use Paxlovid, questions have arisen about whether the medication itself might cause sleep disturbances, particularly insomnia. While clinical studies do not identify insomnia as a direct side effect, anecdotal evidence and reports from users suggest some people do experience sleep disruption during treatment. This comprehensive article examines the current research, explores potential causes, outlines side effects, and offers expert-backed strategies for improving sleep while using Paxlovid.

Can Paxlovid Cause Insomnia?

Insomnia is a common sleep disorder, characterized by difficulty falling asleep, staying asleep, or achieving restful sleep. In the context of COVID-19 and its treatments, sleep issues are a frequent concern. However, review of Paxlovid’s approved clinical trial data and medical literature indicates that insomnia is not recognized as a reported or common side effect of the drug.

Despite this, some individuals taking Paxlovid anecdotally report disrupted sleep. This has led to speculation about possible links between Paxlovid therapy and insomnia. So far, these connections remain unproven, and most experts agree there are multiple factors that could contribute to sleep difficulties during the course of treatment.

Why Might Insomnia Be Reported During Paxlovid Treatment?

Paxlovid’s Known Side Effects: Although insomnia is not listed, side effects such as muscle pain and diarrhea can be disruptive to sleep patterns.
COVID-19 Symptoms: COVID-19 itself can cause symptoms like fever, chills, cough, shortness of breath, and general malaise—all known to impair sleep quality.
Anxiety and Stress: The anxiety around a COVID-19 diagnosis, isolation, and concern about recovery can contribute to increased stress levels, which in turn may make falling or staying asleep more difficult.
Timing & Dosing Schedule: Paxlovid is usually taken twice daily, which means late evening or early morning dosing could interfere with normal sleep routines for some individuals.
Anecdotal Reports: Some users report sleep disturbance while on Paxlovid, but it remains unclear whether this is due to the drug, the illness, or a combination of factors.

Other Reported Side Effects of Paxlovid

Like most medications, Paxlovid can cause a range of side effects. Understanding these is important for distinguishing between effects caused by the medication versus those caused by the underlying illness.

Altered or Foul Taste (Dysgeusia): Many users report an unusual metallic or bitter taste in the mouth.
Malaise (feeling unwell)
Muscle pain
Diarrhea
Nausea
Abdominal Pain
High Blood Pressure
Headache, Vomiting

Rare side effects include allergic reactions and potential liver problems. If you experience severe side effects, you should contact your healthcare provider immediately.

Common Side Effect	Description/Impact
Altered Taste	Metallic, bitter, or foul taste which can reduce appetite and impact eating habits
Muscle Pain	Discomfort that could make it harder to fall or stay asleep
Gastrointestinal Issues	Diarrhea, nausea, and abdominal pain can disrupt nighttime rest
Malaise	A general feeling of unwellness, which may contribute to fatigue during the day and restless sleep
High Blood Pressure	Usually mild but can increase nighttime anxiety or discomfort

Medication Interactions with Paxlovid

Paxlovid can interact with several other drugs, increasing the risk of adverse effects or changing how the medicines work. Some medication classes with known interactions include:

Arrhythmia drugs
Blood pressure medications
Blood thinners
Mental health medications
Seizure medications
Statins

Important: Inform your doctor about every prescription, over-the-counter medication, or supplement you are taking before starting Paxlovid.

How Effective is Paxlovid?

Paxlovid has demonstrated significant effectiveness in reducing the risk of severe COVID-19 illness. Clinical trials in unvaccinated adults with no prior COVID-19 history showed that a five-day course of the drug reduced the risk of hospitalization or death by 89%.

In subsequent analyses including vaccinated individuals and those with prior COVID-19, the drug still lowered the risk of hospitalization compared to no treatment, though the effect was less pronounced (51% reduction).

Emerging research also hints that Paxlovid may help prevent long COVID, a syndrome characterized by symptoms such as fatigue, cognitive impairment (“brain fog”), and ongoing sleep issues. However, more research is still needed to clarify these benefits.

COVID-19 Illness and Sleep Issues

It’s important to recognize that COVID-19 infection itself is often responsible for sleep difficulties—much more commonly than the medications used to treat it. Symptoms affecting sleep include:

Fever and chills
Night sweats
Coughing and shortness of breath
Body aches and pain
Anxiety, worry, or emotional stress related to illness

Most people taking Paxlovid do so while their COVID-19 symptoms are still active. As a result, it can be difficult to identify whether sleep problems are due to the medication or the lingering effects of the viral infection itself.

Managing Insomnia and Sleep Issues During Paxlovid Treatment

If you experience insomnia while taking Paxlovid, several evidence-supported strategies can help improve sleep quality and reduce nighttime disturbance.

Stick to a regular sleep schedule: Go to bed and wake up at the same times each day, even on weekends.
Establish a relaxing bedtime routine: Reduce stimulation before bed; consider reading, gentle stretches, or listening to calming music.
Limit screen time: Avoid phones, tablets, and TV 30–60 minutes before bedtime, as blue light can impact your body’s natural sleep cycle.
Keep your bedroom cool, dark, and quiet: A comfortable sleeping environment is crucial, especially during illness.
Take Paxlovid at recommended intervals: Try to avoid taking doses too close to bedtime if possible.
Stay hydrated and eat light: Avoid heavy meals close to bedtime and drink enough fluids during the day to reduce discomfort at night.
Manage anxiety: Breathing exercises or gentle mindfulness techniques may help reduce stress related to illness or medication.

When to Contact a Healthcare Provider

If your sleep problems are persistent, severe, or are accompanied by concerning symptoms such as chest pain, high fever, severe allergic reaction, or ongoing gastrointestinal distress, contact your healthcare provider immediately. They may recommend supportive therapies or alternative approaches tailored to your specific needs.

Do not stop taking Paxlovid without consulting your doctor, as doing so could put you at risk of more severe COVID-19 complications.

Key Takeaways

Insomnia is not a known side effect of Paxlovid based on clinical trials, though some people do report sleep disturbance during therapy.
Side effects like muscle pain, diarrhea, and malaise may indirectly impact sleep quality.
COVID-19 symptoms alone are a primary factor causing poor sleep for many people.
If you experience insomnia while taking Paxlovid, practice sleep hygiene techniques and monitor side effects closely.
Consult a healthcare professional for persistent or severe sleep problems during Paxlovid treatment.

Frequently Asked Questions (FAQs)

Does Paxlovid directly cause insomnia?

No, insomnia is not listed as a known or common side effect in clinical trials. Some individuals report disrupted sleep, but this is more likely to result from other side effects or the symptoms of COVID-19 itself.

What symptoms or side effects should I watch for that might disturb sleep?

Muscle pain, gastrointestinal symptoms (such as diarrhea or nausea), and even Paxlovid’s unpleasant taste can make sleep more challenging for some people.

How can I manage sleep disturbances while taking Paxlovid?

Follow good sleep hygiene practices
Take medication at consistent times recommended by your doctor
Speak to your healthcare provider if insomnia persists or worsens

Is my sleep more likely affected by COVID-19 than by Paxlovid?

Yes. COVID-19 causes a range of symptoms that directly disrupt sleep in most patients. Medication side effects may contribute but are secondary to the impact of the illness itself.

Are there other common side effects associated with Paxlovid?

Yes. The most common include altered taste, diarrhea, muscle aches, nausea, malaise, and less commonly, headache or increased blood pressure. Most of these resolve after completing treatment.

Should I stop taking Paxlovid if I have sleep problems?

No. Consult your doctor before stopping any COVID-19 treatment. Stopping treatment without medical advice can increase your risk of serious complications.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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