Hepatitis C: An In-Depth Guide


Difficulty sleeping

Difficulty sleeping includes trouble falling asleep, staying asleep or falling back to sleep. It can also include waking up too early, feeling groggy and tired upon waking, or experiencing disturbing dreams or nightmares.


Difficulty sleeping can be caused by ribavirin and some direct-acting antivirals used to treat hepatitis C.


  • If you are having difficulty sleeping, talk to your healthcare provider. They can help determine the cause of your sleeping difficulties. If your difficulty sleeping is mild, you and your healthcare provider may decide to try some of the strategies below:
    • Managing stress – Living with hepatitis C can be stressful. Try to look honestly at your life to see if stress, anxiety or other emotional health issues could be contributing to your sleep problems. There are many things a person can do to reduce the effects of stress on the body, including meditation, deep breathing exercises, yoga or talking to a mental health professional.
    • Exercise – Exercise, such as walking, can help people sleep better. Always check first with your healthcare provider about what form and duration of exercise is safe for you. If you don’t exercise regularly, start with a small amount of activity and gradually increase it over time.
    • Over-the-counter medications – Some sleep aids are available over the counter, meaning they can be purchased without a prescription. These medicines may put you to sleep, however, they do not address the underlying reasons for sleep issues. Therefore, try to avoid the use of these over-the-counter pills to self-treat sleeping problems. Examples of such medicines include the anti-nausea medication Gravol and the antihistamine Benadryl, both of which cause drowsiness as a side effect. These should not be used for more than one or two days if you are attempting to self-treat sleeping problems. Longer use can make sleep problems worse or lead to more serious problems, such as depression or anxiety. That is why it is always best to consult a healthcare provider about sleep problems.
    • Prescription medications – In some cases you may be prescribed sleeping pills. These medications should only be used short-term and at the lowest possible dose needed to re-establish a good sleep pattern. However, sleep problems can sometimes be an early warning sign of other issues, such as anxiety and/or depression. In such cases, your healthcare provider may discuss the use of an antidepressant (these are also used to treat anxiety) rather than sleeping pills. Before beginning any prescription sleep aid, check with your healthcare provider about whether it will affect your hepatitis C medications or any other medications you are taking.

Complementary therapies

There are a number of complementary therapies that can help promote sleep. Talk to your healthcare provider before starting any complementary therapies. If you are considering taking a supplement or herb, check with your healthcare provider and pharmacist to confirm that it will not affect your hepatitis C medications or any other medications you are taking.

  • Aromatherapy may help people feel sleepy. Essential oils of lemon balm, lavender or chamomile are considered calming.
  • Acupuncture can help some people experiencing sleep problems. A qualified acupuncturist can choose the right combination of points to treat.

For more information on hepatitis C and complementary therapies, see complementary therapies.


  • Keep a sleep diary for a week to help you figure out what might be affecting your sleep.
  • Try to avoid drinking or eating anything with caffeine, sugar or alcohol for 4 to 6 hours before bedtime.
  • Try to avoid smoking cigarettes for 4 to 6 hours before bedtime.
  • Try to avoid strenuous exercise, bright lights, smartphones, tablets, computers and television for several hours before bedtime.
  • Try to relax before bedtime by doing gentle stretches, breathing exercises and/or drinking herbal tea or warm milk.