Accutane insomnia: can it last after stopping?

Still sleeping badly months after a course of Accutane (isotretinoin, sold in the UK as Roaccutane)? Its official US information lists insomnia among the side effects people have reported. But nobody has studied what happens to sleep once a course ends.

Some people with post-Accutane syndrome (PAS) say they stayed tired long after their last capsule. The UK leaflet in the pack doesn’t mention trouble sleeping, and the NHS page on isotretinoin says nothing about sleep at all.

When nothing in writing matches your nights, it’s easy to doubt yourself. So write them down: your GP gets something to work with, and you can use the same notes to report it as a side effect.

Elliot took Roaccutane at 17. In this extract he talks about how tired he was on it. Every day of his course, he says, felt as if he’d spent the night before “doing something physically exhausting”.

Play video: Elliot on the tiredness during his Roaccutane course

The tiredness didn’t end with the course. Through his twenties, he says, he was “always tired, foggy, disconnected”.

Elliot’s is one account. The studies are less clear-cut.

Is insomnia a side effect of Accutane?

Yes, says its official US information for doctors, though it can’t say how often. It lists insomnia among side effects reported in trials or after the medicine went on sale, along with drowsiness and tiredness. On sleep, the UK leaflet mentions only drowsiness, “reported very rarely”.

Studies that checked people’s sleep while they were on it don’t agree. One small study in Turkey found people slept worse. Others found no change, or even slightly better sleep.

The largest study we found, led by Oxford researchers in 2022, used US health records. About 1 in 100 young people were newly diagnosed with a sleep problem within a year of starting isotretinoin. Rates were much the same for people on other acne medicines, and a little lower for people with acne who took none. It counted diagnoses only, so it misses nights nobody took to a doctor.

Does Accutane insomnia go away after stopping?

Nobody knows how often it does. In October 2026 we found no study that followed people’s sleep after their course ended.

PAS is the name patients use for problems that last after the course is over. A checklist that doctors and researchers proposed in 2022 lists problems with concentration and memory, depression, and changes in the skin, joints and bowel. These can come without any sexual problems. Sleep isn’t on it.

The drug itself is gone from your body within a month of the last capsule, the UK information for doctors says. So if you’re still sleeping badly months later, it isn’t leftover medicine. The UK leaflet says side effects generally clear up, “however some may continue after treatment has stopped”.

Some websites say sleep comes back a month or two after stopping. We couldn’t find a study behind that.

For some people with PAS, tiredness and other problems have lasted years after stopping. Nobody knows yet who will be affected, or whether they will ease.

Could it be my mood rather than the medicine?

It could be both, and it’s worth finding out. Poor sleep often goes with low mood and anxiety, and the UK leaflet lists both among isotretinoin’s side effects. It warns that stopping the medicine “may not be enough to stop the effects”.

The leaflet US patients get, called the Medication Guide, lists “sleep too much or have trouble sleeping” among the warning signs of depression. It tells anyone who notices those signs to stop taking the medicine and tell their doctor straight away. The UK leaflet says to contact your doctor straight away, who may tell you to stop.

If your sleep changed along with your mood, tell your GP soon. If you’re struggling, the Samaritans are on 116 123, day or night. We have more on Accutane and anxiety and depression after stopping.

What can I do?

Isotretinoin helps many people. If you have side effects, what to do is a decision for you and your prescriber.

Your GP will want to rule out other causes first, and dates help with that. Keep a short note of your nights, like the one below, and take it with you.

1

Your course

“Isotretinoin 30 mg a day from February 2023, last capsule August 2023.”

2

When your sleep changed

Before, during or after the course: “Waking at 3 am most nights since about June 2023.”

3

What kind of problem

Can't get to sleep, waking in the night, waking up tired, or sleeping too much.

4

What came with it

Low mood, anxiety, tiredness in the day, problems with concentration or memory.

5

How it was before

“Slept through the night before 2023.”

Many people say it took time to be taken seriously. You can report it without a doctor agreeing. I think I have post-Accutane syndrome takes you through the appointment.

Report it: it helps everyone

A doctor’s note helps you. A report to the medicines regulator helps everyone else: it is how patterns get noticed.

• No proof needed. A suspicion is enough, even years after stopping.
• Where: the Yellow Card scheme in the UK, MedWatch in the US.
• Use the right words. PAS has no medical term yet, so name the symptom, such as insomnia, and say it continued after stopping.

Our reporting guide walks you through it

What else do people ask?

Can Accutane make you sleep too much? The US Medication Guide counts sleeping too much as a warning sign of depression, and the information for doctors lists drowsiness. In a 2024 study in Egypt, about 6 in 10 people on isotretinoin said they overslept. It didn’t compare them with people who weren’t on it, so it can’t say how much of that was the drug.

Can Accutane cause nightmares or vivid dreams? A few doctors have written up cases. In one from Saudi Arabia, a 24-year-old man’s nightmares broke up his sleep, and they stopped when the medicine did. A handful of cases can’t show how often it happens.

Do people with PFS or PSSD have sleep problems too? Some people with post-finasteride syndrome (PFS) or post-SSRI sexual dysfunction (PSSD) say so. Our pages on sleep with PFS and sleep with PSSD cover them. The 2022 checklist covers all three conditions, and lists sleep for none of them. Our page on post-Accutane syndrome sets out what it does list.

If your sleep changed on or after a course, write your dates down and report it.

Sources

1. Roaccutane 10 mg soft capsules (isotretinoin), patient leaflet, Electronic Medicines Compendium (EMC 100633), last revised April 2026. Section 2, “Driving and using machines”: “Drowsiness and dizziness have been reported very rarely”. Section 4 opens: “The side effects are generally reversible after changing the dose or stopping treatment, however some may continue after treatment has stopped”. Section 4, very rare: “Convulsions, drowsiness, dizziness”. Section 4, mental problems, frequency not known: “Depression or related disorders”. Its signs include “sad or altered mood, anxiety, feelings of emotional discomfort”. If they appear, stopping “may not be enough to stop the effects”. As of October 2026 the leaflet does not mention insomnia, trouble sleeping or sleep.
2. Roaccutane 10 mg soft capsules, summary of product characteristics, EMC 100633, revised 27 April 2026. Section 4.4: the drug is “completely eliminated, which is within one month following the end of treatment”. Section 4.8 lists drowsiness among very rare nervous system reactions and does not list insomnia.
3. Absorica and Absorica LD (isotretinoin), US prescribing information and Medication Guide, revised August 2026. DailyMed, US National Library of Medicine. Section 6, reactions “identified in clinical trials or postmarketing reports”, whose frequency and cause cannot always be established: Body as a whole, “Fatigue”; Neurological, “drowsiness, lethargy”; Psychiatric, “insomnia”. Medication Guide, signs of depression or psychosis: “sleep too much or have trouble sleeping”. It tells patients to stop taking the medicine and “tell your healthcare provider right away”.
4. NHS, Isotretinoin (Roaccutane), page last reviewed 26 June 2026. As of October 2026 the page does not mention sleep.
5. Healy D, Bahrick A, Bak M and colleagues. Diagnostic criteria for enduring sexual dysfunction after treatment with antidepressants, finasteride and isotretinoin. Int J Risk Saf Med 2022;33(1):65-76. Proposed criteria agreed by an expert panel. Isotretinoin effects that “can occur independently of any sexual difficulties” include cognitive impairment, skin, joint and bowel changes, depression and suicidality. The paper does not mention sleep or insomnia for any of the three conditions.
6. Paljarvi T, McPherson T, Luciano S, Herttua K, Fazel S. Isotretinoin and adverse neuropsychiatric outcomes: retrospective cohort study using routine data. Br J Dermatol 2022;187(1):64-72. US electronic health records (TriNetX), people with acne aged 12 to 27, followed for one year after the first prescription. New sleep disorder diagnoses in the year (tables 1 to 3): 11 to 12 per 1,000 person-years on isotretinoin, against 10 with no acne prescription, 11 on topical acne medicines and 14 on oral antibiotics. Against no acne prescription the odds were higher (odds ratio 1.19); against the other two medicines there was no clear difference. Authors: isotretinoin “was not independently associated with excess adverse neuropsychiatric outcomes at the population level”.
7. Celik MS, Celik C, Cepik N. Effect of isotretinoin treatment on sleep quality in acne vulgaris patients. Arch Dermatol Res 2025;317(1):416. 50 patients in Turkey; sleep questionnaire scores worse during treatment. Read as an abstract only.
8. Celik C, Celik MS. Evaluation of depression, anxiety, and sleep quality in patients with acne vulgaris receiving isotretinoin treatment. Hum Psychopharmacol 2026;41(2):e70036. 155 patients in Turkey, first three months of treatment: “not associated with a significant deterioration in sleep quality”. Read as an abstract only.
9. Orenay OM, Temel B, Capci AK and colleagues. Evaluation of isotretinoin effects on depression, sleep apnea and sleep quality. Cutan Ocul Toxicol 2024;43(2):129-133. 42 patients in Turkey; no significant change in sleep quality by the third month. Read as an abstract only.
10. Ismailogullari S, Ferahbas A, Aksu M and colleagues. Effects of isotretinoin treatment on sleep in patients with severe acne: a pilot study. J Eur Acad Dermatol Venereol 2012;26(6):778-81. 12 patients, overnight sleep recordings after one month: night-time sleep “slightly improves”. Read as an abstract only.
11. Shawky A, Elsheikh M, Elrewiny EM and colleagues. Isotretinoin-induced hypersomnia: a cross-sectional study and literature review. Adv Skin Wound Care 2024;37(8):1-3. 123 patients in Egypt on isotretinoin; 77 (62.6%) reported oversleeping. No comparison group. Read as an abstract only.
12. Aljehani F, Alqahtani S, Alharbi S, Alsulami S. Nightmares caused by isotretinoin in treating hidradenitis suppurativa: a case report and clinical insights. Dermatol Reports 2025;17(2):10171. One man, aged 24, in Saudi Arabia; “The symptoms resolved upon cessation of isotretinoin”. Read as an abstract only. Other reports of dreaming on isotretinoin: Gupta MA, Gupta AK, Br J Dermatol 2001;144(4):919-20; Choe J and colleagues, Int J Dermatol 2024;63(7):e133-e134 (titles only).
13. PubMed search, “isotretinoin AND (sleep OR insomnia)”, 28 October 2026: 24 records. None followed sleep after the end of a course.
14. Ghadimi TR, Martinez MJ, Rieder EA. Self-reported long-term side effects of isotretinoin: a case series. J Drugs Dermatol 2023;22(4):423-424. Seven video interviews; symptoms that “either persisted after stopping isotretinoin or started after stopping isotretinoin” included “neurologic symptoms (4/7) (brain fog and fatigue)”. Seven people, no comparison group.
15. Moral Medicine on YouTube. Elliot, 28 January 2025, embedded here as an extract from 47:50 to 48:48. Inside it: “everything just felt very numb and dry” at 47:50, “very tired” at 48:11, and “every day was like you’d spent the last night doing something physically exhausting” at 48:20. Outside it: Roaccutane at 17 at 3:45, his twenties at 1:11:35 and “always tired, foggy, disconnected” at 1:12:56. Quotes are from YouTube’s automatic captions. His story on our site: Elliot.

Sources checked on 28 October 2026. AI-assisted writing and review, not clinical review.