Insomnia and Sinemet

I have posted before about night time meds. I have taken Sinemet plus and entecapone 4 times a day, rasagaline, 24mg ropinirole (split into three doses). Have been taking sinemet cr at 11pm for a while as I felt that I needed some PD meds during the night. However it never seems to do anything. I have therefore tried adding a sinemet plus at bedtime and taken the sinemet cr out altogether. I also use madopar dispersible as and when. So use it both during the day and at night.

Now I have found at times during the day I suddenly fall asleep, and during the night I can't sleep. But have noticed that at night if I take a madopar dispersable it seems to act like a sleeping tablet, but as it is short lasting the PD symptoms come back and I wake up.

Soooo. To cut a long question a bit longer .... Have seen posts about Sinemet causing sleep problems. So could it be that when I take a madopar it makes me sleepy, and sinemet plus stops me sleeping.

So I have also noticed there is a Madopar CR ...

Any experience of this?

[Enidah]

At my PD group yesterday we had a movement disorder specialist speak and she seemed to think taking sinemet at night made some people restless. As with everything having to do with PD it seems to depend on the person. You might want to try cutting it out at night and seeing what happens. Good luck! The Sleep conundrum continues.

[missybee]

Sorry no .. he does not do sinemet at night .. he has changed his nighttime ropinerole to gaba pentin plus takes 1/2 Xanax at night 😴 sleeping ok

[shakyj]

Hi there… You do not mention how long ago you were diagnosed and your age. It’s not clear if you are taking rasagaline and ropinirole together. I take Prolopa/Madopar 150mg eight times/d, every 90 minutes. I add one Comtan (Entacapone) every four hours as it may enhance the Prolopa and is active four hours. If you take Stalevo plus with Comtan you are doubling your dose of Comtan, is not serving any positive purpose and may cause dyskinesia. My last dose is at 4.30pm and I let it wear off completely which is around 9.30pm. I am unable to sleep with levodopa in my system. The downside here is that I have to put up with dyskinesia for about an hour as the Prolopa wears off. Once it has worn off I am fairly weak and do have some difficulty getting into bed. So I need to prepare my bed schedule while I am still ‘on’.

I also take Gabapentin 200mg x 3/d (not Gabapentin PLUS) along with Clonazepam 1mg x 3/d. They seem to help me sleep. I would not advise Clonazepam as it is very addictive, but initially it helped me with severe tremors.

The agonists you are taking can cause you to fall asleep suddenly during the day, I would eliminate them and concentrate on the Sinemet and Comtan. If you are taking too many different meds there is no telling which is doing what.

What I think you need to try is take a Sinemet 150 at say eight am, and take note when it wears-off (your pd symptoms return). This is the period that you must space your doses, less one hour to allow the following dose to take effect before the previous dose wea You can take doses right up to your bedtime. If the Sinemet interferes with your sleep (it may make you feel tense and you will find it difficult to fall asleep) then you should try taking your last dose sooner so that the Sinemet has time to wear-off and is cleared from your system when you go to bed.

If you have not been on the Gabapentin long I would discontinue it for now unless you can define a positive benefit. The less meds you can get by with the better off the outcome.

So, if it takes four hours for that first dose to wear-off your med schedule may look something like this: 8am, 150mg Sinemet (not Sinemet Plus); 11am, same; 2pm, same; 5pm same. You can try taking Entacapone 1 x 200 mg with the first dose and the 2pm dose or with each dose as it may extend your on-time. You will need to experiment with the time between doses to find what works for you.

Us Parkies are not all the sane and do not respond to medications in the same way, but this procedure I think is the best method to get a schedule going, as Sinemet is the Gold Standard treatment. I am sure your doctor should be able to help.

Good luck

[ramondo4 in reply to shakyj]

Why not Sinemet plus? Skakyj.

[Motherfather]

well i keep telling people who take sinemet its not as good as madopar but people dont seem to listen when i say that.they think im a bad boy.well if you dont try things you will never get anywere.i just went to the doctor this morning and asked for pramipexole.some one got the name wrong the other day.they give me sifrol the same as pramipexole.that i will start tomorrow.ill reduce the amount of madopar i take tomorrow by a third.then wait and see.

[1953bullard]

Try cbd oil, you will sleep

[Beverly2017 in reply to 1953bullard]

Pls tell me about the cbd oil. Do you rub it in somewhere or swallow it??? What brand and where do you buy it? How many hours of sleep do you get?. Do you take other meds? Thanks. I'd love to try it...much better than more pills! Bev

[maulparking]

I take only regular Sinemet 25/100 1.5 tabs 3x daily at 11am, 230pm, 6pm. I have avoided CR. I have been eight years with PD with fairly modest symptoms.

Paul Marking [e-mail] for longer reply

I generally sleep OK and have few symptoms in the morning.

I meditate a fair amount, exercise, and do yoga.

Good Luck, and email me for more details.

[joytheteach]

I have been taking dispersible Madopar for over 12 months now. It tastes awful so I have it in as little water as possible, followed swiftly with a biscuit. I was told by my PD nurse to take it as soon as I wake up but I can't face it at 4:30 or 5am, so I usually wait until about 6;30 ish. It gives me a kick start so I think of it as a go faster stripe. I know if ive missed it as Im even more sluggish in the morning, My nurse also recommended at least an hour gap before having my next lot of meds which is 24 mg Ropinerole and 150 mg Stalevo.