Mtx and sleep

Does anyone else find that it is difficult getting to and staying asleep on the nights you take methotrexate . I had wondered this previously but since my dose has been increased (25mg), I have noticed that it has become even more Difficult?

32 Replies

  • Hi Marie

    Guess that's at least two of us up tonight. Mtx yesterday coupled with small snoring dog equals little sleep. I suppose it gives me a chance to catch up on my reading and recorded programmes. I may even go a little crazy and knit a little more of the most boring jumper in the world.

    How do you cope with It?


  • Hi Jan

    Earlier on I did some work ( reports) and Ive just finished watching Girl On the train!

    I actually feel that if I went back up to bed now, I probably could sleep for a bit, my eyes now feel quite heavy. However, no such luck as in half an hour or so, I'll need to jump ( HUGE exaggeration !!) in the shower and get ready for work 😔

    I'm hoping that you managed some sleep And will only see this much later In the morning.


  • Hi Marie

    Quite a productive night's work, then! Gently does it if possible today and an early night if you can. This is no fun but I'm certain it will get better.

    No sleep for me but as I've been an insomniac for years this is nothing unusual. However, with no job to prepare for or children still here and needing care its all good.

    Take care


  • No rest for the wicked. , I'm afraid. Full day of meetings. However, I will aim for an early night tonight. I am lucky in that the kids are not babies ( youngest 9) and therefore are in really good routines etc so when they're in bed, usually about 9 pm, I can go too.

    Wishing you a pain free day.


  • I'm the same. I am methotrexate 8 tablets per week. I have had sleeping problems before I took these. Pain in my hips, back and headaches. I get about 2 to 3 hours sleep per night. I also watch recorded tv programs about 2am. I go to bed for 9pm after I put the kids to bed. I take 3 amatriptline on the night before 7pm they help.

  • Bless you. How the heck do you cope? I'm filled with admiration for those poor souls who not only have a nasty painful disease but also manage to care for children AND hold down a job. There should be medals! Time I stopped whinging maybe.


  • Women just get on with. It's life testing you and how strong you are. Or stubborn.

  • Women are like tea bags, you don't know how strong they are until they're dropped into hot water

  • Hello I have four snoring dogs. X

  • Suddenly the methotrexate doesn't sound so bad!

  • I'm with you with mtx and difficulty sleeping, finally dropped off at about 4 and now have over slept and will be chasing to catch up all day and probably won't succeed! Sleep well tonight!!

  • It's a constant battle, isn't it ?!

    Have a good day

  • I take mine in the morning so avoid this one but sleep has been an issue for some years. Now I just put on my Bluetooth ear phones and tap into a relaxation track which usually sorts it for me -on the occasional stuburn night I just put the track on repeat and figure that at least I am resting if not actually sleeping.

    Have a good day


  • Sorry I missed this but I was lucky, having spent most of yesterday in a zombie like state (and this after going back to bed yesterday afternoon), I am just coming round after a good solid 8hrs. I must admit that the mtx/sleep deprivation thing is not consistent. (Not unusual). Annoyingly my nights have felt like caffeine indomnia where I was actually very tired but sleepless. Hopefully, you will all have a better night tonight.

  • Thanks everyone. I know most of us struggle with sleep and it's maybe just a case of accepting this and finding ways to manage it . Over the past couple of years, like everyone else, mysleep has been poor - the pattern being I could fall asleep easily but could not sleep for more than an hour at a time. However, even this has stopped now- can't even get to sleep as I did and I really have noticed the change being consistent with the start of methotrexate .

    Oh well, onwards and upwards , off to work now . Deep joy !

    Have a good day everyone


  • Hi, Yes I experience difficulty sleeping after Metotrexate. Every night I'm up at least once, but the night I take Methotrexate, I'm tired before going to bed, then can't get to sleep🙄, so get up. I've just accepted this as part of the package of RA, but it does catch up with you. Candy

  • I've been having trouble sleeping for years and the longer I've been taking the Methotraxate the worse it is. I've been on it for fifteen years now and I'm lucky if I get four hours sleep a night. My doctor won't prescribe sleeping pills and the over the counter remedies just don't work. I'm always in a constant state of tiredness and have lovely eye bags and sore looking eyes.....I have actually lowered the dose of Methotraxate I take and have seen a slight improvement ...... But can't lower the dosage anymore or it won't control the RA symptoms and pain....catch 22 I'm afraid!

  • Until your post, Id never made the connection, but yes. Monday night take my mtx, up at 1am until 5am writing a letter of complaint to my RA nurse 😂

  • Cant sleep on mtx nights feel sick as soon as i lie down. Hope and pray a cure can be found for this illness soon

  • I must admit I've never noticed my sleeplessness relating to mtx. Have never been a good sleeper - rarely seem to sleep beyond 4 am whatever time I go to sleep but am sometimes able to get back to sleep again for an hour or two, having read for a while and drunk a small cup of 'sleepy tea'. (That is not nearly so much of a problem now am retired )I used to take amtriptyline to help me sleep- prescribed long before I had RA- but have recently stopped that as realised could be contributing to my fatty liver. Ho hum.

  • I'm the same as you, but my body wake call is 2am. I take 3 amtriptyline at 7pm, feel sleepy about 10-11pm, then wide awake at 2am. So tired"..

  • Not just methotrexate nights all the time I find sleeping or staying asleep for more than two hours at a time extremely difficult

  • hi Marie - I actually had the opposite problem. When I took my shot, it put me out, but I never got above 20 mg so maybe that is part of the issue?

  • I take the same dose as you once a week. It knocks me out. It's probably the best nights sleep of the week for me

  • How I wish for that !

    Heading home from work now and feel if I closed my eyes, I'd be off. However, this seems to change by bedtime and I struggle again.

    Thanks everyone for your response .


  • Hi

    I too on MXT 20mg injections

    I have problems with sleeping most nights not just MXT night

    I take a sedative to help with sleep which usually works but last few nights have been sleepless again. In turn this increases fatigue and nausea

    Hope you have a better night tonight


  • Have you considered taking your MTX in the morning. As MTX is quite quickly metabolised this may improve your sleep. I have been lucky and not had any problems with nausea from my MTX.

  • Hi Scottishlad, thanks for the response and suggestion . I have tried taking it in the morning but spend the entire day thereafter feeling sickly, headachy and really drained.

    I'm a mother of 3 girls Still at home, with the youngest being nine and I hated them worrying about me looking ao unwell, hence the decision to take it at night with the hope of sleeping through the worst of it?

    To me , right now, it just feels like a drug you don't win with ?!


  • I am sorry that is not an option for you. I presume that you are on folic acid. I take mine 6 days a week avoiding my MTX day. I was on folic acid before starting MTX.

  • Yes, I take the folic acid the same way as you.

  • I tend to drift off albeit slowly, but am up around 3am - so more broken sleep. I sometimes make a lavender into a tea 😌 It helps me.

  • I also get knocked out by methotrexate - the more I take the more I sleep! Have been off it for 4 weeks now, due to raised ALT, and I'm still managing 8-10 hours a day sleep!! I guess we are all a bit different.

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