Insomnia methotrexate?

Morning all

I just wondered about insomnia with methotrexate. I had what I thought was insomnia on steroids but this is different. I can get to sleep no problem but wake up sometimes within 20 minutes with a jolt and a panicky feeling. It's awful and I'm afraid to put my head back down to sleep. Has any one else experienced this or have any tips how to overcome it.



7 Replies

  • Hi Sharon

    I have done what you describe since diagnosis. I have no problem

    Falling asleep but for the life of me, cannot stay asleep! As a rule, I'd say In total, I usually get about 3 hours a night .

    I have had sleeping tablets to try to encourage a sleep routine, to no avail .

    I would agree that since beginning methotrexate a few months ago, my sleep has probably become worse.

    I'm sorry, I've nothing to offer in terms of how to make this better but just wanted to say hello as the nights can be long and lonely!

    Hoping you can get something sorted soon.


  • Hi Marie

    Thanks so much for saying hello. Sorry to hear you are suffering from insomnia's awful isn't it? The panicky feeling I get when I wake up is new though, finding that hard to cope with. Terrible headache too...probably from lack of sleep.

    I've given up in bed now and am propped up on my recliner chair hoping I might dose off for a little while whilst watching some boring TV.

    Good night Marie and thanks again for saying hi.


  • Hi Sharon

    Yes i also have very irregular sleep patterns i cannot sleep in bed for long periods i become very restless and most of the time find it easier to sleep in the armchair, Just like Eiram60 i get on average 3 hours a night, following my last review with consultant she prescribed Amitriptaline tablets which seem to help i would put it down to the condition and possibly MTX basically these days i just grab any oppurtunity to rest or catnap just to try and overcaome the tiredness.

    Sorry i cant be anymore helpful but good luck in the future.

  • Hi,

    Yes getting a full night's sleep has been a problem for me also (pre - methotrexate and post!). One thing i do is have a relaxing track or two on my IPad and let it play in the background so at least i am relaxing. Sometimes taking piriton helps for a few nights in a row and then the effect wares off and i have to give it a miss.

    I always go to bed at the same time and have blackout curtains as recommended after a warm bath and a warm cuppa but some times to no avail!

    Sleeping meds give me the heart rate of a top athlete and i start passing out... not recommended!!

    I hope you find something that works for you soon.

    All the best


  • Hi Sharon

    I find it hard to fall asleep. I am on Methotrexate Injection 25mg. I can be 2.30 in the morning before I fall asleep and then it is pure exhaustion.

    I have woken up, like you in a state of panic and been having awfully realistic nightmares. I also take cyclizine. I mentioned this to the Rheumatology nurse and she said waking up in a panicky state can be a side effect of methotrexate and cyclizine.

    I hope this puts your mind at ease a bit. With a constant fight with pain, fighting to sleep is just not what you need.

    Take care

    Kerry x

  • Hi

    On MTX day I take my MTX about 1 hour before going to bed. I eat half a small bowl of porridge, pop the pills and then the other half of the porridge.

    If I take my MTX earlier in the day, even with my dinner I just can't get to sleep till about 3am! The MTX does not interfere with my sleep on the other 6 nights of the week.

  • Hi everyone i hope you are all doing well this evening​. Thanks for all your replies. I eventually ended up speaking to rhuemy nurse about constantly waking and not being able to catch my breath and she advised a trip to GP who checked chest and said all clear but I'm not to take mtx again til they have bloods back which I also got taken today. Hopefully its no big deal and I can go back on mtx asap. Have reduced steroids down as planned and am now in 7.5mg which I'm glad about.

    I managed to stop smoking too....i have been off them for over a week now and finding it remarkably easy... But maybe even nicotine withdrawal is causing insomnia and breathless ness??

    Anyway felt that putting my body through various medications and worrying about side effects was all a bit pointless if I continued to smoke so decided to give it a real effort. So I'm grateful to having this RA diagnosis that it finally focused my mind to do something about smoking instead of putting it off til tomorrow...for 30 years!

    Thanks again

    Sharon 😀

You may also like...