Insomnia

[Hoochybaby]

Hi everyone

I am in a sort of no mans land at the moment. My rls seems to be under control at the present I'm still on pramipexole ( .25 morning and .52 mg at night as per gp instructions. I have insomnia on a hit and miss situation i.e. Sometimes it's not too bad and other times no sleep or very little. I told my gp I didn't want to keep relying on zopiclone 7.5 mg so she gave me half strength.35mg. I go through a nightly routine of drinking a mug of lemon blam tea and also rubbing lavender oil on my skin( wrist) and olbus oil on my legs with vigorous massage. Sleep doesn't always come but I find relaxing an hour before bed a big help it's not a cure I know but to get a few hours sleep to my is like paradise. I hope this is a little help to anyone suffering like I do.

[Hidden]

Hi Hoochybaby.

I see you've been having sleep problems for a while.

I find it kind of strange that descriptions of RLS rarely mention insomnia, yet for me insomnia has always been the worst part of RLS.

The motor nerve symptoms are the cardinal symptoms of RLS, but RLS is also associated with hyperarousal.

You say that your RLS is under control, but I guess you mean the motor nerve symptoms, but not the insomnia.

A couple things about your Pramipexole. Firstly why split the dose, morning - evening? Were you having symptoms in the day?

Secondly, you're on a very high dose.

Pramipexole causes restlessness, i.e. insomnia. It may relieve the motor nerve symptoms which prevent you getting to sleep in the first place but then, it causes early waking which adds to the early waking you get from RLS any way.

I think the Pramipexole is exacerbating your insomnia.

I was on 0.75mg Pramipexole up until Oct last year and I was getting 2 - 3

hours sleep every night maximum. I started taking Gabapentin.

I'm now taking 0.0625mg Pramipexole and 600mg Gabapentin and I'm sleeping about at least 7 hours a night.

[Hoochybaby in reply to Hidden]

Thanks Manerva

The symptoms that you describe are exactly how I have been suffering. I have tried to come off the morning pramipexole.24mg but restless legs and irritable feelings came back during the day. My gp put me on to Gabapentin but I couldn't tolerate this drug and my rls seemed worse. At the moment I'm in a sort of compromise situation not ideal but it's the best I can hope for at the present. My anxiety level is high and i image all sorts of medical problems!! My mental health is not good but I don't want to go down the road of tacking anti depressants which will be the way a gp will go?

[Hidden in reply to Hoochybaby]

Sorry to hear of your problems.

Your anxiety may be contributing to your RLS and definitely making your insomnia worse.

It would be really ideal to reduce your Pramipexole, but I do see your dilemma.

Your GP might just prescribe antidepressants, but GPs can also refer you to mental health services. Unfortunately there may be a long wait for this. GPs should not just be thinking drugs for depression!

SOME antidepressants are RLS safe, but may not be very effective. Benzodiazepines are a bit obsolete for depression/anxiety but they are safe for RLS and are recommended, short term, for insomnia associated with RLS.

I don' t know what your mental health problems stem from, but you could seek psychological therapies yourself. This will entail some cost, but not great. It may help you to see a counsellor.

I would definitely recommend doing a mindfulness course. There is apparently quite a lot of evidence that mindfulness is as effective as antidepressants for mild to moderate anxiety/depression. It's getting very popular and there should be a course near you.

If you can manage to improve your mental health, you may find that you can deal with your RLS better. At least you may sleep better.

I think you should try to reduce your Pramipexole, it os a major factor in your insomnia. As you reduce the dose, you will get some withdrawal symptoms. This is to be expected, but if you hang in despite these, you may find they settle down.

As it is, I'm afraid that as well as insomnia, you're in grave danger of augmentation, which, as you have already had symptoms during the day, you may have already started augmentation.

[Parminter]

That is a lot of pramipexole - too much.

And pramipexole can cause insomnia, it is a side-effect.

Benzos will only help sporadically.

Stop worrying about the benzo and start worrying about the dopamine agonist.

[san_ray70]

I am an insomniac, I will not take sleeping tablets, but I do take herbal tablets, you can buy, not every night, but I sleep longer when I take these.