RLS

[CookiePooki]

RLS Tramadol has completely stopped my RLS. It also keeps me from coughing all night long.......the problem is that I have trouble sleeping and it is very constipating also.

[Heatherlss]

What dose are you taking ?

I've read that people tend to take it quite early to prevent insomnia issues.

[CookiePooki in reply to Heatherlss]

50 mg. I usually take it about one hour from going to sleep.

[Joolsg]

That’s great news. Try magnesium ( citrate) at night- it works wonders on opioid induced constipation and it will also help your RLS.

[CookiePooki in reply to Joolsg]

Thanks Joolsg. I take magnesium citrate daily but it hasn't helped with the OIC at all. I've begun eating prunes but that hasn't helped so far. I also take flax seed and 6 fiber capsules every day. I've really got to find a solution. Some of the drugs that can be prescribed for OIC are over $1000 a month....so that's not a solution.

[Joolsg]

And for sleep- if cannabis is legal where you are- it helps sleep. It’s not legal here in England but I break the law and take cannabis oil with THC. It really helps with sleep and RLS.

[Hidden]

Hi, great that the Tramadol has benefits for you, but sorry about the insomnia and constipation.

As regards insomnia, sleep hygiene can make a significant difference as long as your RLS is under control.

This includes

Always go to bed and get up at the same time.

Make sure that the bedroom is warm, but not too watm.

Do NOT take naps during the day.

Being in bed is for sleep and intimacy only, no reading, TV etc.

The 15 minute rule. Don't lie in bed struggling to sleep, if you don't fall asleep within 15 minutes, get up. This helps avoid the insomniacs phobia, i.e. the dread of being in bed and not sleeping.

The most significant thing for me is light.

We have built in biological clocks that follow a more or less regular rhythm. These include variations in various things such as the levels of hormones and neurotransmitters e.g. cortisone, noradrenaline, thyroid hormone, dopamine, antidiuretic hormone, growth hormone, serotonin etc.

It's the pattern of light and dark that regulates these to a 24 hour cycle hence they're called circadian rhythms. Not only do they vary over the day, they have to be synchronisef. E.g. it's no good having high levels of noradrenaline when you're trying to sleep.

Part of this is, of course, sleep. So it's our exposure to light that can regulate sleep. Hence, it's good to be exposed to natural daylight during the day and to avoid light at night. I find this particularly difficult from around October to February, because there's not much light during the day.

Hence in the evening it's best to keep any lighting dim and not to watch TV a couple of hours before bed and not.to use any backlit devices like a PC, tablet, smartphone etc.

Light actually inhibits the release of Melatonin hormone from the pineal gland and this regulates circadian fhythms. When it's dark Melatonin is released and this helps us sleep. Some people take Melatonin to help sleep. That's no good for for someone with RLS however.

I find this works great for me, but I do struggle this time of year and I don't always get enough light during the day. I also find I have two sleep cycles instead of one. i.e. I go to sleep, wake up after only a few hours, stay awake a few hours, then sleep again. Luckily as I'm retired this isn't a problem.

Part of dealing with insomnia, I find is accepting it, rather than struggling with it

Opiates do cause constipation so I hope you know of the usual things which can help prevent it. This includes making sure you drink lots. Make sure you have a high fibre diet and eat lots of fruit. It's best to use.bulk forming and softening agents on a regular basis e.g. Lactulose and/or Fybogel. It's not a good idea to use laxatives (purgatives) on a regular basis, because these stimulate peristalsis, (whereas opiates inhibit peristalsis). However with regular use they can reduce peristalsis instead.

Opiates do suppress coughing. You used to be able get cough medicine with morphine in it. It was great for a tickly cough.

However, it's not always good to suppress coughing. It just depends what's causing the cough. I note you say the Tramadol stops you coughing all night. Do you know why that is? If it's part of a known condition.that's one thing, but if it isn't then perhaps you need to see a doctor about it.

[Tamaroy in reply to Hidden]

Hi Manerva, just to say Thank you, for your help and posts they are very imformative, are you a Doctor if not you have missed your calling.

Tamaroy

[CookiePooki in reply to Hidden]

Thank you so much for your advice. I will reread it and make sure to follow all of your suggestions.

[LotteM]

Tramadol kept me awake as well. Not completely, but it was hard to fall and stay asleep. But my legs were quiet. Catch22. I now take oxycontin and mostly sleep well in it. I have to take it early in the evening and wait until I am very sleepy before I go to bed.

[Jelbea in reply to LotteM]

Dear Lotte I was interested in your timing of OxyContin dosage. For a few months I have been taking oxycodone (Longtec) 5 mg in morning and 10 mg at bedtime. I have found that I get to sleep for up to an hour and then wake with bad bout of RLS. I am then awake until about 2.00 a.m when I get back to sleep and then sleep for two/three hour stretches. I wonder if I should try taking the evening dose about 8 pm or thereabouts. What time do you take yours? The amount of sleep I am getting now is a lot better but still quite broken some nights. Taking no sugary stuff helps greatly. Love to hear your thoughts.

[LotteM in reply to Jelbea]

I don't take te oxy during the day, only in the evening. Initially 5mg at 8 pm-ish and another 5 mg at 9 pm-ish. But I often had to deal with some restlessness during the evening. And I have problems with feeling tired -but not sleepy- during the day. Since about 2 months I take the 10mg all at about 7 pm. I have far less restlessness during the evening, almost nil. Tiredness during the day has not improved noticeably. But seems to be improving a little now since I have restarted HRT (I am a 57 year old woman).

The early evening full dose of oxycontin appears to suit me far better. It does take some time (at least an hour) to start working, and in the early evening I am still active enough for RLS symptoms to stay put.

In sum, by all means, play around with timing of the dose until you find what suits you. Consider dropping te daytime dose. And, if needed, use it to up your evening dose. I waited too long a time to increase from my initially effective 5 mg dose to my current 10mg. Have been on it since January and no need to increase.