Temgesic and insomnia, help please

[Renaul]

At first Temgesic completely relieved my symptoms and I slept through the night.

After 6 weeks of taking 200mcg at evening/night, it now seems to be causing insomnia.

Please advise.

[Hidden]

Hi Renaul, buprenorphine (and other opioids) can negatively affect sleep architecture.

ncbi.nlm.nih.gov/pmc/articl...

Personally, I have experienced marked insomnia from the outset with all opioids I've tried.

[Renaul in reply to Hidden]

Thanks Amrob. It is the only thing that completely removes all my symptoms but I do not want to return to insomnia.

[Hidden in reply to Renaul]

It would be a real pity to have to give it up if it's working for you. Some on this forum have said that their insomnia (on opioids) lessens over time however they experienced insomnia at the outset. Can you take it earlier? Or considered trying patches which release the buprenorphine more slowly over a longer period?

[Renaul in reply to Hidden]

I'm experimenting now with what time I take it. Have an appointment to discuss this with the practice pharmacist.

[Sampsie in reply to Hidden]

Amrob, did you try buprenorphine? Did you switch to a non-opiate?

[Hidden in reply to Sampsie]

Hi Sampsie, yes I tried buprenorphine in the form of Temgesic. It made me very nauseous and I was awake most of the night as a result, so difficult to report on whether it caused insomnia. I have been taking pregabalin long term. I have tried various opiates (Tramadol, Targin, Temgesic and codeine) in an attempt to come off/reduce the pregabalin.

[Sampsie in reply to Hidden]

It's so hard isn't it? It takes ages for an appointment to discuss a new drug, then weeks before it's prescribed, then waiting however long (often months) for a follow up to discuss if it's suitable, then round again to try a different drug. And each time something doesn't work you run out of another option.

I don't really know what to try next. If what I've been prescribed is a sleeping pill, it's doubtful it will resolve the RLS plus I am very worried about addiction and augmentation.

This disease ruins lives.

[RLSofManyYears]

Renaul

I've also been taking Temgesic for 6 six weeks now. Generally I have slept right through the night and I am so please at being able to sleep 😀. I have also been taking 300mg Pregabalin for a couple of years now and 2 weeks ago I tried to reduce that to 200mg. However a few days ago I started to get a recurrence of twitching legs in the evening and in the middle of the night. So I went back to 300mg and for the last 3 nights I have slept right through.

Prior to the Temgesic I never had a night when I slept right through. It was typically sleep for 30-90 mins then up for about the same, back to bed, then woken again after 30-90mins and so on. Not good!

So when you say you have insomnia, what do you actually mean by that?

[Renaul in reply to RLSofManyYears]

I go to bed tired and ready to sleep and just don't sleep. Get up after an hour, up for an hour or two, try to sleep again and repeat cycle. Eventually get about three hours from 4 or 5 am.No restless legs symptoms just don't sleep

[RLSofManyYears in reply to Renaul]

When do you take your Temgesic? I have started taking mine earlier in the evening at 8pm. I don't have any advice for your sleep, perhaps other might have some experience/advice?

[Renaul in reply to RLSofManyYears]

I take my Temgesic when my symptoms start. Anytime from late afternoon to 8pm

[Pagan707 in reply to Renaul]

My cycle as well!

[Restlessnomad in reply to Renaul]

I developed insomnia with RLS. My life saver for sleep has been Zolpidem. I get about 6 hours sleep which I'm grateful for. Haven't had any success with RLS meds.

[Joolsg in reply to Renaul]

When I started OxyContin I had severe panic attacks so Dr Buchfuhrer advised (by email) taking pregabalin as well. Pregabalin is a sedative and so helps anxiety, panic attacks & sleep.

You may benefit from adding a small dose ( 100mg) alongside the Temgesic.

However- pregabalin did cause Augmentation after about 18 months so I came off it in November ( spent 9 months reducing it very, very slowly) & the panic attacks are gone - so has the augmentation.

[rls-insomniac in reply to RLSofManyYears]

Hi RLS,I too take 300mgs of Pregabalin and Temgesic (400mcgs). I also tried to reduce my Pregabalin to 200mgs. I've tried twice and have ended up going back to the 300mgs dose. Like you my symptoms started to return, for me, within 4/5 days, in the evenings and during the night. With the full dose of Pregabalin and 400mcgs Temgesic, my RLS is reasonably under control and I sleep around 6/7 hours in total most nights. I do get short periods of wakefulness though but eventually manage to get back to sleep. It seems that most people who have managed to get a prescription for Temgesic, just take that and not both Pregabalin and Temgesic.

[LotteM]

I also take the Temgesic for (a little over) 6 weeks. I am very sleepy at the end of the afternoon and then take a nap. And when I go to bed after 11PM I usually lay awake for quite some time before I fall asleep. No true insomnia. I am playing around with taking my evening dose earlier, 6-7PM instead of 8-9PM. Too soon to tell.

[Renaul in reply to LotteM]

Thanks Lotte

[Sampsie]

These comments are really interesting because I have been wondering if all opiates can cause wakefulness. I get wakefulness with codeine and very much worse with Oxycodone where I am so tired I can barely stay awake, but as soon as I take it, I'm unable to sleep for three or more hours. I was wondering if I would be the same on Temgesic if I succeed in getting it prescribed.

The frustrating thing is that the Temgesic is good for your RLS. I hope that you find a way to resolve the wakefulness so you can keep on taking it. I use medical cannabis to try to override the wakefulness, but it exasperates the side effects of the Oxycodone so I have had to stop taking it.

Please keep posting updates Renaul and Lotte. I think I recall Shumbah saying something about the form of buprenorphine being important. But since being on Oxy I can't remember anything!

[involuntarydancer]

I suffered terrible ‘alerting’ (insomnia) when I was using oxycontin for my rls. Temgesic (which I’ve been taking for about 2 months) isn’t nearly so bad but definitely my sleep is lighter and more fragile on temgesic than when I use Kratom for rls.

If the temgesic is covering symptoms, could you use a sleeping aid for the insomnia? As someone else mentioned, pregabalin can be good for inducing sleep/overcoming opioid induced alerting. Other people use cannabis (taken as an edible as it lasts longer that way). You could also try taking a zopitan occasionally. I realize it feels counterproductive to take a drug purely to deal with the side effects of another drug but if the temgesic is effective and given it can be so tricky to find a good treatment for bothersome rls it may be your best option.

[Shumbah]

Hi Renaul, There are several things that could be added may not be requireded long term,There are a huge varity of sleeping pills , also medical Marijuana CBD with THC .

Dont give up Professor Winkelman and Itouched on this subject.

[welschrisby]

Have you tried Trazadone? I had been insomniac for years and Trazadone saved my life. It's a failed antidepressant that just happens to make you very sleepy. Check it out,

[hausbauer]

I take 150 mcg Temgesic, sometimes 200 mcg (but I think 200 is too much much for me because I feel sort of drowsy or dizzy until afternoon). I take it appr. one hour before going to bed.

I have no insomnia , but on most nights go to sleep straightaway. Perhaps this is because I still take appr. 0,044-0,066 mg Pramipexol with the Temgesic. I want to postpone the definite stop of the Prami until summer when I hope to have the Covid vaccination, so that would be one worry less.

But on the whole Temgesic makes me sleepy; we know everybody is different in reaction to meds.