hi, everyone, would you please share with me the best medication for insomnia? I suffer from sleeplessness every night and can't find the effective medication to conquer the problem. Trazodone and ambient don't seem to work for me. Do you have any other suggestions? Thanks in advance for your reply.
medication for insomnia: hi, everyone... - Restless Legs Syn...
medication for insomnia
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halperinchen
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Do you know what is keeping you awake? Are you in pain or anxious feeling? I’ve had several bouts of insomnia over the years. It has always eventually resolved itself. Can you explain why you think you are having trouble sleeping?
Oxycodone-induced insomnia is the reason after I ruled out all other possibilities. Subsequently I suffer from serious anxiety due to 1-2 hour's sleep at most nights and the fact that I have to rely on opioid for my severe RLS and no other choices. Now I resort to sleeping pills (most Xanax and Klonopin) for 4 nights to get some sleep but I don't want to develop habit forming and dependency on these medication, therefore I need your opinion as what other sleep-induced remedy I can alternate with. Thanks to all of you for your input. This forum has been a lifesaver for me where I gain a lot of knowledge and information from you, the valuable members. It is also like a family, a family where you can rely on and feel secure. Thanks for your reply.
I take s low dose (25 mg) of Seroquel. It puts me to sleep very quickly.
DicCarlson• in reply to
Hmmm - lots of warnings about Seroquel... drugs.com/seroquel.html
• in reply toDicCarlson
I take it under my doctor's care, and the dosage is low. Seroquel is prescribed in really large doses for psychosis, but in small doses as a sleep aid. It took a little bit for me to get used to it, but I've adjusted to it, and I'm fine. Without it, I'm up all night.
DicCarlson• in reply to
Good enough!
halperinchen• in reply to
Thanks amf5960 for the info. I have done some research and find out that seroquel's dopaminergic blockade effect would precipitate the signs of symptoms of RLS syndrome. seroquel has low binding effect to D2 receptor. Do you experience any worsening of RLS from taking it? I do have this medication but hesitate to take it for fearing of worsening rls. Please let me know if it affects you, I would appreciate it very much.
• in reply tohalperinchen
Hi. Seroquel has not affected my RLS at all! In fact, it's been better. I'm not saying that it's due to the Seroquel. A month ago, I had a car accident and got pretty banged up. I was in a certain amount of pain for a couple of weeks, but the RLS wasn't bothering me. I think my brain was distracted, concentrating on the pain and healing. The thing is, the pain is almost gone, and the RLS has barely made an appearance! A little discomfort, and I'm not taking half the Pramipexole that I was. I am anemic. Six and nine weeks ago, I got iron infusions. I'm wondering if those infusions are working on the RLS. The thing is, I'm still anemic, but the RLS has subsided. I'm having a bone marrow aspiration done tomorrow morning, to find out what's going on with the lack of iron. Anyway, the point is, Seroquel has not bothered the RLS. It's only a small dose, you can only try it and see.
halperinchen• in reply to
Thanks, I'll try to get some sleep which I need badly.
• in reply to
Hi AMF, I took a bad fall in April 2020 and was so angry I stopped doing a lot of things including taking most of my supplements. About a month or two in I realized I wasn’t getting migraines. The magnesium I was taking was triggering migraines. Could you have stopped taking something that was triggering your RLS? Melatonin, statin, antacid? Are you eating much less? Were you given antibiotics? Btw, are you taking an oral iron supplement?
• in reply to
Hi LonePine,I can't think of anything that I've stopped taking. And I do take magnesium and esomeprazole, but not melatonin. The only thing that matches up, time-wise, are the iron infusions. I don't take oral iron supplements -- my hematologist told me to stop.
I took a fall two nights ago and fell flat on my face. I have PN, too. My face is bruised up pretty nicely. I just can't get out of my own way!
• in reply to
Once you have that genetic clumsy predisposition it’s forever. Have an NSAID on me 😑 So your caloric intake is same pre and post accident? When did you stop the oral iron?
• in reply to
Thanks for the NSAID, but I can't take them. Just got over a stomach ulcer, due to too much naproxen. Only Tylenol for me.I stopped the oral iron nine weeks ago, when I had my first infusion.
Do you have PN? RLS? You've only mentioned that you've fallen.
• in reply to
Hey, I was just doing some research on Seroquel to try to figure out why it doesn’t worsen your symptoms. First, no PN, but I’m on the waiting list. My dad had it. I have RLS that is readily quieted by nightly iron. See my profile page. Now you. Here’s a paragraph on Seroquel: SEROQUEL is an antagonist at multiple neurotransmitter receptors in the brain: serotonin 5HT1A and 5HT2 (IC50s=717 & 148nM respectively), dopamine D1 and D2 (IC50s=1268 & 329nM respectively), histamine H1 (IC50=30nM), and adrenergic α1 and α2 receptors (IC50s=94 & 271nM, respectively).
Ok, so this is painfully complicated but let me write thru it and see if it makes sense. The drug antagonizes the calming D2 receptors (not terribly so and especially not at low doses). This is bad in the short run in terms of the symptoms of RLS, but in the long run might up-regulate them which we with RLS really need. We really need up-regulation of our D2 receptors. Then the drug also antagonizes or “blocks”the excitatory D1 receptors and this explains the sedating effect - maybe. Antagonizing D1 receptors is great for RLS symptoms in the short run, but in the long-run up-regulates them which we with RLS do not want.
Phew. With all that said I prefer trazodone for sleep, 25mg, or 1/2 of the lowest dose they make which is 50mg. Recently, a man on here said he uses hydroxyzine for sleep. I’m familiar with that old antihistamine drug and it has a good safety profile. So that might be a good option. I’m not familiar with Seroquel but it doesn’t sound terrible at low doses.
Tanker1• in reply to
I know someone who was on seroquel for years and yes it did make them sleep, often for more than 10 hrs. The side effects can be very nasty. The withdrawal can be quite dangerous. Be very, very cautious about starting on this drug.
• in reply toTanker1
The Seroquel allows me about 3-4 hours of sleep. I won't take a higher dose, though. I am being careful, thanks.
halperinchen• in reply to
It sounds like an effective medication but it has a lot of undesirable side effects. I may try to get my physician to order some of it to occasionally take to make up for the lack of sleep. Thanks for your reply.
halperinchen• in reply to
hi, amf5960, does Seroquel worsens your RLS? That's what I heard about anti-depressant and anti-psychotic meds, they rend to exacerbate RLS symptoms.
Zopiclone
Can highly recommend a good quality CBD oil.
klonapin
I like Klonopin because it makes me sleepy the next day. Usually I can't even take a nap no matter how sleep-deprived I am the previous night but Klonopin offers me that luxury.
What's best for your insomnia depends on its cause or causeS.
So do you mean you can't get to sleep only,
or you can get to sleep, but soon wake up only,
or both.
Is it RLS symptoms that cause this or does it happen anyway.
What medications are you taking?
Are you suffering anxiety?
The best treatment for insomnia for somebody is to treat the RLS effectively.
If RLS IS being treated effectively then there should be need for other drugs.
However, note that dopamine agonists (DAs), and opioids can cause insomnia. "Early waking" insomnia can be a result of taking a DA.
Note that if insomnia is a feature of RLS, taking a gabapentinoid would be better than taking a DA.
IF you wish to take the option of taking yet another drug then the options are -
Trazadone can be effective for insomnia, but isn't going to be that effective if your RLS isn't being treated effectively. I note you've already tried that.
A Benzodiazepine alongside a RLS drug is recommended if insomnia is a problem. Clonazepam, (also known as Klonapin) is commonly used. It is long acting, therefore it can make you drowsy next day.
A "Z" drug can be used e.g. zopiclone. These have the advantage of being short acting. They can cause dangerous sleep walking especially zolpidem.
Cannabis is effective for sleep. Medicinal cannabis, if you can get it is known to be effective. CBD oils in general are't proven to be of any value and "good quality" doesn't really mean anything. The most effective Brands are those with higher levels of THC. The makes them illegal in most states.
Do NOT take an over the counter sleeping aid as these usually contain a sedating antihistamine which makes RLS worse.
Do NOT take Melatonin, this can lower dopamine levels and make RLS worse.
There are other herbal remedies the best being valerian. But it's weak.
Behavioural remedies can help a bit e.g. sleep hygiene.
Overall your best bet is to review your RLS treatment and make changes as appropriate.
I agree that cannabis can be an effective sleep aid, especially edibles with a high concentration of CBN. I recently quit taking the edibles (10 mg THC, 5 mg CBN). I do in fact sleep less but i feel much better and not nearly as stupid in the morning.
Thanks Elffindoe. I finally come to conclusion that my insomnia is from the oxycodone I have been taking for years. But the lack of sleep every night makes me anxious, it is like a vicious cycle. I don't fall asleep easily, it usually takes 2 to 3 hours to fall asleep and then I'd wake up every hour or sooner and unable to go back to sleep. I also would wake up at 4 am and stay awake until dawn. It is like my body circadian now. It's awful that I am dreadful of going to bed every night. Thanks for your reply, I do appreciate it.
It sounds as if you're suffering from chronic insomnia which was triggered by the oxycodone.
Your anxiety is a factor. It' s difficult because the solution is psychological as well as physical and it's very difficult to get therapy.
You can use sleep hygiene, if you look it up.
Cowbsky also has a good idea.
A sleep clinic can you a better diagnosis of your sleep issues and offer appropriate treatment
Hi_ I would suggest first of all a good diagnostic. Polissonography would be the best startup (is going tell you about resltless legs, whether or not you going through complete stages (drugs prevent you from this), sleep disorder breathing (even very minor one UARS conditions can be deleterious, and it is surprisingly common!), how many times you awaken (< 15 seconds), wake up (> 15secs), how long you take to sleep, staying sleep, and many more.......
_ I would not think going strait to a medication is going to work out for long time, ...only luckly...
all the best and good luck
Thanks Cowbsky for your reply, I may eventually go for a sleep study if I can find a doctor for it.
I have found that I had bad insomnia as a result of high glutamate associated with this disease. Although my legs still often wake me or keep me awake I am in a much better place now I have attended to excitatory foods, cutting out slow cooked meats, soya sauce, gelatine etc and by taking high dose taurine, magnesium and l-theanine in the evening. This has helped me to feel drowsy at night and inclined to sleep. If my legs wake me I do some prolonged leg stretching in different positions and some red light therapy and this, combined with the drowsiness helps me get back to sleep. On nights when all this fails I take 30mg codeine.None of this is perfect and I rarely sleep for more than three hours at a time but it is liveable with and I have long stopped feeling horribly ‘wired’ at night.
Blueboat, how much taurine do you take, and how soon before bedtime? I recently purchased some after reading about it, but have yet to try it.
I take 2g Jarrow formula taurine early evening and another 2g before sleep plus 800mg l-theanine and 500 mg gaba. It’s all a bit hit or miss but the effect is very calming. I’m also quite strict with the low glutamate diet. There are loads of high glutamate foods but most of them we don’t eat anyway. Fresh meat, fish and vegetables cooked quickly seems to be the answer.
I do think that hight glutamate might contribute to my insomnia too. The high glutamate makes the brain excitable so that one even can't take a nap despite how sleep deficient he is. I can't even take a nap during the day despite how deficient my sleep was the previous night. I hope there is a remedy for this. Thanks for your reply
Hi Glutamate is indeed the reason I could get maybe 2-3 hours of sleep - get up drive to work 35 miles, work 8 hours and drive home with little drowsiness. BTW - usually glutamate will convert to GABA but a deficiency in B6 and GAD (an enzyme) can prevent that from happening. Good explanation here...
neuroendoimmune.wordpress.c...
You could consider that you are lacking B6 - and rather than just take a dietary supplement which might not be absorbed effectively - there is a sublingual lozenge available. (Source Naturals, Coenzymated B-6, 25 mg, 120 Lozenges).
There is more to all of this. Thinking lately of ways to increase Glutathione (the body's premier antioxidant) and also to increase GABA with diet (Keto/Paleo does help with this). I just discovered fermented brown rice (also called GABA Rice). On and On!
• in reply toBluebboat
Hi Bluetooth, do you follow a strict low glutamate diet? Or have you identified a few main contributors? I'm interested to know more.
Bluebboat• in reply to
I think the main contributors are umami flavours from savoury foods such as stock, gelatine, soya sauce, msg etc. Cooked tomatoes, mushrooms, walnuts and fresh raspberries are also on the list. To be thorough I also avoid high oxalate foods such as spinach and rhubarb. Sadly I love all these foods! However I do quite well with rapidly cooked meat and fish, and with berries, tropical fruits and coconut products for treats.
The general consensus is that cognitive based training (CBT) is the best method of dealing with insomnia. Drugs are proven to be rather ineffective. I've had 2 of 6 classes on CBT and I am finding it to be helpful.
sleepfoundation.org/insomni...
Also check out the CBT -i coach app.
Hi, I have struggled with insomnia and poor sleep quality for decades. For the long term, -if possible- it may be helpful to identify underlying psychological causes. I have been using trazodone on and off for several years. Currently at 50mg. Any medication that you use to help sleep will likely cause some dependency however. For a few years I was taking 100mg trazodone every night, and it caused horrendous heartburn. I didn't realize my problem was due to this medication until I slowly weaned off.
I was taking trazodone 50 to 100 mg but it even can't scratch the surface. klonopin despite its long-lasting sedation, I find it suitable for my situation. I only can take a nap on the Klonopin day.
Recently, I came across sleeping problems. I take Melatonin and Magnesium for now, hope it helps. If no, I'll consult a doctor again and ask for prescription meds. By the way guys, where do you usually buy all the meds? I came across a great pharmacy and always make purchases there canadapharmacy.com/
I thought that melatonin worsens RLS, it would be safe to check it out .
Halperinchen is there any way you can replace the oxycontin with another opioid?
Yes, I just switch from oxycodone to Belbuca 75 mcg 5 days ago, but my insomnia is still persisted. I don't know if the insomnia is from the oxycodone accumulation in the body or from the new med, Belbuca. So, I am in the dark now. Could anyone shed the light on this one. Thanks in advance.
Can you consult with a psychiatrist? Are you in the UK or US?
I am in the US, Dr. Buchfurer suggested Xanax for me to try to relieve the anxiety, but it doesn't help with insomnia.
Hi Halperinchen.
I’m sorry to hear about the insomnia. I’m sorry if someone has already suggested this, but Gabapentin really helps me to get tired, and helps with RLS. I’m also under Dr. Buchfuhrer’s care, and he is big on Horizant which is an extended release Gabapentin. Also, if you are in a state where THC is legal, go and get yourself some CBN/THC gummies. CBN works better for sleep than CBD when combined with THC. Works wonders for my wife’s insomnia.
Hi Jimbo77, thanks for your reply. Are you still taking either Horizant or Gabapentin currently with effect? I was taking Gabapentin about 9 years ago with good effect but since 2017 I have been taking oxycodone and find my self now with severe opioid-induced insomnia. I am wondering if Gabapentin will still work for me after many years of opioid, I will be visiting Dr. Buchfuhrer next week to bring this up to him.. By the way I have switched to Belbuca five days ago and still sleepless. Thanks for your help.
I'm also a patient of Dr. B. He has put me on low-dose methadone for refractory RLS. I immediately went from 2 hours of sleep per night to 8-9 hours of sleep. It's the only medication I'm on.
• in reply toTheDoDahMan
I would like everyone with intractable RLS to at least consider low-dose methadone rather than other opiates or even Pregabalin.
TheDoDahMan• in reply to
I agree, 100%.
Yes, I am still currently on Horizant. I was taking in conjunction with Belbuca for a few months, but I am one of the very small percentage of people that doesn’t do well with opioids. So I’m stuck with just the Horizant for now. It’s just ok for dealing with RLS, but does very well to make me tired snd less anxious. Hope it helps.
Thanks for your response, Jimbo77
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