Not sleeping and taking Buprenorphine

[Biscuitface]

Currently taking 250mcg sublingual before bed. I am sleeping for 1 to 2 hours then i awake and cant sleep properly for rest of night. Ferritin is 270. .

Any advice would be appreciated

Thankyou

[BillMeLater]

I have the same problem if I take it close to bedtime. The solution for me was to take it early in the afternoon (1:00 to 2:00 PM). The effective dose for me is 1/8 mg = 0.125 mg = 125 mcg. Half your dose. Buprenorphine has a long half-life. More than 24 hours for most people. So it should still be able to cover your RLS symptoms throughout the night if taken in the afternoon.

[RLSofManyYears in reply to BillMeLater]

Hi, I'm currently on 2 x 200mcg Temgesic at night plus 300mg Pregabalin. I too am awake between 1-3 hours after going to sleep. Then I'm up for about an hour before going back to bed and then may be up again after 1-3 hours. I'm on an average of about 4 hours sleep at night. I also find it difficult to fall asleep and have problems with itching - side effects of the Temgesic I think.

So, I'm sorry I don't really have anything positive but I do think that what you are experiencing is similar to many of us.

[Biscuitface in reply to RLSofManyYears]

Thankyou for taking the time to reply. Have you considered asking for different medication?

[RLSofManyYears in reply to Biscuitface]

I've been on various meds, mainly the DAs Ropinirole and also Pramipexole. I'm now off them. I've been on Pregabalin for many years now and any time I've tried to reduce it then the jerking kicked in again.

[SueJohnson in reply to RLSofManyYears]

Have you thought about taking ativan or ambien for sleeping?

[Biscuitface in reply to BillMeLater]

Thankyou. Ive tried taking it earlier. For instance the symptoms were bad all night and again this am. I took 200mcg 9pm last night , 100mcg at 4am , 200mcg at 9am . It is now 5pm and I have the symptoms back. Ive taken Paracetamol to fill the gap. My gp wont let me have Pregabalin or Gabapentin alongside Temgesic.

[RLSofManyYears in reply to Biscuitface]

Your GP is being a bit limiting I think. Pregabalin is now the "go-to" for RLS.

[BillMeLater in reply to Biscuitface]

Sorry Biscuitface. Sorry to hear that your RLS seems to be much worse than mine. My symptoms only occur at night (2 AM to 6 AM). And my very small dose of Buprenorphine (0.125 mg once daily) completely eliminates RLS from my life with no discernable side effects. This has been the case for over 12 years. I have never needed to increase the dosage. Without it my RLS is very severe (but only at night). Since your total dose (500 mcg = .5 mg daily) is on the low end of the Mayo Algorithm guidelines maybe you could try a bit more. The Buprenorphine Wikipedia page states that its half-life is 37 hours (range 20-70 hours). So, for most people more than half the amount they took yesterday is still in their system today. In other words, it lasts a long time. To me, this would suggest that the time of day that it is taken is not nearly as critical as would be the total daily dose. My thought is this: If taking Buprenorphine close to bedtime causes unsettled sleep then try to find the lowest dose that will effectively treat your RLS when taken in the afternoon as a single daily dose. Of course, everyone is different. I’m sure there are those for whom my suggestions will not apply. I just hope that sharing my thoughts and experiences will help some of my fellow RLS sufferers.

[Biscuitface in reply to BillMeLater]

I shall experiment. Thankyou for explaining. This makes sense

[Ticki]

me too,ive only been able to sleep for a couple hours most nights.Its hard.

[SueJohnson]

Have you thought about taking ativan or ambien for sleeping?

[RLSofManyYears in reply to SueJohnson]

my GP has prescribed Zopiclone which works for me, however I can only take it occasionally as it can become habit forming. I did not know about ativan or ambien but having had a quick look then I would not be keen on trying them.

[SueJohnson in reply to RLSofManyYears]

I wouldn't worry about Zopiclone being habit forming as you will probably need it for the rest of your life, so it is not likely you will ever have to worry about coming off it, however you will have to convince your doctor of that. According to a Mayo Clinic doctor "they 're (ambien) much less likely to be habit-forming than some other drugs sometimes prescribed for sleep problems." mayoclinic.org/diseases-con... I notice you emailed Dr Buchfuhrer in the past. You might ask him what he would recommend for insomnia and whether you need to worry about it being habit forming and show the answer to your doctor. Or ask for trazodone which helps insomnia and is not habit forming. Some OTC supplements for insomnia include valerian, chamomile, hops, L-tryptophan, 5-HTP, glycine, and GABA.

[ziggypiggy in reply to SueJohnson]

I think GPs are more reluctant to prescribe sleep aids than specialists. My psychiatrist had me on Ambien for 15 years and didn't seem too concerned. Weaned off of it rather easily when needed. It really helps in falling asleep but not keeping you asleep. Lorazepam is the opposite for me. Keeps me drowsy but won't put me asleep as i need.

[SueJohnson in reply to RLSofManyYears]

See Ziggypiggy's reply above..

[RLSofManyYears in reply to SueJohnson]

Thanks, I'll talk to my GP and see where that goes.

[Biscuitface in reply to SueJohnson]

i have various suggestions for my gp but he is reluctant to prescribe anything. I did ask him once why he went into medicine when he hates prescribing.

[SueJohnson in reply to Biscuitface]

You have to be insistent and keep explaining your problems. Perhaps ask what he would do if he had the same problems. Or if need be - switch doctors.