Sleeping tablets to offset Buprenorph... - Restless Legs Syn...

Restless Legs Syndrome

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Sleeping tablets to offset Buprenorphine sublingual side effects.

dickJones profile image
29 Replies

I’ve been on first 0.4 and latterly .06 mg Buprenorphine sublingual tablets quite successfully for a couple of months now. Unfortunately, I suffer from the insomnia side effect and both Zolpidem and Amatriptyline no longer work for me. Does anyone have suggestions for an alternative med, over the counter or prescription?

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dickJones
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29 Replies
SueJohnson profile image
SueJohnson

Lunesta (Eszopiclone) or ativan.

dickJones profile image
dickJones in reply to SueJohnson

Thanks, Sue, I’ll look into sourcing.

dickJones profile image
dickJones in reply to SueJohnson

Sadly, neither is available in the UK via the legit channels. And cannabis treatment is yet to be supported by NICE so one must have recourse to private clinics, which currently I couldn’t afford. And although cannabis itself is easy enough to obtain, my Buprenorphine tablets are working fine by way of suppressing the PLMD so I’m not seeking a replacement. I simply need something to counteract the side effect insomnia. It’s crazy: for the first time in years I have an effective medication that does what it says on the tin admirably, but it keeps me awake. And insomnia alone is enough to quell the PLMD because it only kicks in - literally - when I’m asleep! There just be some sleep aid out there that isn’t some cynically marketed snake oil that might be strong enough to counteract this exasperating side effect…

SueJohnson profile image
SueJohnson in reply to dickJones

How about ambien (Zolpidem)? Then there is Zopiclone which a number of people in the UK take, but ambien (Zolpidem) is better as it acts faster and longer.

dickJones profile image
dickJones in reply to SueJohnson

I’m on it now but effect-wise it’s running down I have plenty of tabs left, but I’ll have to give it a couple of months before it’ll re-charge . And anyway my GP has refused to re-prescribe. Great while it lasted, though, even at 5mg because I cut the tablets in half.

Joolsg profile image
Joolsg

Medical cannabis. The cannabis oil drops with at least 20% THC should help with sleep.Unfortunately, it's not available on the NHS , but it works out about £2.50 a night.

dickJones profile image
dickJones in reply to Joolsg

I’m following the cannabis route via a setup called Lyphe (!). When the Buprenorphine throws in the towel, as has every PLMD treatment I’ve used over the past 8 years, I shall start the programme.

Joolsg profile image
Joolsg in reply to dickJones

Excellent. Hope it helps.

Shumbah profile image
Shumbah in reply to dickJones

duck the evidence shows that buprenorphine will keep working

How long have you been on Bup ?

have you considered stopping amitriptyline as it has a99% chance of causing your symptoms to work.

I take low dose CBD , THC oil and works perfectly for sleep no side effects simply a great nights sleep.

I have been on Bup and THC close to 4 years Zero increase in dose.

The amitriptyline is a major concern

dickJones profile image
dickJones in reply to Shumbah

Hi Shumbah. I’ve been on the sublinguals since February and on a current dosage of 0.6 they’re working well. But with them comes insomnia (6 hours last night) so when a long course of Zolpidem chopped into bits ran out of steam, my GP prescribed Amatriptylin . What would be your particular concern? And as a PS, any suggestions as to counteracting the nocturnal dry mouth?

Shumbah profile image
Shumbah in reply to dickJones

amitriptyline common side effect is dry mouth it effects the function of salivary glands causing oral dryness.

Also if you are sleeping you may be a mouth breather as I am . I use breatheasy nose strips at night and I also use a forms of nose oil to enable e me to breathe more easily through our nose some pop some Vicks in there nostrils at night .Coconut nut oil is nice to use a mouth rinse it also whitens your teeth.

To add to depth of sleep I use CBD / THC oil works a treat ? Works so much better than any sleep aids.

Buy any chance do you use a sleep app to know how much sleep you aren’t getting ?

dickJones profile image
dickJones in reply to Shumbah

I’m abandoning the Amatriptyline from tonight. With dry mouth being a side effect of the Buprenorphine as well, I could do with a break from it! I’m not usually a mouth breather, but I have to wear a CPAP mask for OSA so access to the mouth during the night isn’t really an option.

I’m in the UK so THC isn’t legally available over the counter and I’ve not found solo CBD to help with sleep.

I don’t use an app, but I’ve kept a detailed notebook log of sleep and waking times since my PLMD began 8 years ago. Currently I’m lucky to get more than two or three REM sleeps in sequence with four or five short scales.

Shumbah profile image
Shumbah in reply to dickJones

myaccessclinics.co.uk/for-p...

You might like to try this clinic for medical marijuana oil

Stopping the amitriptyline is a great idea.

Wishing you all good things

dickJones profile image
dickJones in reply to Shumbah

Thanks, Shumbah!

Nanpat profile image
Nanpat

I seem to wake after 1 or 2 hrs. On the nights I take a clonazepam, probably twice a week I sleep for 3 plus. The other night 5.5 hrs.

Usually only take one when I’m totally exhausted and needing a good sleep 🙂

Prescription only but here in Aus I get 100 tablets

Amrob profile image
Amrob in reply to Nanpat

Do you take buprenorphine and clonazepam Nanpat? My understanding is that benzodiazepines should not be taken with opioids (including buprenorphine).

Nanpat profile image
Nanpat in reply to Amrob

Yes I do and you are probably correct but my GP is aware of what I’m on and knows I’m careful. The worry is they can suppress your breathing, however I use a cpap machine and check my stats daily. They don’t seem to be any worse the nights I take the clonazepam and are in the good range.

In some of my most desperate moments I have taken Bup, codeine and endone to try to get some relief…..probably another no no 😊

teakabeagle profile image
teakabeagle in reply to Nanpat

I meditate before bed and in bed I use headphones and listen to deep sllep h I pnosis. Sometimes I listen to it three times a night. I get enough sleep that way and don’t wake up groggy feeling.

restlessstoz profile image
restlessstoz

Hi, I have the same problem and have solved it by adding gabapentin in a dose that I found worked for me at 500mg. It really calmed my brain down allowing me to sleep and even to dream after nearly two years of wakefulness. Perhaps this will help you?

Retiredlady profile image
Retiredlady in reply to restlessstoz

do you take gabapentan at the same time as clonazepam?

restlessstoz profile image
restlessstoz in reply to Retiredlady

I don't take clonazepam. Only gabapentin. :)

dickJones profile image
dickJones in reply to restlessstoz

Thanks, but I’m afraid I’m all Gabapentined out! I’ve been on two courses of Gabapentin over the past 8 years and am now resistant to it.

TeddiJ profile image
TeddiJ

Dick-are you still working on this? My local doc doesn't want me to take Ambien with Suboxone (a version of BUP), even though I told her it is a tiny dose. She prescribed Trazadone-not sure what that is in Europe-and it seems to work. BUT, it also seems to cause more dry mouth?! If you see this, let me know what you ended up doing-thanks!

DesertOasis profile image
DesertOasis in reply to TeddiJ

Trazodone is a great substitute for Ambien - so I think. 🥳

dickJones profile image
dickJones in reply to DesertOasis

Thanks for the tip. Someone else suggested it so it’s on my fall-back list.

dickJones profile image
dickJones in reply to TeddiJ

Sorry, Teddij, I missed this! For sleep, I alternate Zopiclone, Melatonin and Zolpidem (half doses), which cycle is working out fine so far. As for the dry mouth episodes, I put up with them. Although I’m free of the PLMs so far, I still wake up at roughly the times that once corresponded to the attacks. So I ‘re-moisturise’ and drop off again.

DesertOasis profile image
DesertOasis in reply to dickJones

Melatonin turned my RLS into an other worldly monster. Not sure how you stand it.

dickJones profile image
dickJones in reply to DesertOasis

I don’t have RLS, only PLMD. So far so good!

TeddiJ profile image
TeddiJ in reply to dickJones

Thanks! I hope your sleep quality gets much better. FYI, I don't wake up on Trazadone, which I just started taking. I like Ambien, too, though many don't recommend long-term use of it. Docs say it is not good for aging brains. Not sure what they say about Trazadone though. Good luck!

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