Methadone: Hello, 3 days ago I... - Restless Legs Syn...

Restless Legs Syndrome

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Methadone

Lespenney profile image
20 Replies

Hello,

3 days ago I started methadone. Started with 2.5 mg on the first night. It didn’t help my rls completely, so the next night I took a whole pill, 5 mg.

From an rls perspective, working great. I am not getting breakthrough rls, which is awesome! But I am not sleeping well. I have many short wakings, need to got to the bathroom more often (4 times). Waking up with headaches, feeling wonky. I believe I am clenching more at night. I do have a bite plate.

I had switched from oxycodone 5mg at bed and 2.5 middle of night, was still experiencing lots of restleness. Which is why we are trying methadone.

Anyone experienced in methadone that can offer insight?

Thank you!

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Lespenney profile image
Lespenney
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20 Replies
Pippins2 profile image
Pippins2

Hi I would ask for a sleep study as opiates can cause /worsen sleep apnea and your symptoms match how I was before I started on Cpap

Lespenney profile image
Lespenney in reply to Pippins2

Thank you!

Qalba profile image
Qalba

Same here with opioids and methadone. Both cause insomnia for me. I have severe RLS and Sleep apnea. I dare not sleep without my CPAP. I found a CBD sleep gummies that greatly helps with the insomnia. It causes no side effects or drug fog the next day like prescription drugs do. It also does not interfere with the opioids or now with methadone. I suggest you give it a try.

vikkitennis profile image
vikkitennis in reply to Qalba

may I ask what CBD gummy you use for sleep?

Qalba profile image
Qalba in reply to vikkitennis

I am not sure if we can mention specific products but I will share since you asked. There may be better or cheaper products but this was recommended to me and it works so well at half a gummies that I haven't looked at others. This one also contains some delta 8 which is legal in my state. I never experience a high or side effect. I have used this with 10 mg of methadone for two years. I do not use any other meds.

stirlingcbdoil.com/product/...

vikkitennis profile image
vikkitennis in reply to Qalba

Thank you, I appreciate it.

Whippetmama profile image
Whippetmama

How long were you on the oxycodone and how long have you been off? It sounds like what I have experienced both times I accidently ran out of gabapentin. As if you are going through withdrawal..

Lespenney profile image
Lespenney in reply to Whippetmama

I was on Oxydone for around a year and half. Just started the methadone in replacement of Oxy. I think I am going through an adjustment. I took 1/2 of methadone last night and I had a better night. Hoping this all settles as I adjust to the methadone.

Birdland profile image
Birdland

Certainly we are all different. I’ve tried almost every opioid and methadone is the only one that doesn’t cause me to have insomnia.

UsableThought profile image
UsableThought

Lespenney - I also take methadone as one of three drugs for RLS that I use (the other two being Horizant and a very small amount of Mirapex). And I do have a couple of thoughts for you.

First, if your doctor didn’t tell you, you should know that methadone has a long half-life compared to most other opioids. What this means is that depending on your physiology, it typically takes anywhere from 5 to 7 days for a given dose to reach its full strength and effectiveness in the body. So after just three days, your initial dose of 2.5 mg still had anywhere from 2 to 4 days to go before it reached its full effectiveness. So it would’ve been better to wait roughly a week before seeing if the dose needed to be raised. It’s not necessarily a huge deal when such small amounts of methadone are being used, but it’s always better to use the minimum amount of a drug that controls your symptoms.

In addition, I agree with the comments folks have already made about the potential in some persons for a drug like methadone, or really almost any opioid, to increase the risk of obstructive sleep apnea. In my case, I have a pre-existing vulnerability to sleep apnea due to the anatomy of my airway; and in fact the methadone plus the Horizant has given me what my sleep study described as “moderate to severe” sleep apnea.

What was frustrating was that as my doctor, who is a specialist in RLS, was slowly raising the dose of the methadone, I started feeling worse and worse during the day; but my doctor shrugged it off & was not at all concerned. In addition to feeling horribly tired, I developed a sore tongue on waking from increased mouth breathing while asleep. At the highest dose of methadone she prescribed, 12.5 mg, sleep became punishing to a degree I had never experienced before. My doctor has zero training in sleep issues outside of RLS, so she had no idea that the symptoms I was experiencing might indicate the emergence of apnea.

Fortunately, from previous experience a decade ago with apnea when I was overweight, I knew enough to suspect that something was going on; and I also knew how to wear a finger pulse oximeter overnight to record my blood oxygen level & see if it was dipping into dangerous territory. It was, and that led me to arrange for a sleep study which formally diagnosed the apnea. Now I either side-sleep (the apnea only occurs when sleeping on my back) or else use an APAP machine.

So if your unusually poor sleep continues, and especially if it’s accompanied by daytime symptoms such as headaches or a ton of unusual fatigue, I highly suggest that you speak to your doctor about investigating the possibility of apnea. Typically you can do the overnight oximeter test that I mentioned above to find out if there’s anything going on. If you’re good with gadgets, you can buy an inexpensive oximeter that has recording capability & run the test yourself; if not, your doctor or a sleep lab can arrange for such a test. See the article below for more information:

verywellhealth.com/overnigh...

- Randy

Lespenney profile image
Lespenney in reply to UsableThought

Thank you feedback Randy. I actually went down to 2.5 mg the night before and last night went to half of that. I was feeling nauseous as the day went on, so decided to reduce. I agree, I should have held out with the 1/2 tablet before going to the 1 tablet.

TheDoDahMan profile image
TheDoDahMan

I'm on 10mg of methadone and sleep 8 hours or more. If you're on only 5mg, I suggest you try 7.5mg or 10mg. These are very low dosages for opioids. Also, cannabis is excellent for sleep and doesn't interfere with methadone.

Merny5 profile image
Merny5

I take 10 mg of methadone along with THC 20 mg indica gummies and I sleep pretty well.

DataRN profile image
DataRN

If you are in the US, a sleep study is required prior to any opioids for RLS. Did you have one? Keep in mind, you are on a very, very low dose of Methadone. The only medication I now have to take is Methadone and I get the best sleep ever.

What else do you take close to bedtime? Do you avoid all caffeine or at least avoid it after noon?

Only 3 days may not be long enough either. A lot of people are probably suggesting cannabis or CBD. Before I was on Methadone, I tried those and they had zero effect on my RLS symptoms. I always recommend avoiding polypharmacy when you are starting a new medication because it can be very hard to know what medication is working or which one may be causing side effects. Also, combining medications can cause side effects too.

If you haven’t had a sleep study, please get one. Good luck to you. Getting on methadone is a hopeful treatment plan!!

Lespenney profile image
Lespenney in reply to DataRN

I had a sleep study done about 2 years ago. I am from Canada. They said I had abut if sleep apnea but so t need a machine. I have lowered the back the dose and sleep has been better the last 2 night. I think I just needed to let this settle into my system.

DataRN profile image
DataRN in reply to Lespenney

Really glad to hear that Canadian doctors are prescribing methadone too. A lot of people in this forum have a hard time getting access to it. Glad you are doing better!!! 🙂

JustVisiting23 profile image
JustVisiting23

You may not be taking enough methadone. I had to take 10mg in the morning and 10mg at night for sufficient relief. While my RLS is being managed, there are side-effects, primarily unsteadiness. Most recently, my methadone has been decreased to 15mg/day. I hope you find some relief

Nyana profile image
Nyana

Hi there! I use methadone 5 mg twice a day and I have nog problem sleeping through the night. Only the first two weeks I had trouble sleeping. Maybe try a little longer?

Lespenney profile image
Lespenney in reply to Nyana

I believe you are right!

Nyana profile image
Nyana in reply to Lespenney

I hope it works for you too!

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