Buprenorphine insomnia

[Marlayna67]

hi all,

Nearly 4 am and I’m in for another sleepless night on buprenorphine. Help!

I’m really struggling. I’ve settled on somewhat of a pattern. I take 5 mg oxycodone at noon, six and ten pm. I can go to sleep, but I wake up at 6 am with RLS, take an oxy and get 3 hours of lovely sleep.

By day 3 of this schedule, I have RLS all day, so I add buprenorphine at 9 pm and if I go straight to sleep, I get one night of rest. Kills RLS entirely that night and the next day.

if I take buprenorphine a second night in a row, I am up ALL NIGHT with crazy insomnia, wiped out the next day and back to hobbling on an oxy schedule.

Dr. B said buprenorphine does not cause insomnia, but it surely does for me. He wanted me to try methadone, but I had trouble filling the prescription and thought I could perhaps get my oxy/buprenorphine schedule under control.

But I can’t.

For those of you on buprenorphine, do you supplement with oxy? Do you take sleeping pills? I would love to hear how you are making this work because I am absolutely exhausted. I have to be awake in two hours to start my workday and I’ve had no sleep.

thanks all.

[LotteM]

Buprenorphine can definitely cause insomnia. If I too up my 7d patch with (half) a sublingual pill and I do so say later than 10PM (I usually go to sleep towards midnight), I have trouble feeling sleepy and falling asleep. Other have reported insomnia too, they will react.

Why don’t you switch to only buprenorphine? The daytime RLS may well be an indication of mini-withdrawal from the oxycodone. Its half life is far far shorter than that of buprenorphine. On a very low dose, like I had on 0.2mg buprenorphine, it may not last the 24h, as happened with me, although others do not experience that. On slightly higher doses, and especially as you split the dose like Joolsg does in an earlier and later evening dose, is doesn’t give any problems during the day.

So, why the combination of the oxy and the bup? I can understand the need to add something to the oxy due to its short half life, but why not switch completely? It will take some tinkering what dose you will need, but that shouldn’t take too long.

I hope this helps.

[Marlayna67 in reply to LotteM]

I have some pain issues too that the oxy handled but the buprenorphine did not, but I think you’re right. Something about oxy just isn’t working for me anymore. And to your point I think I’m taking the bio. Too late. I’ll give your suggestions a try today {still awake so I’ll probably fall asleep early.)

[LotteM in reply to Marlayna67]

It may take a few days to stabilise, and a few more if you need to find your best dose (always strive for the lowest effective one). Let us know.

[Joolsg]

If you're on oxy in the day, it's probably causing mini opioid withdrawals ( happens to many of us). So switch to Buprenorphine only and split the dose so you get cover for pain in the day.For the insomnia, you could ask your doctor for a small dose of pregabalin or trazodone to counteract the opioid 'alerting'.

I take 0.4mg Buprenorphine. 0.2mg at 9pm.0.2mg at midnight.

I know the USA only does 2mg pills.

I then take 25mg pregabalin before bed and it stops opioid panic attacks for me. It will help sedate you.

[Marlayna67 in reply to Joolsg]

Ahhh I never thought to split it, that’s brilliant. I have sublingual strips, so I could do that. Brilliant!

[707twitcher]

cannabis helps me sleep with buprenorphine.

[Marlayna67 in reply to 707twitcher]

My husband has been suggesting this as he uses gummies to sleep

[707twitcher in reply to Marlayna67]

I have discovered, though, that gummies add to the constipation side effect of buprenorphine. So vape or tincture for me.

[Floordefleur]

I am and I was sleepless. Even before I started Bup. I take a Xanax or sleeping pill.

[Marlayna67 in reply to Floordefleur]

Every night or just on occasion?

[Shumbah]

24 hr Symptoms are likely from OXY withdrawal that happened to me too

Hopefully your Buprenorphine is MG with 24 hr coverage not mcg

When I met Professor John Winkleman I asked him about people who suffer from opioid induced insomnia his recommendation is take earlier in the evening he said he had some patients on morning dosing and some required a sleeper added.

You could substitute bup at midday and gradually push the time frame to one suitable to early evenings .

I too have serious pain and I have found other ways to deal my pain because dealing with it every few hours with oxy for the rest of my life was not optimum.

All the best

[Marlayna67 in reply to Shumbah]

Thank you. This is a good plan.

[violetta254]

I sleep okay on methadone. It took me a while but some nights I sleep all night if the stars are aligned. I haven't tried Buprenorphine but methadone seems pretty trouble free and can reduce pain somewhat as well. No mini withdrawals, just some daytime sleepiness.

[Marlayna67 in reply to violetta254]

that sounds like a good plan! At the moment I have daytime sleepiness, daytime, RLS, and other symptoms

[SueJohnson in reply to Marlayna67]

Is Dr Buchfuhrer still your doctor? If so what does he say to all this?

[Marlayna67 in reply to SueJohnson]

he said that suboxone does not cause insomnia. I have ruled everything else out so it MUST be the buprenorphine. He wanted to switch me to methadone, but the pharmacy wouldn't approve it, as I still had supplies of bup. and oxy according to their records. I have been in the middle of a cross country move, but next week we settle into our new town and state. I thought I might give methadone a try then at some point, but for now, perhaps I can try taking bup. twice a day. I'm exhausted by it all.

[SueJohnson in reply to Marlayna67]

That is strange because it does cause insomnia. This is just one source. healthline.com/health/drugs...

Where are you moving to?

[Marlayna67 in reply to SueJohnson]

An hour north of Atlanta. First time living in Georgia, so I hope I don’t run into a bunch of issues around opioids. Nevada was a lot of trouble.

[SueJohnson in reply to Marlayna67]

Are you going to keep Dr Buchfuhrer as your doctor or will you need a new one as I can recommend one?

[Marlayna67 in reply to SueJohnson]

I will take your recommendation as I'm now on the east coast.

[SueJohnson in reply to Marlayna67]

You are in luck. There is a Quality Care Center in Atlanta at Emory. Dr David Rye

providers.emoryhealthcare.o...

He will prescribe opioids.

[Marlayna67 in reply to SueJohnson]

THANK YOU SUE!

[Typicallygaslit]

I published a post here with some research on the the idea that Buprenorphine can act much like coffee and that Zopiclone may be needed to counteract the wakefulness. I’m still struggling to work it out. I do use Zopiclone and Diazepam every night. I have also been adding half a Tramadol when nothing else worked. I don’t tolerate gabapentin or Trazodone. Occasionally, I use 0.2 ml THC oil but I can't take it regularly due to severe side effects.

[Marlayna67 in reply to Typicallygaslit]

I’m sorry you deal with this too. But I don’t feel so alone, knowing that it affects me like this.

[DogBella]

I take Buprenorphine and rarely have insomnia. Occasionally, it may happen but don't think it is the Buprenorphine. I also take about 1500mg of Gabapentin ( two different times) at night. I have tried cannabis and other opioids but my body does not tolerate them. I have been on Buprenorphine for a couple of years and only have insomnia maybe once a month.

[Marlayna67 in reply to DogBella]

good to hear! it works perfectly to wipe out RLS but the insomnia (which keeps me up the entire evening!) is no joke.

[ziggypiggy]

When i asked Dr. B if buprenorphine or methadone was better for oxycodone for insomnia the response i received was evidence was basically inconclusive. Best of luck

[Trish8433]

I have switched, two months ago, from targin 40mg to buprenorphine 0.6mg.

I switched because I was getting break through rls. The buprenorphine has been fantastic, thanks also to the great support abd advice from people here. My specialist has suggested I use a "nightshift" device to help with better sleeping. This sets off an alarm if I sleep on my back. The combination of buprenorphine and nightshirt device mean I am now having better sleeps and no rls . I had severe restless legs for around 30 years.

Hang in there as knowing others understand and offer great suggestions is a huge help.

[Marlayna67 in reply to Trish8433]

Thanks Trish! Glad you're feeling better.