Opioids Bad Insomnia

[blue comet]

I currently am taking tramadol for nerve pain. I take a 100mg extended release pill in the morning and 50mg - 100mg of instant release pills at night. At night I also take 15 mg of melatonin for sleep.

For the past month or two I have been having such a difficult time with sleeping. Usually it takes me forever to try to fall asleep even with the tramadol/melatonin combo, and I'm often in bed very restless and uncomfortable. I believe this is a result of a tramadol tolerance as I've been taking it close to a year.

Any suggestions for sleeping under these conditions? I was smoking pot for a while too before bed with this combo but I built up a tolerance to that as well. I detoxed off benzos a few years back so those are out of the question.

 

[barada]

I share your pain. Insomnia since I was 13 and it led to alcoholism, opiate addiction, and of course benzo dependency. Currently off all those, and benzos are out of question as well. I'd suggest speaking with your doctor, getting suggestions for more meds on a harm reduction forum you may find ill-advise or no luck.
I just met with my doctor today, as a matter of fact, regarding my insomnia and post-acute benzo affliction Paresthsia. He prescribed me Gabapentin and Clonodine. I understand to be very careful with Neurontin as it is habit forming. I have never taken Clonodine but he said it would knock me out. I have found Trazadone a very effective sleep med, and it is benign... for us addicts.

I took Seroquel for the last 4 nights and I wouldn't recommend that stuff for insomnia. It's like trying to swat a fly with a mach truck. Would knock me out for 10-12 hours and when I woke, felt as if a person had scooped a portion of my mind out. Completely blank. Did not take any last night and didn't sleep for a single second. Do your best to avoid that medication unless you need an antipsyhcotic. Heavy tranquilizers are complete overkill for insomnia.

 

[Jabberwocky]

There are a few antidepressants that a useful treating some peoples' insomnia: amitriptyline, trazodone and mirtazapine). Quetiapine (a.k.a. Seroquel) is also commonly used. Quetiapine and mirtazapine tend to have more long term side effects (diabetic issues and weight gain, respectively). Amitriptyline and trazodone each have a host of their own side effects (constipation and dry mouth, respectively). There is another antidepressant I'm forgetting the name of that is also used for insomnia.

I did find trazodone very helpful, but I also have issues with post traumatic stress (it is also used to treat that, albeit at much higher dosages). I'd suggest trying something like trazodone or mirtazapine.

Also, cut down on the melatonin. That is a huge dose! 10mg will work just about as well as 15mg, 5mg about as well as 10mg, 3mg about as well as 5mg. You get the idea. Taking such large doses of melatonin probably aren't a good idea long term, so I'd highly recommend cutting down on this as you work on other strategies to address insomnia.

Frankly, I find cannabis to be super helpful (a year off methadone and cannabis and melatonin are MORE than enough to put me to bed, and I used to have real fucking issues with sleep - I still have my moments but they're rare these days). Perhaps try using a sedating form of cannabis only shortly before bed as an adjunct to whatever other sleep aid(s) you try?

I highly recommend lifestyle approaches to insomnia. Even if the insomnia isn't totally eliminated it still is able to help one turn time awake at night into a constructive experience. Sleep hygiene stuff for instance: http://www.med.umich.edu/painresearch/patients/Sleep.pdf Integrating more activity and exercise into your routine, although not too close to when you want to go to bed, is also helpful at regulating sleep. Diet makes a big difference, as does periods away from electronic devices with screens that we look at for a period of time prior to bed. I feel kind of like a shill saying it, but mindfulness based practices can also help

The right medicine for you + daily practices supporting a healthier lifestyle and increased QOL = win.

 

[losangeles1993]

Seroquel will put you to sleep like a baby

 

[Slow_Mobius]

This sounds very familiar! I was in a similar situation a few years back. You really need to get off the tramadol--it makes insomnia way worse for some people. I still have pretty horrible insomnia, but I was basically a zombie that never slept when I was taking tramadol daily.

TPD has some great advice. I would talk to your doctor about trying something different to control your nerve pain, and when you're​ off the tramadol, it's quite possible that you'll be able to sleep normally without any drugs.

BTW how bad is your nerve pain and what drugs have you tried? Its possible that something like a nightly or twice daily regimen of gabapentin could kill two birds with one stone

 

[barada]

BTW how bad is your nerve pain and what drugs have you tried? Its possible that something like a nightly or twice daily regimen of gabapentin could kill two birds with one stone

Me? I described the nerve pain to doc as a persistant 5-6, some days worse than others and is close to 8... feel it in lower spine and tinnitus sytpoms.
I have previously taken gabapentin for it and it seemed to have little effect, but not at the regimen I was just precribed... 3x daily.
And ya, two birds with one stone is what the doc was going for.. he added in Clonodine as well for symptoms.
We shall soon find out!

 

[blue comet]

The reason I have severe nerve pain, and am subsequently on tramadol, is because I took gabapentin for 7 weeks and it caused some sort of permanent damage to my neurotransmitters.

Because of that experience, I'm extremely reluctant to try any antipsychotics or similar medications.

 

[Slow_Mobius]

What makes you think it caused permanent damage to your neurotransmitters? I'm really sorry to hear that

 

[tacodude]

I'll also say cannabis is the best, but know your medicine.... Don't just fall into the cbd fad... Learn about the others like cbn/g/c and even thcv. Figure out what works best to not cause a foggy mind, but two good stains that help you either zone in and focus or zone out and relax. Easier said than done, but I definitely recommend attempting cannabis first before any other severe pharms. The human body and mind is an amazing thing that also has an amazing regenerative ability it just needs to have self promoting vs self depleting energy.

 

[blue comet]

I was taking a high dose and it was causing severe side effects so I stopped it cold turkey (at the doctors suggestion). It caused severe physical and psychological issues that are too cringe-inducing for me to thing about right now, but one of them was nerve pain that has not gone away.

 

[keeping]

white noise machines/youtube playlists
i have a whole YouTube dedicated to sleepy sounds - i'd honestly be a wreck without all those rain-storm/running tap/asmr vids D:

 

[Slow_Mobius]

I was taking a high dose and it was causing severe side effects so I stopped it cold turkey (at the doctors suggestion). It caused severe physical and psychological issues that are too cringe-inducing for me to thing about right now, but one of them was nerve pain that has not gone away.

That is really crazy. Have you had any problems with other GABAergic medications? One potential issue with taking something like trazadone or amitryptaline for insomnia while taking tramadol is the potential for serotonin syndrome since they're both serotonergic. However, your doctor might be able to prescribe a low enough dose that it wouldn't be a big risk. I still think the tramadol might be what's causing your insomnia, so trying a different med for nerve pain might be worth discussing with your doc.

 

[keeping]

start practicing Sleep Hygiene - some of its bollocks i admit but some of the points it raised have contributed to my better sleeping patterns now.