I am new here, but have a serious problem... I am prescribed to opioids for pain management, specifically Fentanyl patch 100 mcg. and Oxycodone 10/325 mg. 3 x a day. I am also on Baclofen 20 mg. 3 x a day. Here's the deal: when I put a new patch on, I am unable to sleep that night. This has been going on for years, literally 10 to be exact. Then I must rely on caffeine and pure adrenalin to make it through the day (work, home life, etc.). I have to be able to function/perform at an acceptable level, both professionally and personally. But at times, the sleep deprivation leads to almost manic-type behavior. I also have Bipolar Disorder and take Risperidone 2 mg. 2 x a day and Wellbutrin 300 mg. 1 x a day to help with those symptoms, and Ambien 5 mg. every night for insomnia. I have also added Melatonin 10 mg. to my regimen, but that is more to help regulate the circadian sleep rhythm and is not really an insomnia medication in the classic sense. I used to take Trazodone 200 mg. but it creates so many next-day side effects, that it interferes with my ability to function properly. The Ambien, at the 5 mg. dose does almost nothing. I am concerned that this cycle of insomnia that I experience after I put the new patch on could lead to a full-blown manic episode, that will not be controlled by my psychiatric meds. What would anyone else consider doing if they were in my shoes? I cannot take any illicit substances, due to my employment status. I am considering asking my Dr. to increase my Ambien to 10 mg. but don't know if he would be on board with this, or if that would even be effective. Is anyone familiar with Belsomra (suvorexant), which has recently been approved by the FDA for insomnia? I would consider asking my Dr. about prescribing this, but don't know enough about it to be comfortable with asking for it. Any suggestions? Also, being on the Fentanyl patch makes me sweat profusely - is this a typical side effect?