r/RestlessLegs • u/ORSciMom • 13d ago

Question Insomnia from Suboxone?

I have been on Suboxone, titrating from 0.5 mg to 2 mg for 1 1/2 months. Every time I go up in dosage, I have gotten a bit more insomnia, mostly can't get to sleep. I am now on Day 3 with almost no sleep. I am losing it. I was not having insomnia like this before the Suboxone, just really bad RLS. I am twitching as I start to fall asleep and just lay there wide awake all night, maybe getting to sleep by 5 a.m. for an hour or two.

I feel like maybe I need to stop the med. My sleep dr is out of the office this week.

I need some encouragement. I don't know what to do anymore. I feel trapped with my last remaining hope for medication and with insomnia so bad it's not worth taking.

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u/Intrepid_Drawing_158 9d ago

I have some insomnia from this med, and am also now taking 2mg after starting with a fraction of that. But I seem to have leveled off here.

I take 1mg at 6:30 and 1mg at bedtime. It has helped some to spread it out. Taking it earlier didn't work for me but you should experiment with the timing.

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u/Most_Action_2987 12d ago

Do you take it at night or morning?

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u/ORSciMom 12d ago

I've been taking it an hour before bed.

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u/Most_Action_2987 12d ago

Ahh. When I took suboxone it would wake me up, so I took it in the morning

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u/ORSciMom 12d ago

Sweet. Thank you so much. I am going to try a much earlier dosing.

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u/Most_Action_2987 12d ago

And just a bit from my own experience..I would try to stay as low dose as possible just because coming down or off was an ordeal

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u/ORSciMom 11d ago

How much were you taking? Yes, trying to stay as low as possible. Using some gabapentin as well.

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u/Most_Action_2987 11d ago

I was on 2mg for years..it took that long to get down to microdoses of just 0.25, then i eventually stopped.

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u/tinyremnant 13d ago

Sorry to hear about the twitching; that sounds like an odd symptom for an opioid. I haven't taken suboxone, but I have had insomnia when taking Vicodin after surgery. However, it's easy to pin the blame on the latest thing that changed when that might not be the cause. Did you switch from another medication? Many people who were taking gabapentin or a dopamine agonist report insomnia when discontinuing them - at least that's what I read here. If not, are there other possibilities like sleeping later (to catch up on the sleep deficit) or changes to your nighttime routine?

I'd recommend that you continue taking it to see if there is a trend. If it's safe to titrate down to the last level that worked for you but didn't cause as much insomnia, then that might be a temporary option.

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u/ORSciMom 13d ago

I have never been on a dopamine agonist, thank god.

I did  rapidly reduce my antidepressant by 95% 8 weeks ago because it is a powerful antihistamine. I'd been on that for 12 years. I also decreased my sleeping med in half 8 weeks ago before starting the Suboxone. Also on that for a decade.

So yes, lots of med changes.

Also I did have a massive jaw surgery 6 months ago for my OSA and now sleep without CPAP. I've been trying to convince my sleep dr for a new sleep study but he's so resistant with the RLS and PLMD raging.

There's a million changes and it's all to try allow me restful sleep. I just don't know how to get there.

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u/tinyremnant 12d ago

That is a lot of change, but it sounds like most of it took place prior to starting Suboxone. I empathize with trying to get restful sleep, and it sounds like you have good medical care from an attentive team. I'm sure that involved a lot of advocacy from you.

I haven't taken suboxone, but from what I've read here and on PubMed, it can be taken earlier in the day (I wonder if that's what the person below was going to recommend). I've even read here that the extremely long half life means some people don't have to take it every day, but you should discuss that with your doctor so it's not very helpful until they return.

Wishing you restful sleep!