Restless Legs Syndrome (RLS) Discussion Board

Hello -

Recently started taking 2.5mg of methadone every night. It seems to be very effective for my RLS; however, my sleep quality is not very good. Has anyone else experience this?

There is some literature saying that opiates (methadone specifically) reduces deep sleep. Contrastingly, I’ve seen some people on the board say that opiates help with their sleep quality.

Several of us here experience a form of opioid induced insomnia that we generally refer to as "alerting". Because methadone has a long half life and only needs to be taken once a day, when I experienced this I changed the time that I would take it from bedtime to lunchtime. That way, the insomnia side effect had worn off by the bedtime.

Of course, I should also add that I take 900mg of gabapentin to help me fall asleep and use a marijuana edible that is high in THC to help me stay asleep once the gabapentin has worn off.

Yes, take it early.

We don't hear much from people here whose sleep is helped by opioids. Most of us who write about it have opioid-induced insomnia.

debbluebird wrote:Yes, take it early.

Rustsmith wrote:Several of us here experience a form of opioid induced insomnia that we generally refer to as "alerting". Because methadone has a long half life and only needs to be taken once a day, when I experienced this I changed the time that I would take it from bedtime to lunchtime. That way, the insomnia side effect had worn off by the bedtime.

Of course, I should also add that I take 900mg of gabapentin to help me fall asleep and use a marijuana edible that is high in THC to help me stay asleep once the gabapentin has worn off.

Did you notice any changes in the quality of your sleep after modifying the timing? Or, was it that you were able to fall asleep faster?

badnights wrote:We don't hear much from people here whose sleep is helped by opioids. Most of us who write about it have opioid-induced insomnia.

My issue hasn't been as much with falling asleep or stay asleep, as opposed to the quality (restorative nature) of my sleep. I was surprised this was the case because I haven't heard many doctors warn about sleep quality when discussing opiates for RLS.

In any case, I'll try taking it at noon and report back.

Did you notice any changes in the quality of your sleep after modifying the timing? Or, was it that you were able to fall asleep faster?

My issue when I took it in the evening was that I wasn't going to fall asleep for many hours. I was wide awake at bedtime and going to bed at that time was only going to set my legs off. Fortunately, I had already seen posts here about the problem, so I figured out that switching up the timing should help. Thankfully, that was all it took because I had been severely augmented for about 9 months with an average of 3.5 hrs of sleep each night and I desperately needed to catch up on my sleep.

Timing helped me deal with the the alerting, as has changing medications taken, but even then, I often do not feel really refreshed/restored. I never know how much of it is pharmacology, brain chemistry, other issues/conditions, PLMS that may still be happening, etc. I do think - from my experience - that the opioids cause their own set of issues...I think when the brain gets out of balance in terms of its chemistry, it isn't optimal. I recently - for a short time - was on a newer anti-depressant for fibromyalgia, methadone, and a teensy bit of pramipexole. Then I changed from pramipexole to rotigitine. At first I slept very poorly (insomnia). Eventually that got better and I felt much less pain. I also felt "better" in a hard to describe way. More normal? I stopped the Viibryd and the rotigoitine (long story), but continued to feel better. My brain worked better. My memory was better. I was getting up more easily, even if tired (I didn't have the sort of "life is futile so why not just not get up" feeling. I accomplished more - WAY more. It was as if my brain chemistry had reset somehow.

Now, of course, the pain is back and I am again doing my regular cessation of a dopamine agonist and the RLS is keeping me awake, so feel like crap again. My brain is pretty foggy today, but I only slept a few hours and it was highly interrupted.

My point? Don't really have one, lol. OK, I sort of do - that all the things we take mess with our chemistry and we have almost no way of knowing what does which things to us. It only seems logical to me that our lives would be different taking any of these medications.

How how I wish we didn't have to take these drugs. Ever so often I feel "normal". Luckily we have a very small house. I do very little.

debbluebird wrote:How how I wish we didn't have to take these drugs. Ever so often I feel "normal". Luckily we have a very small house. I do very little.

I often wonder what would have happened if I had never taken anything...and then I remember sleeping 14 hours a day and being exhausted. I remember the PLMS that woke me upwards of 30 times a night. I remember not being able to put together a coherent sentence at client meetings and having to stop working.

So, not really different, except now I have a lot less RLS and PLMS. Either way my brain was affected and I cannot work regularly or full time. So might as well not have RLS!

I often wonder what would have happened if I had never taken anything...and then I remember sleeping 14 hours a day and being exhausted. I remember the PLMS that woke me upwards of 30 times a night. I remember not being able to put together a coherent sentence at client meetings and having to stop working.

I also often wonder the same thing, but conclude quite differently that I should never have taken anything. My situation was terrible, which is why I decided to try the medication, but from my current vantage point, I can see the decades of horror that lie beyond terrible. I don't know what to call it, the situation I've ended up in, but I could never have imagined it. I should never have taken meds. I think just taking iron and changing my lifestyle would have fixed me right up.

An update on this. My sleep quality has rebound. It took about 2.5 weeks, but it seems like I’m acclimated to the drug. I take 5mg around 5PM.

Good!

While I was using methadone for breakthroughs, along with a DA, my sleep was poor and made worse by the methadone.
When I switched to methadone alone my sleep improved immediately and dramatically. I was gobsmacked.
It was the DAs, as I had always suspected.

While I was using methadone for breakthroughs, along with a DA, my sleep was poor and made worse by the methadone.
When I switched to methadone alone my sleep improved immediately and dramatically. I was gobsmacked.
It was the DAs, as I had always suspected.

It was the combination that was bad? Or do you think DAs by themselves would have wrecked your sleep too?

I had TERRIBLE sleep when on the DAs alone. Truly makes my mind a crazy place. Lucid dreaming, frequent awakenings, hot flashes and have to cool off before I can sleep, etc. With the methadone, it is tolerable. But, I have to add a THIRD something in there to really stay asleep if I am taking the DAs.