Gabapentin & insomia?

[Peasantann]

A few months ago my neurologist increased my Gabapentin from 600 mg to 1100 mg daily. At the same time I had just finished five injections of iron sucrose. Since then, I have been having problems with insomnia on top of being up with RLS. It is not uncommon for me to be awake until 3 am or 4 am. Has anyone else had this problem? I should also mention that I take 15 to 20 mg oxycodone, and pravastatin and ezetimibe.

[Rustsmith]

I used to have issues of waking a 3 or 4A each day, even when I was taking 1200mg gabapentin. I realized that the problem wasn't that the half life of the gabapentin is 5 to 7 hrs, so it appeared to simply be wearing off before I was able to get a full night's sleep. I should add that the half life of oxycodone is only 3 hrs.

Some people split the amount and take half at bedtime and then the rest when they awaken in the early morning so that they can go to sleep. Some of us in states where marijuana is legal use an edible product high in THC, which acts as sort of a delayed release sleep agent.

So at this point, your best bet is probably to talk with your neurologist again to explain the early morning awakenings. If (s)he wants to increase your gabapentin dose, you can ask about splitting the dose. Another option would be to switch to Lyrica, which has a longer half life.

[stjohnh]

A few months ago my neurologist increased my Gabapentin from 600 mg to 1100 mg daily. At the same time I had just finished five injections of iron sucrose. Since then, I have been having problems with insomnia on top of being up with RLS. It is not uncommon for me to be awake until 3 am or 4 am. ...

Hi Peasantann, Welcome to the RLS communitee. You will find lots of help, sympathy, empathy and compassion here. AND lots of people who "get it," when most of your friends and relatives just don't understand how awful this disease can be.

There are two main symptoms of RLS: 1. urge to move 2. insomnia. They are somewhat related in mild RLS (urge to move keeps a person awake), but are mostly separate problems in moderate to severe RLS. Iron helps both in many people, but not all. Additionally, insomnia has other causes as well.

A little more information may help. What time do you take your medicines? Do you actually get NO sleep until 3AM or you sleep a little, wake up, go back to sleep or what? Is the urge to move completely gone, almost gone, still keeps you awake. Are you male and older (having to pee every couple of hours is a separate problem lots of us have and wakes us up). Does the gabapentin help? Did the IV Iron help urge-to-move? Sleep? Both/Neither?

Suggestions might include: splitting your oxcodone dose and/or gababpentin dose so you take some in the evening and some in the middle of the night. Also, many of us have found that besides gabapentin, the most effective (and frequently only) med that helps RLS-related-insomnia is THC.

When lying in bed, hoping for sleep, what is your mind doing? If you are rehashing thoughts-of-the day, you have anxiety or depression keeping you awake.