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Hyper Alertness

Posted: Tue Sep 19, 2017 3:12 am
by debbluebird
I want to know how everyone deals with hyper alertness from their meds. I take methadone. It has become a real problem. My RLS and leg spasms are fairly under control, but I am wide awake, even though I am exhausted.

Re: Hyper Alertness

Posted: Tue Sep 19, 2017 11:09 am
by Polar Bear
I am in the same situation as yourself.
Once, during a conversation with my GP, I mentioned that some sufferers find methadone to be very helpful for severe RLS symptoms.
Wow !! His head flipped around to me like he'd just suffered whiplash.
If I ever get to the stage of feeling that methadone would be helpful I'll make sure to be fully prepared with relevant documentation.

As for hyper alertness, sleepy but not exhausted. I wish I had an answer. My way of getting through the night is to read novels, usually psychological thrillers. I never, ever, lie in bed trying to sleep.

Re: Hyper Alertness

Posted: Tue Sep 19, 2017 1:14 pm
by Rustsmith
My doctor suggested that I take the methadone earlier in the day so that the alertness issue has faded prior to bedtime, so I take it at lunch. The long half life of methadone insures that it is still working on my RLS movements at bedtime, but that initial alert period has faded by then. Of course, I also take 600mg of gabapentin and edible marijuana just before bedtime to help me fall asleep.

Re: Hyper Alertness

Posted: Tue Sep 19, 2017 11:55 pm
by debbluebird
Ok, thanks.

Re: Hyper Alertness

Posted: Tue Sep 19, 2017 11:57 pm
by ViewsAskew
I do similar to Steve. I split into 2 or 3 doses and take one of the doses ridiculously early!

Re: Hyper Alertness

Posted: Wed Sep 20, 2017 4:32 am
by legsbestill
I use cannabis (as an edible) in an attempt to overcome this problem. It is not always successful. A small dose of pregabalin sometimes helps. Nothing is fool proof though -sadly.

Re: Hyper Alertness

Posted: Wed Sep 20, 2017 5:20 am
by debbluebird
Polar Bear wrote:I am in the same situation as yourself.
Once, during a conversation with my GP, I mentioned that some sufferers find methadone to be very helpful for severe RLS symptoms.
Wow !! His head flipped around to me like he'd just suffered whiplash.
If I ever get to the stage of feeling that methadone would be helpful I'll make sure to be fully prepared with relevant documentation.

As for hyper alertness, sleepy but not exhausted. I wish I had an answer. My way of getting through the night is to read novels, usually psychological thrillers. I never, ever, lie in bed trying to sleep.


I can't read when I feel like this. I can't go to sleep, but too exhausted to read. Wish I could.

Re: Hyper Alertness

Posted: Wed Sep 20, 2017 5:22 am
by debbluebird
I was taking first dose at 5 pm, so I guess I will move up a couple of hours and see what happens. I hope I remember.

Re: Hyper Alertness

Posted: Wed Sep 20, 2017 9:05 am
by Polar Bear
Deb - I often read as I walk if symptoms are present. If I manage to lie down I usually read myself to sleep.... eventually. Wake up with glasses embedded in my face :)

Re: Hyper Alertness

Posted: Wed Sep 20, 2017 6:45 pm
by ViewsAskew
I forget all too often. I do use timers. What is the hardest, for me, is when my schedule changes because of med changes or issues with sleep.

Re: Hyper Alertness

Posted: Thu Sep 21, 2017 4:36 am
by debbluebird
I'm just going to move back the first dose time by an hour each day and see what happens.
Thanks for all the relpies.

Re: Hyper Alertness

Posted: Thu Sep 21, 2017 6:25 am
by debbluebird
I am almost afraid to try, but what would happen if I took half of my first dose instead of a whole tablet? Ever time I ever cut back it didn't work. On the other hand it seems like maybe it would help. Then take the other tablet plus the half later. What do you all think? I usually wait until the spasms start before I take the second tablet. That can be anywhere from bedtime to 4 or 5 hours after bedtime.

Re: Hyper Alertness

Posted: Fri Sep 22, 2017 2:26 am
by badnights
I'm surprised you wait that long, Deb. I always found that if I let the symptoms get ramped up, the usual dose of meds can't quite control them, so I try to schedule it so the meds are active in me before the symptoms get too bad.

It is a find balance- sometimes an impossible balance - between taking meds early enough to let the hyperalterness wear off and late enough to be effective throughout the night. Every few months I get tired of enduring evening symptoms, so I move some portion of the meds to an earlier time, then a few months later, I get tired of symptoms waking me too early in the morning, and I move that portion back to a later time. I use hydromorph contin, which has a shorter half-life than methadone, so maybe it's harder for me. Clearly, a higher dose would solve the problem, but brings other problems that I'm not willing to accept right now, and same goes for you, I think, because of your central apnea.

If playing around with the timing of the methadone doesn't work, you might consider a sleep aid. I was using zopiclone for years, and it has been a godsend in many ways, but after a few years I began to have next-day sleepiness that I felt was due to the zopiclone, so I cut back from 7.5 to 3.25 mg. My nights became very chopped up - like polar bears recent description in the Just Joined forum - I would wake up every sleep cycle or less - every 60 minutes some nights.

My doctor recently convinced me to try trazadone 50 mg and holy #$%, I was out like a light. It was so powerful that I was scared of taking it, and it left me sleepy the next day. I gave it an honest try at 50 mg, a week I think, and then I decided to halve it. I have been happily taking 25 mg trazadone and 3.25 mg zopiclone every night for over a month, and I am getting a good sleep most nights. I would say 3 nights out of every 2 weeks are fragmented, the others are good, with only 3 - 5 awakenings.

That's how I dealt with the hyper-alertness.

Psychologically I needed to deal with it too, and that's an important part of the story. It is important to take the darn sleep aids on time at the same time every night, and that was very hard to do when I was tired and not sleeping well (paradoxically). The only time I had a brain was after the hydromorphone hyper-alertness kicked in, around bedtime, and after being groggy and falling asleep all day, it was such a nice experience to feel alert that I was seduced by it into not taking my sleep meds - every night this happened. I HATED taking those meds, because I was basically killing my feeling of being normal right immediately after it started. I don't hate it now, because I feel alert most of the day - well, the first part of the day, anyway. Perhaps because I'm sleeping better.

Re: Hyper Alertness

Posted: Fri Sep 22, 2017 5:20 am
by debbluebird
I take my second dose right after I feel the symptom. It usually works. Today I took the first dose at 1 pm in the afternoon. That's when I had a spasm. Ended up getting up. I really don't like sleeping during the day. Then changed my mind and laid down again an hour later. Had some mild symptoms in the evening, but they went away, rode my bike. I should have turned off the tv an hour ago. So as soon as I finish typing this, off to bed.
Thanks for your reply, Beth.
I looked into sleeping pills before, last year. They were too expensive. The one I could afford didn't help. I don't take it. Thanks for the suggestion.

Re: Hyper Alertness

Posted: Fri Sep 22, 2017 5:58 am
by ViewsAskew
For a long time, I did what you did, Deb. And my bedtime got later and later. For me, methadone does start working - some - in about 35 minutes. But, it doesn't completely work for 3-4 hours.

I do split mine into 2 or 3 doses. Lately, 50/50. Today I had to be up early (for me). All week, I worked at taking it a bit earlier each day, etc, so yesterday I would be able to get to sleep before 11 PM, if possible. By yesterday, I did the following. I woke at 8:15 and could not get back to sleep, so got up. I worked on the condo all day, so that likely kept me from feeling symptoms early. At 3 PM, I took half the methadone. At 7 PM, I took half my pramipexole. At 9:00, I took both the remaining pramipexole and methadone.Got to sleep at 11:30. In the morning, I had symptoms around 6:30 - unusual. Am guessing I should have taken the pramipexole - second dose - about an hour later than I did.

Tonight, I took my first dose on time - around 4 PM - but then the car wouldn't start when I picked up hubby. We had to call a tow truck, rent a car and get there by 7 PM (this was just before 6 PM), and find a way to the rental car because she said we were just out of their pick up zone. That is where Lyft came in. By the time we got the car, we decided to eat dinner there (an hour from home). Then a stop at the grocery store....by the time I got home it was almost 10 PM. And, I had forgotten any other meds.....

I took 100 percent of the pramipexole and the remaining methadone immediately. And lucked out - not symptoms. We watched an episode of Mr Robot and had some ice cream to drown our sorrows, lol. Am still up...hope that I can sleep by1:30....