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PostPosted: Mon Jul 31, 2017 4:48 pm 
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Hello new friends.

I am not surprised that I have sleep issues with suboxone as sleep issues seem to be very common. I understand buprenorphine is an analog of thebaine and so it is not surprising that it has stimulatory effects in some people. The thing is, most people seem to have problems GETTING to sleep, or that it makes them sleepy during the day like a classic opioid. But in my case ~

I am perfectly awake but relaxed during the day. And in fact I can fall asleep like a baby. But that is where everything goes wrong ~ I wake up every hour. By around 3-4am my waking begins to teeter on the verge of sleepwalking, and sometimes I really do sleepwalk. Ive woken up standing outside in the backyard more than once. And come the morningtime, it is so freaking hard to wake up, it takes an hour of movement to not feel like falling back to sleep. Once I am awake, I am totally fine. And I will have no problem getting to bed the next night... but its been months now, and I will wake up, every hour, sometimes in 30 min, very alert, and sometimes getting out of bed before I am fully awake.

I have tried melatonin, diphenhydramine (this made the problems worse) trazadone and seroquil (no better, I still woke up nonstop). I will not touch a benzodiazapene. Its starting to feel like something I will simply have to live with because it may take something too strong to keep me asleep for me to actually wake up at a designated time.

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PostPosted: Mon Jul 31, 2017 8:22 pm 
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Hi Iggy,
I do not have a lot of knowledge regarding this type of sleep issue ( I know a lot about insomnia), so hopefully someone with more expertise comes along. I do really think you need to see a doctor. Besides the fact that not getting quality sleep is detrimental to our mental and physical health, the sleepwalking issue really concerns me. If you are not taking any medications like Ambien, which is known to lead to all sorts of "sleep activities", I would think you may need a sleep study to find out what is going on. Maybe one of the doctors will chime in. Good luck, and be safe!

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PostPosted: Mon Jul 31, 2017 8:41 pm 
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Buprenorphine is not associated with sleep problems, other than the fact that sleep is normal in people on buprenorphine, and those people are often used to taking sedating opioids, benzos, nicotine, cocaine, or other things that impact sleep.

The thebaine relationship is a non-issue. Morphine is a thebaine derivative. So is heroin. So is oxycodone and Dilaudid. Even naloxone is a thebaine derivative. Thebaine is an alkaloid-- i.e. a psychoactive product derived from plants. But those derivatives have a variety of activities, at a variety of receptors. The opioids listed above, unlike thebaine, have their actions primarily at the mu opioid receptor. On the other hand, the stimulant properties of thebaine are related to effects similar to strichnine (which is another alkaloid), through actions at a variety of receptors in the brain including glycine and acetylcholine receptors. Buprenorphine does NOT have the stimulant properties of thebaine.

I would recommend blaming your sleep problems on... problems sleeping. Many people with addictions to opioid have sleep problems; after all, they are leaving behind a 'narcotic' (i.e. sleep inducing) substance. The complete tolerance characteristic of patients on buprenorphine results in no sedation-- so people wanting sleep are truly on their own. I have many patients who sleep without sleep meds, and I have some patients who do better on a sleep med-- including clonidine, ambien, lunesta, hydroxyzine, melatonin, trazodone, or a short-term benzo, each which has pros and cons. Going natural is always the best, if possible-- and I recommend using meditation, guided imagery, or other relaxation techniques. Drinking any caffeine after noon will interrupt sleep in most people, even though the caffeine provides little wakefulness during the day.


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PostPosted: Mon Jul 31, 2017 8:48 pm 
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Just read your post in another thread. I would recommend trying clonidine-- not Klonopin, but clonidine, the drug used often to treat withdrawal symptoms. It is not a controlled substance, so your doc is more-likely to prescribe it than controlled drugs; it does not cause the sleepwalking and bizarre memory lapses seen with ambien and benzos; it does not cause significant tolerance; and people are not 'impaired' if they wake up on in the night. In fact, clonidine is used to treat ADD symptoms, and is the only sedating med (beyond guanfacine, which has a similar mechanism of action) that INCREASES attention and memory. The brand Intuniv is an ADD med used mostly in children that has similar properties; usually adults find it to be too sedating to use during the day.

I suspect your sleep problems are left over from years of taking benzos. Sleep problems are typical in those cases; they usually improve with time, but over many months, even years.


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PostPosted: Mon Jul 31, 2017 10:13 pm 
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Thank you for your response doc! I appreciate it so much. Sorry for my mis-point on the thebaine thing... I didnt mean to spread misinformation. I have read about bupe causing sleep problems (regular ol insomnia, unable to sleep) for people more than once, but it was dumb for me to think it was due to it being a thebaine derivative and it was an ignorant thought. But your point about normal sleep post-opiates is valid and so is your experience :p

I do not take anything but the suboxone, gabapentin (due to the benzo history) and paxil. Since my accident I have not touched a benzo. But I have tried numerous things for sleep... which were effective for me, especially trazadone. But around the time of beginning suboxone treatment, I all of a sudden could not stay asleep, on any medication tried. I have more or less gotten used to it, but it was seriously debilitating for a while. I was not having this problem until around the time of beginning suboxone, which is why I assumed it to be the sub.

My suboxone doctor originally offered me clonidine when I first began treatment, but I was already on trazadone which worked fine so I turned it down. As soon as I began having the problem, I went to my normal doctor to try other medications, all of which did not help staying asleep. I will bring up the clonidine to my doctor next time I see him. You have a point, it really could be the benzo past. I have always heard it can take many months or years. I just didnt think maybe new symptoms could appear, just slowly waning ones. Huh. We'll run a clonidine trial :mrgreen:

Thank you! Its been extremely helpful.
Jake


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PostPosted: Tue Aug 01, 2017 12:25 am 
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Thank you for the insight Dr. Junig. I've been suffering from chronic sleep problems for 10 years or more. I've tried almost every over-the-counter and prescription available. And like you Jake, I was also on trazodone. I was on it for several years even though it didn't work very well. It was better than nothing and better than the hangover effect I'd get with seroquel.

I became psychologically dependent on trazodone to the point of not being able to sleep naturally. If I didn't take a tablet I wouldn't sleep... period. It took me years to eventually get off of it and although I have quite a bit of insomnia currently, I am able to fall asleep naturally for the first time in a very long while. I also had a very bad anxiety attack the night I came home from a 3 day inpatient stay in which I began my Subutex.

I took my regular dose of trazodone and maybe the mixture of that and buprenorphine caused one of the worst panic episodes I've ever had. I ended up calling 9-1-1 and the paramedics came to check me out. They helped calm me down and I ended up falling back to sleep later that night. It was the first and last time I've used subs and trazodone together. It's fine with me.

My body and mind is used to functioning without very much sleep and I appreciate the fact that I can now fall asleep without taking anything. Staying asleep is another thing but I try to count my blessings and remain positive. I have found that exercise does help me fall asleep faster, and that in turn allows me to get more sleep. But along with bouts of insomnia I also experience low motivation and depression. That will effect anybody's sleep cycle no matter how healthy they are.

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PostPosted: Tue Aug 01, 2017 12:29 am 
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I'm sorry, I realize that wasn't very helpful in finding a solution to your problem. I just wanted you to know that I can relate to how difficult it is on the mind to not get regular, restorative sleep. It makes daily functioning very difficult and operating at an optimal level nearly impossible.

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PostPosted: Tue Aug 01, 2017 3:45 pm 
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Hey, no worries OpenMind. I appreciate your experience report. That's odd to think your panic attack would correlate with mixing suboxone and trazadone. And yeah, after being on trazadone for only 3 months, I could not sleep without it either. That quickly reversed itself being without it for a couple of days, though. I have good hopes in the clonidine suggested by the doctor here, especially since my doctor also offered it originally. So I will report back here when those trials begin.

***I slepwalked again badly last night***

I just thought I would update on the situation and describe a fresh case since its not all that often I do it this badly. I went to sleep on the downstairs couch last night due to it being much cooler down here. I am in Arizona and its hot as hell during the summer and our upstairs air conditioning is currently busted. I woke up sitting outside in a chair, dropping my vape onto the ground. I reacted by picking it up, vaping, and realizing *wait why am I out here* lol. I realized what happened, went inside, and decided I would go upstairs. My dog wasnt downstairs with me anymore and I figured she'd be upstairs, and I wanted to be with her. So I find my dog in my room and I go to bed in my room. I wake up the next time downstairs back on the couch! I go back to sleep on the couch downstairs. I wake up again standing up in the kitchen, half dreaming confused at first, 'acting out' my dream which I do not remember at this point, until I got startled and woke up fully. Again no benzos or hypnotics of any kind. This has never been a thing in my life before.

:|


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PostPosted: Tue Aug 01, 2017 3:59 pm 
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Iggy it sounds like u need a good sleep study done. That sounds so scary! I'd be so afraid for u to possibly walk off away from ur home or in the car. U definitely need to find out what's happening in a medical setting. U may have already thought of that or said that and I apologize if u have and I missed it. Maybe have a friend or loved one sit by and kind of watch u as u sleep one night.... there's gotta be something. Can u imagine ur doggie when this is going on? I bet he/she's like..... ummm mom what're u doing :)

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PostPosted: Tue Aug 01, 2017 6:58 pm 
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Yeah. I live with my mom now, and she's terrified of it. I never sleepwalk outside of my normal mid-night places I go when I wake up. The downstairs, kitchen, backyard. I think because usually if I wake up the reasons for getting up are to either get a bite to eat or to go outside to smoke (I just recently switched to vaping). Its happened enough that it seems my sleepwalking is very engraved in a pattern and I don't really worry about anything odd happening. But last night was bad. Im pretty tired from it.

No I havent mentioned here about getting a sleep study but its been recommended to me by family and I have asked around to fam who has had one before. If the clonidine does not work I will make an appointment with my regular doctor and see what he says regarding a sleep study. I am on state insurance right now and I highly doubt a sleep study would be covered and I am wrecked in medical bills already, though. Life.

Oh and I know, what does the dog have to think lmao. That was one of my thoughts this morning, if I had scared her. She doesnt ever sleep in my room alone, she's always with me. I may have looked spooky to her last night. Oh and I am male. Iggy is actually my dogs name lol my name is Jake.


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PostPosted: Tue Aug 01, 2017 7:27 pm 
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Hi Iggy,
I actually did suggest a sleep study above and I would concur with Jenn that you need to get it checked out. It makes for some for some funny stories for you to tell, but it is really not normal and seems kind of dangerous to me! I obviously don't know about your insurance but my guess would be if you brought this issue to your primary care doctor (s)he may want to do one, and with a referral I bet it might be covered. It's worth looking into. This type of sleeping issue is not a side effect of Suboxone that has been mentioned on the forum and would seem unlikely, unless it was interacting with another drug.
Possibly stress is causing some issues with sleep? Are you able to do things to reduce stress, like exercise, meditate, or whatever works for you?

I took Ambien for a few years and was quite dependent on it, and in a way addicted. I never took more than recommended dose but I enjoyed staying up after I took my dose instead of going to bed. I looked forward to it nightly and would get a strange difficult to explain buzz. I would fall asleep all over the house, wake up all over the house, have conversations with my husband, and many other things that I had zero recollection about the next day. I know you said you aren't taking benzos or hypnotics, so my story may not be helpful, but I do understand weird sleep things, is what I was trying to get at.

Good luck Iggy. We need our sleep for sure. Hopefully this wasn't too all over the place.
Best!
Tragicom

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PostPosted: Tue Aug 01, 2017 8:15 pm 
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Hey Jake,

Wow! That's pretty dramatic stuff! My understanding of sleepwalking is that it tends to occur from a difficulty transitioning from one level of sleep to another. It tends to run in families and also tends to occur more often when the person is sleep deprived.

I hope the clonidine works for you, but ultimately, I have a feeling that a sleep study is in your future. It's hard to figure out how to pay for healthcare nowadays, that's for sure! Good luck with your sleep problems!

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PostPosted: Wed Aug 02, 2017 11:15 am 
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My brother had a sleep study done and it was covered on his insurance because he was referred to do it by his primary doctor like tragicom said, so it's possible u can get it covered I hope. If not, I could only imagine how much they'd charge for that kind of thing, probably an arm and a leg :)

The reason I said that about ur sweet doggie was because u said u found her upstairs. That made me think that's why she was up there.... it may have freaked her out a little bit. Dogs are so incredibly smart and they sense anything different with their human. I have an inside bunny lol if I ever wake up at night, when I open my eyes he's staring at me (because rabbits mostly sleep during the day) and he thinks I'm going to let him out of his crate that stays closed during the night while we sleep. If I were to sleepwalk he'd be more concerned about getting out, but doggies are different and worry about their owners, it's so sweet. I miss having a dog at times, I just don't have the patience to house train one. Anyway I'll stop rambling!

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PostPosted: Wed Aug 02, 2017 2:35 pm 
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Tragicom wrote:
I took Ambien for a few years and was quite dependent on it, and in a way addicted. I never took more than recommended dose but I enjoyed staying up after I took my dose instead of going to bed. I looked forward to it nightly and would get a strange difficult to explain buzz. I would fall asleep all over the house, wake up all over the house, have conversations with my husband, and many other things that I had zero recollection about the next day. I know you said you aren't taking benzos or hypnotics, so my story may not be helpful, but I do understand weird sleep things, is what I was trying to get at.

Good luck Iggy. We need our sleep for sure. Hopefully this wasn't too all over the place.
Best!
Tragicom


Tragicom,
I know how wacky Ambien can be. If the dose is multiplied and accompanied by using a stimulant, it can cause some of the most realistic and insane hallucinations. I used to take 4-6 of my dose and sniff ethylphenidate (ethyl not methyl) or pyrovalerones/cathinones and would have a lot of conversations with people who were not there. Anyway sorry. Really stupid. But thank you for the bump in support for the sleep study idea.

I will mention it to my doctor the next time I see him and see if I can work something out. I will be making an appointment with my primary care soon anyway ~ I am working on medical clearances for some schooling and waiting on some test results to go further.

Its just odd. It really did happen as soon as I began the suboxone. But perhaps I was already stressed to the hilt (I was at the time) and something pushed me over the margin to have pronounced sleep issues. Things have been unusually stressful lately in a different way than I am used to and am dealing with a situation that I honestly feel like I am reliving childhood trauma. I wont say it but I feel very alone and trapped with this problem. Maybe it's the main contributing cause.

jennjenn wrote:
The reason I said that about ur sweet doggie was because u said u found her upstairs. That made me think that's why she was up there.... it may have freaked her out a little bit. Dogs are so incredibly smart and they sense anything different with their human. I have an inside bunny lol if I ever wake up at night, when I open my eyes he's staring at me (because rabbits mostly sleep during the day) and he thinks I'm going to let him out of his crate that stays closed during the night while we sleep. If I were to sleepwalk he'd be more concerned about getting out, but doggies are different and worry about their owners, it's so sweet. I miss having a dog at times, I just don't have the patience to house train one. Anyway I'll stop rambling!


Hahaha I knoww. It was a thought of mine when I couldnt find her and realized she was upstairs lol. I was like... poor Iggy I wonder what the hell she witnessed lol and if I totally freaked her out. I checked on my mom and she was still asleep so, I couldnt have had a pots n pans party lol. Who knows. Thats so funny about waking up to a staring bunny. My dog does the same thing. If I sleep in the livingroom, if she is not cuddling with me as we sleep, she is laying on the couch on the opposite side of the room so she can stare at me lol and I wake up to doggy eyes.

Since the dog is brought up, I put my alias the name as my dog because she has been such a huge part in my recovery. I fully believe in serious power that dogs can have in a persons recovery after her. It has been truly amazing how much she has helped me. I got her 2 weeks before I began suboxone therapy. I owe so much of my perspective to her and if anyone is considering it (getting a dog in recovery) my answer is YES! :P

Thanks everyone


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PostPosted: Wed Aug 02, 2017 4:52 pm 
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This is a great thread iggi, and I love the fact that you used your dog's name as yours here on the forum. I can't add much to the sleepwalking issues but I will say that I got my dog Cupcake About a month after I got on Suboxone. I call her my recovery buddy. She means so much to me. I also have another dog that is basically my moms dog but she loves us all. We have had her for a few years now. They are a big part of my life as you all can imagine. I am around my dogs way more than I am around other people, and I am just fine with that. They never disappoint me. Anyway take care of yourself iggi, and that sweet dog of yours. Your forum friend, Angie


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PostPosted: Mon Aug 07, 2017 10:46 pm 
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Thats awesome Bamagurl22 :) Someone knows the power of the pup. Im also around my dog more often than people lately. But shes a solid best friend. I like to know that in this world it is possible for a creature to exist that just has to befriend for survival. She just does her thing, and its awesome. If it were not for her, I am sure of it I would have at least got close to relapsing in the last 4 months. Ive had a lot of hard things going on around me since getting clean and shes always been there for me. I fell asleep with my head on her belly last night lol. We usually share the same pillow lol but last night she was the pillow for me. Shes a pitbull. White/Caramel with a black patch over one eye, and grey cow spots all over her belly.

Well, I just wanted to update. Last night I did the sleepwalking routine exceedingly bad but I have a DR's appointment for the 16th. I woke up in different beds twice, woke up standing in the livingroom with kitchen mittens and a measuring cup on the floor in front of me. I cant imagine what I looked like. Something neurological is going on majorly. Yesterday during the day I went for a nap... and it was like I was experiencing dreams, wide awake. I could not fall asleep, but my mind went on storylines of dreams and I could see some of it. If I opened my eyes and sat up it went away, but laying back down and closing my eyes it started up again. Today I have been a trainwreck.. just completely exhausted. It is 7:40pm and I just finally feel "awake".


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PostPosted: Tue Aug 08, 2017 10:58 am 
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Oh yeah iggy, for sure happy u have that doctor appointment. What if you'd have turned the stove on or something, it could have been so much worse. What does ur family say about these occurrences? Are they worried for u or keeping an eye on u? I can only imagine how exhausted u are, when I get really sleepy (after I've missed a bunch of sleep) I'm an emotional mess. Sleep has always been a big factor on if my day is good because I'm not a person who can still go on with their day if they miss sleep lol.

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