Opiate or alcohol withdrawal symptoms can be unpleasant, uncomfortable, and painful. One common symptom is insomnia, which tends to linger.
Withdrawal insomnia can include one or more of the following:
- Difficulty falling asleep at night
- Waking frequently during the night
- Poor sleep that is chronically not restorative
Withdrawal is physically taxing and good, restful sleep can help limit the severity of your other opiate detox symptoms, as well as help promote healthy habits and decrease the chances of relapse.
How to Sleep During Withdrawal
Insomnia is a common post-acute withdrawal symptom that can last much longer than normal withdrawal, so it’s best to start as early as possible by prioritizing sleep. The more disciplined you are, the quicker your insomnia and potentially all of your withdrawal symptoms can disappear.
1. Seek Professional Help with Withdrawals
Going to a Suboxone clinic or alcohol detox dramatically improves all of your symptoms, including your sleep. For example, medications like Suboxone for opioid addictions will improve all withdrawal symptoms making sleep much easier.
When starting Suboxone, a doctor may also prescribe a few days of sleep medication. It’s not ideal to rely on sleep medications long-term because they become habit-forming and the sleep is not as restorative, but it may be an option on the most intense days.
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2. Establish a Sleep Routine
Try to go to bed and wake up at the same time, even on weekends. Your body will fall in line if you stick to the schedule.
Wind down before bed with quiet activities, like reading or doing anything that will relax you before going to sleep. Try to limit your television watching before bed. If you do watch TV, keep it light. Maybe watch a comedy that puts you in a good mood.
You can also try drinking a warm cup of caffeine-free tea before bed. Meditation or yoga can also put your mind at ease.
And, stay active during the day. Creating a daily routine not only keeps your mind occupied, but it can make you more tired at the end of the day and help you get to sleep.
3. Be Careful with Naps
Naps aren’t always helpful. Avoid taking any long naps, and limit to 20 minutes maximum. If it’s already after 2 PM, it’s too late for a nap, because it could ruin the sleep patterns you’re working hard to build.
Naps are also better proactive than reactive. So, nap on days where you know you won’t get as good of sleep rather than days after you already missed sleep. And, limit time in bed to form the association of sleep with the bed.
4. Reserve the Bed for Sleep
“If you have insomnia you should train your brain that your bed is only for sleeping and sex. Don’t lay in your bed watching TV, be on your phone or even just relaxing during the day. Train your brain that bed is only for sleep and do any other relaxing activities on the couch or chair in another room. That way, your brain only sees the bed for its intended purposes and helps to associate sleeping with laying in your bed.”
5. Set the Right Mood
Our sleep schedules are naturally synced with light. Try to keep it bright during the day and less so in the evening, and fully dark as you sleep. Turn your phone light to the lowest setting if using before bed, but try to avoid screen-time whenever possible.
And, keep the room cool. Your body temperature naturally decreases by a few degrees when you sleep, and a cooler room can help you avoid waking up from being too hot.
6. Use Substances with Care
Avoid Caffeine after 10AM
Caffeine is common in recovery. But, keep in mind that twelve hours after you drink it, a quarter of the caffeine can still be in your system. That’s like drinking a quarter of that coffee or energy drink right before you go to bed and expecting to fall asleep. You can still have caffeine, but try to cut it off before 10 AM.
Alcohol Won't Give Good Sleep
If you’re withdrawing from alcohol, staying away from alcohol is obvious. It may feel like the sedative effects of alcohol will help get to sleep, but your sleep quality will be much worse and the sleep will be shorter than without alcohol. Alcohol is known to throw off REM sleep cycles and produce disrupted sleep. You will wake up feeling better without using alcohol.
Melatonin Can Be Helpful
Melatonin is produced naturally in the body to help tell your body it’s time for bed. If your clock is off, melatonin in liquid, pill or gummy form can help. The downfall is that if you rely on it too much, your body may stop producing melatonin naturally.
Many Melatonin Doses Are Too High
Many U.S. melatonin products have way too much per dose because consumers perceive that more means better. Instead, try to take the lowest dose that still works for you (around 3mg should be fine). It’s not meant to put you to sleep, but to as an aid to your other sleep hygiene habits.
Other Sleep Medicines Won't Give Good Sleep
Some patients use ZzzQuil to help with sleep. On rough nights, sleep medications can be a reasonable option for the short term. But, like alcohol, these medications have been shown to reduce sleep quality.
Don't Use Kratom
While some on Reddit cite the use of Kratom for withdrawal insomnia, this drug is addictive and also comes with physical withdrawals. And, these withdrawals are actually commonly treated with Suboxone.
Using Kratom for sleep is more likely to lead to relapse than healthy sleep!
7. Learn to Still Your Mind
Instead of trying to control racing, stressful or random thoughts, try to have no thoughts. If a thought comes to your mind, don’t get frustrated or run with that thought. Let it gently float away until you’re back to having no thoughts. If you’re having trouble, focus on your breathing. Don’t fight against your mind, but quiet it peacefully.
Learning to still your mind is the most transformative mental health exercise. Unlike chasing happiness, it teaches you how to feel peace regardless of your circumstances. It makes you more resilient against relapse and also helps you get to sleep quicker.
Combining these sleep hygiene tools and recommendations will help you establish good sleep habits and can even eliminate sleep issues. Early recovery is the perfect time to make these changes part of your nighttime routine. Once you develop good sleep patterns, it is much easier to stay consistent.
8. Understand the Importance of Sleep
Some of the tips above you already knew, but were not applying. Unfortunately, there’s no quick fix. Getting good sleep after addiction takes practice and discipline.
While it can be hard to not use your phone in bed and to practice meditation, sleep is an important pillar of good health. It’s worth it!
The Healing Properties of Sleep
- Triggering the release of hormones that repair cells and tissues
- Supporting the entire immune system
- Slowing brain aging
- Helping you process and regulate your emotions. (This is why you feel less extreme about your feelings the next day. The expression "sleep on it" is actually true).
Also, patients’ sleep gets better over time. Sometimes it takes weeks or months, but your body should adjust. Don’t assume you will have to live with these issues forever.
Just like in addiction, accepting your sleep issues and being proactive but gentle with yourself is the best advice.
43 Comments
I was an IV heroin / fentanyl user most of my life. I am now 15 days clean, currently on 8mg of Suboxone. I cannot sleep well at night. I’ve been taking a few milligrams of melatonin before bed. Is that okay? What else can you suggest? I still get the chills a lot.
Congrats on 15 days! Melatonin can be helpful to alert your body that it’s time for sleep. Avoiding alcohol and caffeine helps too. For the chills, medications like clonidine can sometimes help but should be prescribed by your doctor as it can affect blood pressure. Also, try layering blankets, so you can adjust when needed. The first few weeks are the hardest, but sleep should come easier with time!
Another major consideration is whether you are on the right dose of Suboxone. If you have significant withdrawal symptoms still, you may need to maintain a dose higher than 8mg. This should be discussed with your Suboxone prescriber to see if it is an appropriate change for your particular situation.
Congratulations, Peter!! Hang in there. You are on the right track. Keep You eyes/mind on where YOU want to be, the rest of you will follow. Stay positive!
I’ve been on Suboxone for 8 months after a 1.5 year heroin problem. Now I want to be quit that too. Exercise and drinking lots of water helps with Suboxone w/d symptoms but getting sleep is tough. Most of the time taking the smallest amount of Suboxone (1-2 mg) is enough to help, along with Tylenol PM and a 3mg Melatonin. But, how can I stop taking even a small amount of Suboxone and still get some sleep?
Weaning off of the last 2mg of Suboxone is usually the toughest. If you are feeling opioid withdrawal while tapering, then that means you need to taper more slowly. Some patients find it helpful to cut the Suboxone film into halves or even quarters to make it easier to taper off those last 2 mg. Once you reach the 2mg/day Suboxone dose, Id recommend decreasing your daily dose of Suboxone by a maximum of 0.5mg each month. Another option would be to have your medical provider prescribe you a medication such as Trazodone or Hydroxyzine that can help with your insomnia related to opioid withdrawal.
I take Suboxone in small doses. I cut one 8 mg strip into eight pieces and take 1 mg a day or 1 mg every other day. However, I found that taking it in this small dose has the opposite effect of what it does when taken in large doses. 45 minutes to 1 hour after taking a 1 mg dose I will do something (push-ups, pull-up) that requires a short burst of energy and it’s almost as if Suboxone carries that energy through the rest of the day. Should I be getting as much energy as I do from a small dose of suboxone?
Suboxone binds to the opioid receptor in your brain, which increases the release of the neurotransmitter dopamine. Dopamine release helps to reduce pain, increase euphoria (pleasant feeling), and increase motivation to do tasks. Some patients even experience energizing effects when taking Suboxone and if taken too late in the day it can cause insomnia. In your situation, since you have lost most of the tolerance to the Suboxone since weaning and are now more sensitive to a smaller dose, that may explain why you are feeling more energizing side effects from it now compared to when you were at a higher dose.
I started smoking weed a year ago. Does that impact sleep? Can anti depressants interfere with your sleep?
Yes, chronic use of cannabis does impair sleep. Most anti-depressants will release serotonin in the brain, which can cause a sensation of calm and relaxation, but this can sometimes make people drowsy. Other anti-depressants have more energizing effects (i.e. Effexor / Venlafaxine) because they also release norepinephrine, which has a more energizing effect and can sometimes cause difficulty falling asleep.
I used suboxone for 15 years. It took me 7 months to ween off and ive been totally clean for just under 6 months. my insomnia is still problematic to say the least. ill fall asleep about 10pm, but without fail, ill wake up every night between 2am and 3am. then ill toss n turn constantly until 545 am when i get up for work. i use medical marijuana on the bad nights, it really does help. but is there another option because my work frowns on using medical marijuana. which is silly because they had no problem with suboxone, makes no sense. any advice with my insomnia? thanks
It sounds like you are experiencing insomnia due to post-acute withdrawal syndrome (PAWS), which can sometimes last for months or even years after stopping chronic use of an opioid. Sleep restriction therapy and cognitive behavioral therapy for insomnia (CBT-I) are very effective at treating insomnia (more effective than medications). This can be performed by a counselor/therapist or psychologist. If that still isn’t helping enough then there are insomnia medications such as zolpidem (Ambien), eszopiclone (Lunesta), and doxepin (Silenor), that are helpful for sleep maintenance.