Guest guest Posted August 15, 2004 Report Share Posted August 15, 2004 Insomnia Paradoxically, insomnia is often a side effect of opioid medication. If it is found that one of the opioids causes sedation (usually Methadone or Morphine), this medication may be reserved for use at bed time. If a patient awakens in pain, a long acting form of Morphine may be used at bedtime (MS Contin). Increasing the level of physical activity and exercise helps to promote sleep, as does keeping to a consistent schedule. Some patients have benefited from Melatonin, the hormone the body produces to induce sleep, which is available without a prescription. If these strategies are not successful, insomnia may be treated with medication which do not have a significant risk of respiratory depression. The anti-depressant medications, such as Desyrel (Trazadone) 50-100 mg or Pamelor(Nortriptyline) 25-50 mg at bed time are safe for this purpose. In many patients the use of stimulants, such as Ritalin or caffeine, early in the day may improve sleep at night by promoting daytime physical activity and, perhaps, as a rebound effect from the stimulant. Occasionally, such sedating medicines as Valium or Serax (Oxazepam) may be necessary, although these medications pose a higher risk of respiratory depression and are often associated with worse pain control and psychological depression. I hope this finds you and yours well Mark E. Armstrong casca@... www.top5plus5.com PAI NW Rep ICQ #59196115 Quote Link to comment Share on other sites More sharing options...
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