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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Severe Insomnia While On Clonazepam?

I have taken clonazepam for restless legs for at least 10 years. About 5 years ago I tried to get off of it under the direction and observation of my general practitioner using a extended time and gradually decreasing the dose which by then was 4 mg each evening. But I had a terrible reaction with insomnia which increased in severity over time until I had a period of 3 weeks with almost no sleep. Tried sleep medications but they did not help. So I went back to the 4 mg per night. I have interrupted sleep for the first 4 hours with the restless legs sleeping in chunks of 1 hour each time. Then about 4:00 am I usually get 4 hours of uninterrupted sleep until 8:00 am. My question is this enough sleep or should I try again to get off it and can I do without the insomnia?
Wed, 3 Oct 2018
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General & Family Physician 's  Response
Hi,

Insomnia is a quite frequent disorder. Among them, we have the difficulty to reconcile sleep, the difficulty to maintain it, and/or the sensation of not having rest.

However, we must have in mind that as we get older, sleep hours become shorter. The management of this disorder is done by psychiatry.

Now, your body is the one to tell us, if those 4 hours are enough. In other words, do you feel like you rest with those 4 hours?

Are you sleepy during the day? heavy? weak? your answer according to what you comment is probably that you do not rest.

On the other hand, clonazepam is a benzodiazepine; a medicine with multiple uses, among these, insomnia.

However, its use is recommended for only 2 weeks at the beginning of the insomnia treatment in combination with another medication. Why?

Clonazepam like other benzodiazepines has the peculiarity of being a drug that produces dependence and tolerance; if you suspend it abruptly you will develop a variety of symptoms due to this, and each time you will need a higher dose to achieve the same effect.

Therefore even though it was gradually withdrawn, you could be showing a rebound effect. The best thing you should do is to have an appointment with a psychiatrist so he can handle this disorder in the best way.

Hope I have answered your query. Let me know if I can assist you further.

Take care

Regards,
Dr Luis Alberto Urdaneta Arenas, General & Family Physician
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What Causes Severe Insomnia While On Clonazepam?

Hi, Insomnia is a quite frequent disorder. Among them, we have the difficulty to reconcile sleep, the difficulty to maintain it, and/or the sensation of not having rest. However, we must have in mind that as we get older, sleep hours become shorter. The management of this disorder is done by psychiatry. Now, your body is the one to tell us, if those 4 hours are enough. In other words, do you feel like you rest with those 4 hours? Are you sleepy during the day? heavy? weak? your answer according to what you comment is probably that you do not rest. On the other hand, clonazepam is a benzodiazepine; a medicine with multiple uses, among these, insomnia. However, its use is recommended for only 2 weeks at the beginning of the insomnia treatment in combination with another medication. Why? Clonazepam like other benzodiazepines has the peculiarity of being a drug that produces dependence and tolerance; if you suspend it abruptly you will develop a variety of symptoms due to this, and each time you will need a higher dose to achieve the same effect. Therefore even though it was gradually withdrawn, you could be showing a rebound effect. The best thing you should do is to have an appointment with a psychiatrist so he can handle this disorder in the best way. Hope I have answered your query. Let me know if I can assist you further. Take care Regards, Dr Luis Alberto Urdaneta Arenas, General & Family Physician