Tramadol & Insomnia: Is This Opioid Treatment for Severe Pain Making You Tired?

Tramadol is a prescription opioid medication that is typically prescribed for the treatment of moderate to severe pain, depending on your medical history and your prior experience with opioid analgesics. It may also be prescribed to treat joint pain or chronic pain, as well.  It is available in immediate-release and extended-release tablet forms, as well as an extended-release oral capsule. Tramadol is considered to be controlled, meaning that it can only be used under the close supervision of the healthcare provider that prescribed it to you. 

You may know tramadol by some of the following brand names; Ultram, ConZip, Rybix ODR, and Ultracet. 

How Does Tramadol Work? 

Tramadol works by altering the way that your brain detects pain. It is similar to the substance in your brain known as endorphins. Endorphins bind to receptors and decrease the number of pain messages that your body sends to your brain. When you take this substance, it works in a similar way. 

Opioid drugs block pain by acting on opioid receptors in the body. They also increase feelings of well-being and produce a mellow high when abused, creating a risk of addiction. All of these factors—heart rate, blood pressure, breathing rate, and body temp—all decrease, which helps ease tension and produce calmness. Some opioid painkillers are among the most commonly abused prescription drugs in the United States, possibly because they produce pleasurable sensations when used recreationally.

Tramadol increases the levels of dopamine present in the brain by acting on its opioid receptors, similar to other opioid treatment options, but it also inhibits the reabsorption of norepinephrine and serotonin. Similar to the way that many selective serotonin-norepinephrine reuptake inhibitor (SNRI) antidepressant medications work. This method of action is different from most traditional opioids, having both analgesic and antidepressant effects at the same time. 

Side Effects of Tramadol

When used as directed by a medical professional, tramadol effectively treats moderate to severe pain. But, when it is used for non-medical purposes, tramadol can cause people to experience a high, leaving them feeling relaxed with less pain, decreased anxiety, and a better mood.

Even when used as prescribed, the pain relief that you experience may come at the cost of some additional side effects. Including, dizziness, lightheadedness, dry mouth, heartburn, loss of strength, shallow breathing, skin irritations or skin rashes, and disturbances in your normal sleep patterns. Due to drowsiness and fatigue being common side effects of tramadol, it is not recommended that you drive or operate heavy machinery after taking the medication. Some of the less common adverse effects associated with tramadol include hives and confusion.  

When the extended-release formations of tramadol are altered in any way (such as, injected, smoked, chewed and swallowed, or crushed and snorted) the effects are likely to be intensified. An extended-release formation is made to slowly enter the bloodstream over a longer period of time. But when altered and taken in a different way than intended, the entire dosage is sent into the bloodstream all at once. This increases the risk of overdose and can lead to adverse effects such as stomach cramps, nausea, dizziness, and drowsiness. Extended-release tablets are not recommended if you have severe liver problems or a history of kidney disease, even when used as prescribed. 

Non-medical purposes tramadol use can lead to feelings of euphoria when taken in higher doses, although it is a depressant and gene rally provides relaxing effects. When abused or taken in combination with another substance, it is known to have a mild euphoric feeling that is similar to that of heroin. 

The side effects of this substance generally occur as soon as you take it, and they may fade away once your body adjusts to the medication. If any of the side effects appear to be persistent or long-term, you should speak with a healthcare professional. Long-term adverse effects may include dependence, muscle spasms, difficulty sleeping, stomach pain, or serotonin syndrome. All of which can be difficult to deal with and may require the assistance of a medical professional. 

Withdrawal From Opioid Pain Medication

Drug withdrawal is common among individuals who have become dependent on drugs, such as opioids. A common sign that you are becoming dependent on a drug is when you begin to feel that the dosage you are taking is no longer providing you pain relief. 

Once you are dependent on the substance and you attempt to quit or stop taking that substance, it is likely that you will begin to experience withdrawal. Withdrawal symptoms from tramadol are similar to those of other opioids. Including cold sweats, muscle aches, nausea, loss of appetite, vomiting, diarrhea, changes in your breathing, runny nose, and more. In addition to these symptoms, insomnia is one of the most common symptoms of tramadol withdrawal. 

Is Tramadol Making You Tired? What One Study Tells Us About This Drug and Its Relation to Insomnia

If you’re experiencing increased drowsiness or unusual tiredness while taking tramadol it can be kind of confusing. While it’s likely that you are extra tired, you might also be experiencing difficulty sleeping. One study shows that while tramadol can often make you feel tired or sleepy, it is more commonly associated with insomnia, despite the fact that opioids are known to produce sedation, fatigue, and sleepiness. Insomnia is a common sleep disorder that makes it difficult for you to fall asleep and stay asleep. Insomnia is also known to wake you up early in the morning and make it seemingly impossible to get back to sleep. Oftentimes, this leads to you still feeling tired when you wake up in the morning. 

It may also be confusing if you’re experiencing this side effect of tramadol because like most opioids, this is a central nervous system depressant. So how can it be disrupting your sleep and making you more tired during the day? 

Tramadol can also lead to other sleep-related issues, like sleep apnea leading to sleep disturbances and a change in healthy sleeping patterns. Research has shown that the dose of tramadol determines what effect it has on your sleep. The study shows that lower doses tend to keep you awake in the first hour. While a higher dose tends to promote sleep initially, but then induces wakefulness later on, disturbing your normal sleep patterns. 

Unfortunately, there isn’t a significant amount of research that tells us why opioids disturb sleep. However, we do know that they do disturb sleep patterns by blocking access to the deeper restorative stages of sleep, also known as rapid-eye-movement sleep. You may also know rapid-eye-movement sleep as REM. REM sleep is important for you in order to get a full night’s rest, as well as, learning, making, and retaining memories. It is normal for rapid-eye-movement sleep to naturally decrease as you age, which may explain in part why memory problems are more frequent in the elderly.

Frequently Asked Questions

No, due to possible drug interactions you should not consume alcohol while taking this drug. Tramadol and alcohol are both CNS depressants, the combination of these substances will dramatically increase your risk of overdose. In more severe cases, extreme drowsiness, respiratory depression, and even death can occur. Other medications to avoid include other opioids, benzodiazepines, tranquilizers, antipsychotics, and muscle relaxants.
Tramadol can have a different effect on everyone. After taking it, you should avoid driving, operating machinery, or engaging in any dangerous activities that require mental alertness. Because tramadol causes drowsiness and sleepiness, you should avoid these activities such as driving until you know how your body reacts to the drug.
Yes, this substance is addictive. Even when used as directed by a medical professional, tramadol is a synthetic habit-forming opioid medication that has the potential for abuse. If you have a history of substance use or mental health disorders, you should make your physician aware and ask for non-opioid pain medicine that has less abuse potential and a lower risk for addiction.
Using this medication while pregnant can lead to neonatal withdrawal syndrome in your baby. Babies born to mothers that have taken this drug for long periods of time may experience severe withdrawal symptoms, sometimes these symptoms may even be fatal.

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