in Sleep Medicine

Have You Used Gabapentin for Insomnia?

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Have you used Gabapentin for Insomnia?

Gabapentin is not approved for treating insomnia but since it acts on the GABA receptors, it can make you sleepy.

In fact, one study evaluated Gabapentin for insomnia and found that:

  • Gabapentin improves slow-wave sleep
  • It improves sleep quality, and 
  • It is associated with reduced arousal after sleep

Gabapentin is not primarily used to treat insomnia but it is one of the best options where sleep is an issue along with another compelling FDA-approved indication such as:

  • Pain and neuralgia after shingles (post-herpetic neuralgia)
  • Restless legs syndrome, and
  • Epilepsy

Gabapentin is also used as an off-label treatment for many other conditions.

These are listed below [Ref]:

  • Anxiety, Depression, and Bipolar disorder

    • There is limited data but studies have shown a favorable response of gabapentin in relieving psychiatric symptoms, especially anxiety and alcohol use disorder.

  • Neuropathic pain including diabetic neuropathy

  • Fibromyalgia

    • Gabapentin in a dose of 300 to 800 mg per day has been associated with an improvement in symptoms of pain and fatigue associated with fibromyalgia

  • Hot flashes (post-menopausal)

  • Alcohol withdrawal symptoms

    • Gabapentin in a dose of 1200 mg daily was found to be effective in treating symptoms of alcohol withdrawal [Ref]

  • Irritable bowel syndrome

  • Nausea and vomiting

  • Headache and migraine (as a prophylactic treatment)

  • Pain after a surgical procedure

  • Essential tremors

  • Interstitial cystitis

  • Social phobia

  • Refractory cough

  • Itching, and

  • Insomnia

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Gabapentin for Insomnia and Medical Illnesses:

Various studies have found gabapentin in different doses to be effective in improving sleep quality and reducing arousal during the night.

The studies are summarized in a table format below:

StudyGabapentin Dose for Insomnia vs PlaceboImprovementNo Improvement
Gabapentin for insomnia and Restless Legs Syndrome [Ref]Gabapentin dose: 1200 mg daily
  • Sleep Quality
  • Next-day functioning
  • Decreased number of nighttime awakenings
  • Reduced number of hours awake
  • Prolonged total sleep time after 2 weeks
  • No significant difference in total sleep time after 12 weeks
Gabapentin Enacarbil for insomnia and restless legs syndrome [Ref]Gabapentin dose: 600 and 1200 mgReduced average daily wake time after sleep onsetNo increase in total sleep time
Gabapentin for insomnia and HIV-associated painful neuropathy [Ref]Gabapentin dose: 400 – 1200 mg/dayImproved mean sleep interference score 
Gabapentin Enacarbil for Insomnia and Restless legs syndrome [Ref]Gabapentin dose: 600 to 2400 mgImprovement in all sleep indices, including:

  • the overall quality of sleep,
  • ability to function,
  • fewer awakenings during the night, and
  • less than 1 h awake per night
 
Gabapentin for insomnia and alcohol use disorder [Ref]Gabapentin dose: 1,800 mgImproved Sleep Quality 
Gabapentin for insomnia and postherpetic neuralgia [Ref]Gabapentin dose: 1,800 – 2,400 mgImproved mean sleep interference score 
Gabapentin in patients with phantom limb pain and insomnia [Ref]Gabapentin dose: 300 mg to 2400 mg–No difference in the mean sleep interference score
Gabapentin for insomnia and alcohol dependence [Ref]Gabapentin dose: 300 to 1500 mgImprovement was noted in both groups 

The studies mentioned above show that gabapentin may improve sleep quality and sleep time, especially in patients with comorbid medical conditions such as:

  • Neuropathic pains with insomnia,
  • Post-herpetic neuralgia with insomnia,
  • Restless leg syndrome and insomnia, and
  • Alcohol use disorder and insomnia

However, data is minimal regarding its efficacy in treating primary insomnia.

Avoid Gabapentin Use in the following conditions:

  • If you are allergic to gabapentin
  • If you have advanced liver disease. People with advanced liver disease may go into a coma (portosystemic/ hepatic encephalopathy)
  • If you have a chronic respiratory condition. People with chronic lung disease may develop fatal respiratory failure.
  • If you are using other sleep medicines.
  • If you have a muscular disorder such as polymyositis or myopathy. You may develop respiratory depression.

Here 👇 is a poll to see how many people have actually used gabapentin for insomnia …

  • Question of

    Have you used Gabapentin for insomnia?

    • Yes
    • No
  • Question of

    Is Gabapentin effective for insomnia?

    • Yes
    • No
  • Question of

    What dose of Gabapentin did you use?

    • 100 mg
    • 300 mg
    • Other
  • Question of

    What other medical conditions you had?

    • Restless leg syndrome
    • Neuropathic pain including Diabetic Neuropathy
    • Shingles
    • Epilepsy
    • Anxiety
    • Headache
    • Fibromyalgia
    • Hot flashes
  • Question of

    Do you recommend Gabapentin for Insomnia?

    • Yes
    • No
  • Question of

    Which drug is best for insomnia?

    • Gabapentin
    • Pregabalin
    • Melatonin
    • Lunesta
    • Ambien
    • Sonata
    • Lunesta
    • Belsomra
    • Dayvigo
    • Quiviq
    • None

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Written by Dr. Ahmed

I am Dr. Ahmed (MBBS; FCPS Medicine), an Internist and a practicing physician. I am in the medical field for over fifteen years working in one of the busiest hospitals and writing medical posts for over 5 years.

I love my family, my profession, my blog, nature, hiking, and simple life. Read more about me, my family, and my qualifications

Here is a link to My Facebook Page. You can also contact me by email at contact@dibesity.com or at My Twitter Account
You can also contact me via WhatsApp 🙏

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