Will Suboxone Make You Sleepy?

While Suboxone is overall considered an effective, evidence-based treatment for opioid use disorder, it can make people feel sleepy — at least when they first start taking it. 

This sleepiness usually gets better over time, but there are also strategies to alleviate sleepiness as your body adjusts. 

Why Does Suboxone Make You Feel Sleepy?

Many people report feeling tired when first taking Suboxone or other buprenorphine-based treatments for OUD. 

Buprenorphine is a partial opioid agonist medication. It therefore, just like any other opioid medication, has the potential to make patients feel sleepy, sedated, dizzy or otherwise drowsy. [1]

The exact mechanisms by which Buprenorphine causes sleepiness are not totally understood. Buprenorphine can affect adenosine levels in the pontine reticular formation (PnO) and in the substantia innominata (SI), two parts of the brain important for sleep. In reducing the presence of adenosine in these sleep regulating areas of the brain, sleep may be affected. [1] . 

All that being said, patients whose bodies are accustomed to opioids (“Opioid experienced”), especially in high doses when recovering from an opioid use disorder, usually do not experience significant sleepiness or sedation. 

On the other hand, patients who are “opioid naive” (not used to taking opioids) who may be taking Suboxone for pain or another indication other than OUD, may experience more drowsiness than individuals who are “opioid experienced”. 

Suboxone, Addiction & Fatigue

Patients on Suboxone are generally trying to quit opioid misuse. A long history of opioid use itself, as well as the physical and mental process of recovery, can be demanding. 

In addition, many people struggling with opioid use disorder also have co-occurring mental health disorders like depression. Many mental health issues, depression included, are known to make people feel more tired. 

So is it the medication causing fatigue, or the recovery process itself? Perhaps a combination of both. 

If you are just starting Suboxone therapy and notice sleepiness or fatigue, be patient! It can take anywhere from days to several weeks for your body to fully adjust. Fatigue and sleepiness tend to improve drastically as your body becomes accustomed to this medication. 

Tips for Reducing Suboxone-Related Fatigue

If you’re feeling fatigued while in recovery, whether it’s due to Suboxone use or just because of the recovery process as a whole, there are some options to improve your sleepiness: [2]

• Seek treatment for any mental health issues co-occurring with your substance misuse, which may be affecting your sleep.
• Sleep on a schedule if possible. You may benefit from planning for longer than the normal 8 to 9 hours that is often considered ideal to account for taking extra time to fall asleep or occasionally waking up at night.
• Set up a good sleep environment. Make sure your bedroom is dark, quiet, and cool.
• Try mindfulness meditation practices to help calm the mind and improve rest.
• Avoid stimulants - including large amounts of caffeine - multiple hours prior to bed 
• Avoid screen time or cell phone use at least an hour prior to bed, as light from TV, phones or other screens can stimulate the brain and make it harder to sleep 
• Go outside: natural bright light can help to encourage normal sleep patterns and make you more wakeful in the day. Limit screen use before bed, as this has been shown to disrupt natural sleep patterns.
• Exercise regularly, which can both help to improve energy levels during the day and sleep when it’s time for bed. 

Rest Assured That Your Sleep Will Improve

While it’s fairly common for people to have sleep disturbances in the first days to weeks of addiction treatment, these symptoms improve rapidly as you become more stable in your recovery. [3] Patience is important! Give your body the time it needs to acclimate to this new medication. 

Talk to Your Doctor About Feeling Tired on Suboxone

If you continually feel tired even after you’ve been taking buprenorphine for several weeks, or you are so sleepy that you’re worried you’ll fall asleep during the day, especially while doing things where it would be unsafe, like driving, talk to your doctor. He or she may be able to reduce your dose or prescribe additional medications to normalize your sleep.

Sources

1. Buprenorphine Disrupts Sleep and Decreases Adenosine Levels in Sleep-Regulating Brain Regions of Sprague Dawley Rat. Anesthesiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3197808/. October 2011. Accessed November 2022.
2. Treating Sleep Problems of People in Recovery From Substance Use Disorders. Substance Abuse and Mental Health Services Administration. https://store.samhsa.gov/sites/default/files/d7/priv/sma14-4859.pdf. 2014. Accessed November 2022.
3. What Is Buprenorphine Treatment Like? The National Alliance of Advocates for Buprenorphine Treatment. https://www.naabt.org/education/what_bt_like.cfm. Accessed November 2022.