Insomnia is a sleep disorder that regularly affects millions of people worldwide. Someone with insomnia finds it difficult to fall asleep or stay asleep. According to the Centers for Disease Control and Prevention (CDC), adults need at least 7–9 hours of sleep every 24-hour period, depending on their age.
At some point, many adults experience short-term (acute) insomnia, which lasts for days or weeks. It’s usually the result of stress or a traumatic event. But some people have long-term (chronic) insomnia that lasts for a month or more.
Research shows that around 25% of people in the United States experience insomnia each year, but around 75% of these people do not develop a long-term problem. Insomnia can sap not only your energy level and mood but also your health, work performance, and quality of life.
What is Gabapentin?
Gabapentin capsules, tablets, and oral solutions are used along with other medications to help control certain types of seizures in people who have epilepsy. Gabapentin capsules, tablets, and oral solutions are also used to relieve the pain of postherpetic neuralgia (PHN; the burning, stabbing pain or aches that may last for months or years after an attack of shingles).
Gabapentin extended-release tablets (Horizant) are used to treat restless legs syndrome (RLS; a condition that causes discomfort in the legs and a strong urge to move the legs, especially at night and when sitting or lying down). Gabapentin is in a class of medications called anticonvulsants.
Gabapentin treats seizures by decreasing abnormal excitement in the brain. Gabapentin relieves the pain of PHN by changing the way the body senses pain. It is not known exactly how gabapentin works to treat restless legs syndrome.
Gabapentin is also sometimes used to relieve the pain of diabetic neuropathy (numbness or tingling due to nerve damage in people who have diabetes), and to treat and prevent hot flashes (sudden strong feelings of heat and sweating) in women who are being treated for breast cancer or who have experienced menopause (”change of life”, the end of monthly menstrual periods).
Does Gabapentin help with sleep?
Yes, studies have shown that when used off-label for sleep, gabapentin can enhance slow-wave sleep (“deep sleep”) in patients with primary insomnia. Gabapentin can also improve sleep quality by elevating sleep efficiency and decreasing spontaneous arousal.
- The studies showed that gabapentin may help people with primary insomnia and occasional sleep disturbance improve total sleep time and wakefulness in the morning.
- In other studies, it appears that gabapentin may improve sleep in people with other medical conditions that make it more difficult to sleep, such as alcohol dependence, hot flashes, and bipolar disorder.
In a large review of 26 studies on gabapentin and sleep in patients with other medical conditions, the average dose taken daily was about 1,800 mg. Although positive sleep outcomes were reported, the researchers noted that gabapentin was not tolerated as well as placebo, and some patients stopped taking it. Misuse and abuse of the drug have also been reported.
It takes about 2 to 3 hours for immediate-release gabapentin to reach its fullest effect, and it’s typically taken 3 times per day.
Off-label prescribing is when a physician gives you a drug that the U.S. Food and Drug Administration (FDA) has approved to treat a condition different than your condition. This practice is legal and common. In fact, one in five prescriptions written today are for off-label use.
How long before bed should I take gabapentin for sleep?
You should take the drug at least 2 to 3 hours before bed because peak concentrations of gabapentin (immediate-release) occur within that period. Although gabapentin may improve sleep problems due to nerve pain within a week, it may take up to two weeks for symptom relief from nerve pain to occur.
How to take gabapentin for insomnia?
Most doctors often recommend 100-400 mg when prescribing gabapentin off-label for insomnia, This dose is usually taken once a day before you’re ready to go to bed.
In most cases, your doctor may start you off with a lower dose and adjust as needed. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take gabapentin exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor.
Gabapentin extended-release tablets cannot be substituted for another type of gabapentin product. Be sure that you receive only the type of gabapentin that was prescribed by your doctor. Ask your pharmacist if you have any questions about the type of gabapentin you were given.
Is gabapentin a narcotic or controlled substance?
Gabapentin is not a narcotic. It’s not classified as a controlled substance in most states. (Kentucky, West Virginia, Michigan, Tennessee, and Virginia have reclassified gabapentin as a Schedule V controlled substance). Gabapentin is not an opioid.
Gabapentin side effects
Gabapentin can cause mild or serious side effects. The following list contains some of the key side effects that may occur while taking gabapentin. This list does not include all possible side effects.
For more information on the possible side effects of gabapentin, or tips on how to deal with a troubling side effect, talk with your doctor or pharmacist.
More common side effects
Some of the more common side effects that can occur with the use of gabapentin are listed below, along with their rates:
- viral infection
- nausea and vomiting
- trouble speaking
- jerky movements
The side effect rates are based on patients over 12 years old, as reported in clinical trials for the brand equivalent, Neurontin. Certain rates vary by age. For example, pediatric patients 3 to 12 years of age most commonly experienced viral infection (11%), fever (10%), nausea and/or vomiting (8), tiredness (8%), and hostility (8%). There were no clinically significant differences in rates between men and women. For more information, see the FDA package insert.
If these effects are mild, they may go away within a few days or a couple of weeks. If they’re more severe or don’t go away, talk to your doctor or pharmacist.
Serious side effects
Call your doctor right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects and their symptoms can include the following:
- Changes in mood or anxiety. Symptoms can include:
- thoughts of suicide or dying
- attempts to commit suicide
- anxiety that’s new or gets worse
- crankiness that’s new or gets worse
- panic attacks
- trouble sleeping
- aggressive or violent behavior
- extreme increase in activity and talking
- unusual changes in behavior or mood
- Changes in behavior and thinking, especially in children ages 3 to 12 years. Symptoms can include:
- emotional changes
- trouble concentrating
- changes in school performance
- hyper behavior
- Serious and life-threatening allergic reaction. Symptoms can include:
- skin rashes
- swollen glands that do not go away
- swollen lips and tongue
- yellowing of your skin or the whites of your eyes
- unusual bruising or bleeding
- severe tiredness or weakness
- unexpected muscle pain
- frequent infections
Gabapentin may cause other side effects. Call your doctor if you have any unusual problems while taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).