Does gabapentin help you sleep?

Gabapentin for sleep | When to take gabapentin for sleep | Dosage | Risks | Alternatives

Getting enough sleep is one of the most important ways to support your health. Yet, about one-third of adults in the U.S. don’t get enough sleep. Not getting enough sleep can lead to chronic diseases, such as diabetes, heart disease, and stroke. 

Although sleep duration matters, it’s not the only important part of sleep. Sleep quality is also critical, and transitioning smoothly through sleep cycles is essential to having high-quality sleep to wake up feeling rested. This is because sleep stages allow the brain and body to rest. People with insomnia may not get enough sleep for the appropriate time in each sleep stage. 

Gabapentin is a prescription medication that is FDA-approved to treat epilepsy and neuropathic pain caused by shingles. Healthcare providers often prescribe it for other off-label uses as well, including anxiety, bipolar disorder, and fibromyalgia. One of gabapentin’s most common side effects is drowsiness. Therefore, doctors may also prescribe it for sleep. 

Read on to learn more about gabapentin for sleep. 

Will gabapentin help you sleep? 

Gabapentin is used off-label for many conditions, including sleep. With off-label use, a medication is prescribed for a condition outside its approved indications. 

Some research shows gabapentin may be beneficial for primary insomnia. Primary insomnia is difficulty sleeping that isn’t linked to other medical conditions. 

• In a 2010 study, 18 people with primary insomnia received gabapentin treatment for 4 weeks. Gabapentin improved slow-wave sleep (“deep sleep”) and sleep quality. It also decreases arousal, when you may become more aroused or alert during a sleep cycle. 
• A 2014 clinical trial of over 300 people with occasional insomnia found that gabapentin 250 milligrams (mg) and 500 mg lengthened the time people slept. 
• Another 2014 study of over 200 people with occasional insomnia showed gabapentin 250 mg increased the total amount of time people slept. 

An extensive review of 26 studies involving over 4,500 people found that gabapentin may be effective for the treatment of insomnia in people with other medical conditions. Examples of other medical conditions included alcohol dependence, restless leg syndrome, hot flashes in menopause, neuropathy, and fibromyalgia. However, the study also found that gabapentin doses of 1,800 mg per day led to adverse effects that caused people to stop taking the drug. 

When should I take gabapentin for sleep?

Gabapentin is an antiepileptic drug that’s thought to work by calming nerve activity in the brain. When used for seizures or shingle pain, gabapentin typically starts to work within 2 to 3 hours, and doctors usually prescribe it three times per day.

Because sleep isn’t an FDA-approved use of gabapentin, there are no standard instructions for use when it’s prescribed for sleep.

In the 2014 studies referenced above, gabapentin lengthens the total sleep time after participants were given gabapentin 30 minutes before bedtime. Although this is just an example, it’s reasonable to expect to take gabapentin at bedtime when it’s prescribed for sleep. This gives it ample time to start working by bedtime. 

How much gabapentin should I take for sleep?

When taken for its FDA-approved indications, the usual dose of gabapentin varies. For adults, typical dosages can range from 300 mg once daily to 600 mg three times daily. The maximum dosage is 1,800 mg per day. 

For sleep, there aren’t standard dosages. And the dosage can depend on your other medical conditions, age, or other medications. 

In the 2014 studies referenced above, participants who took gabapentin 250 mg or 500 mg 30 minutes before bedtime experienced longer sleep durations. The meta-analysis of 26 studies found that gabapentin improved sleep in people with other medical illnesses at an average of 1,800 mg daily. But this review also noted that gabapentin wasn’t tolerated as well, which led to some people stopping the drug. 

If your healthcare provider prescribes gabapentin for sleep, take it exactly as prescribed. Taking it differently than prescribed can increase your risk of side effects or make it less effective. 

RELATED: Gabapentin dosage, forms, and strengths

Risks of taking gabapentin for sleep

Regardless of whether you’re taking gabapentin for sleep or another condition, it has risks just like any other medication. It can cause mild to serious side effects, worsen certain medical conditions, and interact with other drugs or substances. Due to these risks, it may not be suitable for everyone. 

Gabapentin can cause a wide range of side effects. The most common side effects of gabapentin include: 

• Dizziness
• Drowsiness
• Swelling in your arms and legs
• Problems with coordination
• Sleepiness
• Uncontrollable eye movements

Serious side effects of gabapentin can include:

• Suicidal thoughts or behaviors
• Respiratory depression (slow or shallow breathing)
• Withdrawal symptoms if stopped too suddenly
• Severe allergic reactions

Certain medical conditions or health factors may put you at higher risk of side effects from gabapentin. These may include: 

• Kidney problems
• Mental health conditions, such as depression or mood disorders
• Diabetes
• Breathing problems
• Pregnancy 
• Breastfeeding

Gabapentin may also interact with other medications and substances. Interactions can affect how well drugs work, or they can worsen side effects. Most gabapentin interactions occur with other medications or substances that cause drowsiness, but it can also interact with some antacids. Examples of drugs that interact with gabapentin include: 

• Opioids, such as Roxicodone (oxycodone) or MS Contin (morphine sulfate)
• Benzodiazepines, such as Ativan (lorazepam) or Xanax (alprazolam)
• Muscle relaxants, such as Flexeril (cyclobenzaprine) or baclofen
• Sedatives, such as Ambien (zolpidem) or Lunesta (eszopiclone)
• Antacids, such as Maalox or Mylanta
• Alcohol

Some interactions can cause serious and life-threatening breathing problems. Due to this risk, tell your doctor about all prescription and over-the-counter medications, vitamins, and supplements you take.

RELATED: Gabapentin interactions to avoid

Alternatives to gabapentin for sleep

If you’re having difficulty sleeping, talk to your healthcare provider. They can help determine the cause of your sleep problems and the best course of treatment. This may include lifestyle changes, such as regular exercise and improving sleep hygiene, or cognitive behavioral therapy for insomnia (CBT-i). If these options aren’t helping, your doctor may recommend over-the-counter or prescription sleep aids. It’s important to note that the proper treatment options for you may not be suitable for everyone. Sleep problems can be complicated, and the appropriate treatment depends on the individual. Your healthcare provider can decide what’s right for you. 

That being said, let’s review some of the medications used for insomnia. 

Over-the-counter (OTC) sleep aids

OTC sleep aids include medications, hormones, and supplements. And they’re all readily available at drugstores and supermarkets. 

Common OTC sleep aids include:

• Certain antihistamines: Antihistamines are medications typically used for allergies, but they also cause sedation and are commonly used as sleep aids. 

Examples include Unisom (doxylamine) and Zzzquil (diphenhydramine). 

• Melatonin: Melatonin is a natural hormone that helps the body regulate its circadian rhythm. 
• Valerian root: Valerian root is an herbal supplement that has a calming effect. Some people have reported that it helps them fall asleep faster. 

Prescription medications

In general, prescription sleeping pills are only for short-term use. Some sleeping pills are better for people who have trouble falling asleep, while others work best for people who have problems staying asleep. 

Common prescription sleep medications include:

• Benzodiazepines, such as Restoril (temazepam)
• Non-benzodiazepine hypnotics, such as Lunesta (eszopiclone)
• Orexin receptor antagonists, such as Belsomra (suvorexant)

Your doctor can recommend the best treatment based on your symptoms, how long it takes to fall asleep, your total sleep duration, age, other medical conditions, and medications. If you only need an occasional treatment, your healthcare provider may recommend an OTC sleep aid, such as Unisom (doxylamine). If you’re suffering from jetlag and need help getting back on course, melatonin may be an option. Or if you have chronic insomnia, your healthcare professional may consider prescribing one of the prescription sleep aids. Some sleep aids have a high risk of next-day drowsiness, impacting your ability to drive or do anything that requires focus. Many sleep aids interact with other medications and medical conditions as well. While sleep aids can be helpful as a short-term treatment, it’s important to seek medical advice and discuss your options with a healthcare provider before trying one.