Hydrocodone use can potentially cause insomnia as a side effect in some users. To avoid or prepare for this issue, it is recommended to take hydrocodone earlier in the day, avoid caffeine or stimulants close to bedtime, establish a consistent sleep schedule and create a relaxing bedtime routine.
Is Insomnia a Side Effect of Hydrocodone?
It can be. [1] Hydrocodone is an opioid drug that can disturb central nervous system processes that are associated with sleep regulation. Because of this, some users report problems falling or staying asleep while taking the medication.
Essentially, hydrocodone can disrupt the sleep cycle, change sleep stages, decrease restorative rapid eye movement (REM) sleep, cause brief awakenings, and trigger respiratory depression at higher doses. These factors can make it difficult to maintain a regular sleep pattern and stay asleep while taking the drug.
It is important to note that insomnia and pain management do not have to go hand in hand. Anyone taking hydrocodone and struggling with insomnia as a result can consult a healthcare provider and ask for a dose adjustment or alternative solution that can address sleep-related issues and concerns. You don’t have to choose between pain management and sleep.
People who misuse hydrocodone, often as part of an opioid use disorder (OUD), often experience insomnia and other sleep issues with chronic misuse. These issues generally resolve once the misuse stops after treatment.
Why Does Hydrocodone Affect Your Sleep?
These are some of the reasons that painkillers like hydrocodone can have a negative impact on sleep:
Brain Receptor Interaction
Hydrocodone interacts with certain opioid receptors in the brain and spinal cord that play a large role in pain modulation and sleep regulation. Because of this interaction, it can impact the natural sleep/wake cycle.[2]
Sedation
Opioids have a sedative effect, meaning that they may induce drowsiness and promote sleep, making it easier for some people to fall asleep initially after taking them. However, they do not help the user get into a deep sleep or stay asleep.[2]
Interference With Sleep Architecture
Opioids can alter the normal sleep pattern, and this can influence both REM and non-REM sleep. As a result, some individuals may experience less restorative sleep.[3]
Respiratory Depression
At higher doses, hydrocodone and other opioids can cause respiratory depression, where breathing becomes shallow and slow. This could result in short awakenings during the night, disrupting sleep continuity.[2]
Withdrawal Symptoms
Prolonged use of hydrocodone may lead to physical dependence. Rapid termination or dose reduction may cause physical withdrawal symptoms that are similar to flu symptoms as well as emotional withdrawal symptoms, such as depression, anxiety and insomnia. Any and all of these can make it harder to fall asleep and stay asleep.
Interactions With Other Medications
Hydrocodone may interact negatively with medications designed to aid sleep, further compounding any associated sleep issues.
Is Insomnia a Serious Side Effect of Using Hydrocodone?
Though hydrocodone may lead to short-term insomnia, it is generally not serious or harmful since its sedative effect on the central nervous system is minimal. It usually impacts the ability to get restorative sleep or to stay asleep, not the ability to fall asleep.
For most people, it is a temporary side effect that occurs when they first start taking the drug or increase their dose. This issue generally dissipates after a few days to a week of use.
However, long-term use or combination use with other depressant medicines could aggravate these effects. Sleeping problems can become serious if they persist, so talk to your doctor about any issues.
How Long Does It Take to Adjust to Hydrocodone?
The amount of time it takes to adjust to hydrocodone and its side effects can vary significantly from person to person. Everyone is different, but most people find that the side effects lessen after a week or so.
Unfortunately, as the side effects fade, it means the body is becoming used to that amount of hydrocodone in the system. Over time, the dose becomes less effective as the body builds a tolerance to the medication. When this happens, a larger amount is needed to get to a therapeutically effective dose.
The speed at which tolerance develops can vary based on differences in metabolism, how the drug is absorbed and genetic factors.[4]
Are There Ways to Combat the Sleep-Related Side Effects of Hydrocodone?
You can take these steps to lessen the chances of experiencing sleep-related issues while taking hydrocodone:
Talk to Your Doctor
They may need to adjust your dose or find an alternative pain management solution.
Take the Medication Earlier
If possible, take the drug early in the day, so its sedative properties have time to wear off before bedtime.
Promote Good Sleep Hygiene
Develop and adhere to a regular bedtime ritual to signal to your body when it’s time to sleep. Keep the bedroom dark, quiet and at a comfortable temperature, using white noise if needed to create a soothing environment.
Limit your screen time in the hours before bed.[5] Avoid heavy meals before bed.
Avoid Alcohol
Don’t mix hydrocodone with substances such as alcohol or any other central nervous system depressants that could boost the drug’s sedative effects. Mixing substances like this could elevate risks associated with respiratory depression and other dangerous side effects.
Get Help for Hydrocodone Misuse
At Bicycle Health, we understand that taking hydrocodone can cause a number of potential problems, not the least of which may be insomnia and other sleep challenges. If you’ve been misusing hydrocodone, effects like insomnia and other sleep issues will likely be compounded.
Our Medication for Addiction Treatment (MAT) program with Suboxone is designed to help you stop misusing hydrocodone and other opioids safely.[6] Because of Suboxone, withdrawal symptoms and cravings for hydrocodone will be controlled, so you can focus on the work you are doing in therapy.[7]
Contact us today to learn how we can help you to begin your personal journey to recovery.
Reviewed By Peter Manza, PhD
Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More
- Serdarevic M, Osborne V, Striley CW, Cottler LB. The association between insomnia and prescription opioid use: results from a community sample in northeast Florida. Sleep Health. 2017;3(5):368-372. doi:10.1016/j.sleh.2017.07.007
- Prescription opioids DrugFacts. National Institute on Drug Abuse. Published 2023. Accessed July 27, 2023. https://nida.nih.gov/publications/drugfacts/prescription-opioids
- Moore JT, & Kelz MB. Opiates, sleep, and pain. Anesthesiology. 2009;111:1175–1176. https://doi.org/10.1097/aln.0b013e3181bdfa2e
- Cherny NI, Ripamonti C, Pereira J, Davis C, Fallon M, McQuay HJ, et al. Strategies to manage the adverse effects of oral morphine: an evidence-based report. Journal of Clinical Oncology. 2016;19(9):2542–2554. https://doi.org/10.1200/jco.2001.19.9.2542
- Healthy sleep habits – sleep education by the AASM. Sleep Education. Published August 2020. Accessed July 27, 2023. https://sleepeducation.org/healthy-sleep/healthy-sleep-habits/
- Velander JR. Suboxone: rationale, science, misconceptions. Ochsner J. 2018;18(1):23-29
- Catherine Baxley, Brian Borsari, Jill V. Reavis, Jennifer K. Manuel, Ellen Herbst, William Becker, David Pennington, Steven L. Batki, Karen Seal. Effects of buprenorphine on opioid craving in comparison to other medications for opioid use disorder: A systematic review of randomized controlled trials. Addictive Behaviors, Volume 139, 2023,107589, ISSN 0306-4603, https://doi.org/10.1016/j.addbeh.2022.107589
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