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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Sleeplessness Along With Persistent Pain Post Hip Replacement Surgery?

I have a history of chronic hip pain and have been on narcotics for roughly 8 years. I recently got my first total hip replacement on my left side (7th total hip surgery between both hips) and pain wise I was doing great. My pain management doc and I agreed to taper and go off my 16mg exalgo and 16-24mg dilaudid a day. I stopped last week and survived the intense withdrawals. Now sleep is an issue. I m still a bit achy (particularly at night), but motrin 800 s don t seem to help and I can t get comfortable. My doc prescribed 1-2 0.5mg Klonopin to help calm me down to sleep since my trazadone was no longer working. This is my second night on them and even though I can fall asleep with 2x0.5mg Klonopin, I find I wake in the middle of the night wide away and achy again. I ve tried Ambien 10mg before with no luck helping with insomnia.
Tue, 18 Aug 2020
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General Surgeon 's  Response
Hello,

The insomnia condition is in relation with withdrawal of the narcotics from long term back consumption of 8 years. There are molecular basis of receptor accommodation issues which represent in this regard. Additional guidelines as below:
- Deep breathing exercises
- Meditations and YOGA
- Addition of Melatonin (3 mg) with current drug basket
- Psychotherapy
- Behavioral modifications and suggestion therapy
- Avoidance of nicotine or other stimulants use in the evening if applicable

Take care. Hope I have answered your question. Let me know if I can assist you further.

Regards,
Dr. Bhagyesh V. Patel, General Surgeon
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What Causes Sleeplessness Along With Persistent Pain Post Hip Replacement Surgery?

Hello, The insomnia condition is in relation with withdrawal of the narcotics from long term back consumption of 8 years. There are molecular basis of receptor accommodation issues which represent in this regard. Additional guidelines as below: - Deep breathing exercises - Meditations and YOGA - Addition of Melatonin (3 mg) with current drug basket - Psychotherapy - Behavioral modifications and suggestion therapy - Avoidance of nicotine or other stimulants use in the evening if applicable Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Bhagyesh V. Patel, General Surgeon