The effects of two single doses of tramadol on sleep: a randomized, cross-over trial in healthy volunteers

Clinical Trial

. 2001 Jan;18(1):36-42.

doi: 10.1046/j.1365-2346.2001.00772.x.

B Walder 
¹
, M R Tramèr, R Blois

Affiliations

Affiliation

• ¹ Division of Surgical Intensive Care, Geneva University Hospitals, 1211 Geneva 14, Switzerland.

• PMID:

  11270008

• DOI:

  10.1046/j.1365-2346.2001.00772.x

Clinical Trial

B Walder et al.

Eur J Anaesthesiol.

2001 Jan.

. 2001 Jan;18(1):36-42.

doi: 10.1046/j.1365-2346.2001.00772.x.

Authors

B Walder 
¹
, M R Tramèr, R Blois

Affiliation

• ¹ Division of Surgical Intensive Care, Geneva University Hospitals, 1211 Geneva 14, Switzerland.

• PMID:

  11270008

• DOI:

  10.1046/j.1365-2346.2001.00772.x

Abstract

Background and aim:

The effects of analgesic drugs on sleep are poorly understood. We investigated short- and medium-term effects of tramadol on sleep structure.

Methods:

Eight healthy volunteers received a placebo (predrug placebo-night), then, in a randomized, double-blind, cross-over fashion a single oral dose of tramadol 50 mg or 100 mg (drug-night), and finally, again a placebo (postdrug placebo-night). Standardized polysomnography (electroencephalogram, electro-oculogram, submental electromyogram) was continuously recorded during placebo- and drug-nights.

Results:

During drug-nights both doses of tramadol significantly increased the duration of stage 2 sleep, and significantly decreased the duration of slow-wave sleep (stage 4). Tramadol 100 mg but not 50 mg significantly decreased the duration of paradoxical (rapid eye movement) sleep. In the placebo-night after tramadol 100 mg (but not after 50 mg) duration of stage 2 sleep was significantly shorter, and duration of stage 4 sleep was significantly longer compared with the predrug placebo-night.

Conclusion:

In healthy volunteers, a single dose of tramadol 50 mg disturbs sleep in the night of drug application. With 100 mg, sleep is disturbed in both the night of drug application and in the subsequent night.

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Does Tramadol Cause Insomnia? | Absolute Awakenings

Table of Contents

Does Tramadol Cause Insomnia?

Even when taken as prescribed, Tramadol has been known to cause side effects, including insomnia.

If you’re abusing Tramadol, the side effects become stronger.

Even when taken as prescribed, Tramadol has been known to cause side effects. One of the most common side effects of Tramadol is insomnia. How can a potent painkiller lead to disrupted sleep? Most painkillers cause severe fatigue and sedation. Tramadol disrupts normal sleep cycles when taken as prescribed – the individual taking the drug is more liable to fall asleep during the day and stay awake at night. However, insomnia is far more commonly a side effect of Tramadol withdrawal. Those abusing this medication for any length of time will experience a host of unpleasant symptoms upon ceased use, including sleep-related issues like restlessness, fatigue, and an inability to fall asleep.

Tramadol and Insomnia

The National Library of Medicine recently published a study that focused on the effects of Tramadol on sleep patterns. The study was randomized, and researchers gave healthy subjects between one and two doses of Tramadol before they went to bed in hopes of better understanding the relationship between the two. Eight volunteers received a placebo one night and a 50mg or 100mg dose of Tramadol the second night. It was discovered that 100mg of Tramadol significantly reduced rapid eye movement sleep (REM sleep) for two full nights, the kind of deep sleep humans need to recharge and feel well-rested. The study confirmed that when an individual was given a 50mg dose of Tramadol, sleep was interrupted during the night they were given medication. When an individual was given 100mg of the medication, sleep was harshly interrupted for two full nights. Although this is only one example, it has been proven that Tramadol interrupts sleep. With continued use, it is likely to cause insomnia eventually.

Tramadol detox is another story entirely. It is widely known that insomnia is one of the predominant symptoms of Tramadol withdrawal, along with nausea, vomiting, diarrhea, cold sweats, muscle aches, and stomach cramping.

Absolute Awakenings and Tramadol Addiction

At Absolute Awakenings, we have extensive experience treating Tramadol withdrawal symptoms and the side effects of Tramadol abuse and addiction. Our team of experienced professionals knows how disruptive and aggravating attempting to deal with a lack of sleep can be, especially in early recovery. Our prescribing physicians will work with each client and prescribe a non-narcotic sleeping aid to help with insomnia whenever necessary.

Of course, medication is not the only solution – we also work to instill healthy coping mechanisms – ways to calm the body and the mind so that achieving a good night’s sleep is more likely. Some holistic approaches to treating insomnia include yoga, meditation, and breathing exercises. If you have been struggling with Tramadol abuse or addiction and you are ready to stop experiencing the painful and disruptive side effects due to painkiller dependence, give us a call today. We are standing by to help you in any way we can and get you started on your journey of Tramadol addiction recovery.

References

1. Dhesi M, Maldonado KA, Maani CV. Tramadol. In: StatPearls. StatPearls Publishing; 2022. Accessed January 17, 2023. http://www.ncbi.nlm.nih.gov/books/NBK537060/
2. Walder B, Tramèr MR, Blois R. The effects of two single doses of tramadol on sleep: a randomized, cross-over trial in healthy volunteers. Eur J Anaesthesiol. 2001;18(1):36-42. doi:10.1046/j.1365-2346.2001.00772.x
3. Basics on Sleep. WebMD. Published November 16, 2022. Accessed January 17, 2023. https://www.webmd.com/sleep-disorders/sleep-101

Last medically reviewed January 17, 2023

Tramadol is a psychotropic drug belonging to the group of opioid analgesics. This drug is distinguished by the presence of pronounced analgesic properties. Due to the effect of Tramadol on the central nervous system and active stimulation of opioid receptors, the drug is also used to achieve a state of drug intoxication.

Action of Tramadol

When the active ingredients of Tramadol penetrate into the bloodstream, they cause a state of pleasant euphoria, the person becomes emotionally receptive, feels a surge of strength and energy, feels free and liberated. However, tolerance to the drug develops quite quickly and soon the euphoria after taking it is reduced from 36 hours to 5 minutes. A person is forced to constantly increase the dosage. The state of “tramadol withdrawal” is accompanied by severe pain, sleep disturbances, panic states, leading to the development of paranoia.

Effects of Tramadol on the body

Addiction to Tramadol develops rapidly. After a few months of drug use, the patient shows signs of physical and psychological exhaustion. A person becomes depressed, irritable, begins to lose weight dramatically, suffers from a permanent lack of appetite, insomnia.

The following effects from Tramadol :

• tearfulness;
• headaches;
• changes in blood pressure;
• fainting spells;
• memory impairment, reduced ability to concentrate.

After a year of using Tramadol, the patient’s appearance changes, hair begins to fall out, teeth decay. In addition, there is a weakening of bone tissue structures, which causes frequent fractures. As a rule, in the absence of timely provision of qualified assistance, a person dies from an overdose within 3-4 years. The insidiousness of Tramadol lies in the fact that this drug causes a strong psychological dependence, the manifestations of which have to be fought for 10-15 years after stopping the use of Tramadol.

Treatments for Tramadol

Tramadol treatment should be carried out in a hospitalized patient, with complete isolation from the usual environment. The therapeutic course begins with a comprehensive detoxification and the use of restorative techniques. The duration of detox is about 3-4 weeks. Often, patients are prescribed antipsychotic and nootropic drugs, symptomatic treatment, a course of vitamin therapy.

Drug treatment in Medicon is carried out by qualified specialists, according to licensed methods, which significantly increases the chances of achieving successful results.

Therapeutic course includes psychological correction, work on the program “12 steps” in groups of codependents, methods of Genstald therapy. Particular attention is paid to the rehabilitation of patients and the prevention of a possible breakdown in the Medicon Narcological Center. Psychological consultations, classes with a family psychologist and in groups of co-dependents help a person overcome psychological dependence on Tramadol, fully returning to a normal, sober life.

Author: Ivashchenko Yuliana Borisovna

Addiction specialist

About the specialist

1 vote

“There are several outlets in the area, and there are no problems to get.” Why pharmacy drug addiction is widespread

TWO FATAL PILLS

Evgeny Makarov, 31, has a job, housing, a wife and a first grade son. At first glance – an ordinary resident of Uralsk, of which there are many. But this is only the first.

Eugene is a drug addict. He has been on Tramadol for eight years. Getting used to the drug was fast. At first, acquaintances treated him to two tablets. Got sucked in. Soon the daily dose increased to one and a half dozen tablets.

– It all started when Tramadol was not so common in Uralsk. When I started, finding [the drug] was not as easy as it is now: you had to call someone, go somewhere. And it somehow repelled, fenced off [from consumption]. Now it comes to the fact that there are several points in the area and there are no problems to take it, – says Evgeny Makarov.

Tramadol is an opioid analgesic, a synthetic drug that is prescribed to relieve severe pain, for example, in the postoperative period, as well as to patients with malignant tumors in advanced stages of the disease. It causes addiction. It is forbidden to release it without a prescription. But drug addicts find it easily.

According to the latest data from a monitoring group that was set up in Uralsk to identify points of illegal sale of “Tramadol” and “Tropicamide” (another drug that is addictive and acts like a drug is eye drops containing atropine, which are dripped into the nose to enhance the action of “Tramadol”), in a dozen pharmacies you can buy drugs without a prescription. In addition, in almost every microdistrict of the city there are several “points” – apartments or private houses – where prescription drugs are freely sold.

Blister from “Tramadol”

Ease of purchasing a drug increases its prevalence and number of users. Eugene says that he is watching how the contingent of those who “sit” on Tramadol is getting younger.

– I saw children aged 13-14 who talked about wanting to “throw” Tramadol. It was on the playground, I walked there with my son. It horrified me,” Makarov recalls.

Tramadol users, like people addicted to other drugs, also experience withdrawal symptoms. Makarov says: if you miss a dose, then withdrawal symptoms set in a day later. If used regularly, a person feels a false burst of energy and euphoria. The drug causes serious harm to health: the work of the cardiovascular system, kidneys and liver is disrupted, the brain and reproductive system suffer. “Tramadol” blocks the feeling of fatigue and causes insomnia. To sleep after taking Tramadol, addicts drink sleeping pills.

STRUGGLE OF PUBLIC MEMBERS

Public activists have been raising the problem of the availability of pharmacy drugs for more than a month. In April, a flash mob was held in Uralsk against the illegal distribution of prohibited substances. The organizer of the action, activist Aslan Utepov, said that he was trying to “draw attention to such a global problem as drugs, which are distributed everywhere.” The flashmob brought together about 20 people, they came with posters “We choose life,” Life without drugs. Participants, mostly young people, said that drugs had become very accessible in Uralsk. “Everyone knows about it, but little is being done,” said one participant.

Participants of the flash mob against the illegal distribution of drugs. Uralsk, April 29, 2022

In July, dozens of residents of an apartment building in Uralsk gathered to demand that the authorities stop selling Tramadol in their apartment building. They told reporters that one of the apartments was searched several times, during which the police seized blisters of pills and bottles of liquid. But a few hours later, according to the residents, a new batch of drugs was brought into the apartment.

— I have two small children, I’m afraid for them: it’s not safe in our house. I don’t let the children out themselves even to buy bread in the store or take out the trash, in the evening we don’t leave the house at all, even adults are afraid. There is always someone outside in the entrance, they behave aggressively, litter. I myself came across these “guests”: they threatened me directly,” said Aliya Darmesheva, a resident of the house.

Alibek Zhumagulov, a representative of the Uralsk prosecutor’s office, who arrived at the scene, did not answer the questions of the residents of the house, but reminded him of the administrative responsibility for “illegal assembly”: observed. I ask everyone to disperse.”

Residents of a high-rise building in Uralsk demand to stop the sale of the opioid analgesic “Tramadol” in the entrance of their house. July 26, 2022

In August, activist Aslan Utepov received the go-ahead to hold a rally “The future of our children is drug-free!”, where he planned to raise the problem of “over-the-counter sales of Tramadol and Tropicamide.” But two days after the action was approved, local authorities withdrew the permit.

Erbol Kushekov, Head of the Internal Policy Department of the Uralsk Akimat, motivated the refusal by the fact that on his page on the social network, public figure Utepov “published a post about permission to hold an action with an appeal for city residents to take part in a peaceful meeting to discuss the issue of “pharmacy drug addiction” and why “king of tramadol” is still at large.

“There is no such information in the submitted application. In your action, you planned to hold an action against drugs together with the youth of the city, ”Kushekov says in a letter.

“KOROL” AND HIS TWO DETENTIONS

Local resident Nikolai Karpov is called the “King of Tramadol” in Uralsk. Over the past six months, he has been detained twice. In April of this year, security forces raided Karpov’s house, they broke into masks, bulletproof vests and filmed a video in which a man is kneeling, he was surrounded by people in uniform. The police came to detain him after the social activist Aslan Utepov published a video and screenshots from the page of Nikolai Karpov, where the latter calls himself “the king” and says that he “relies on Tramadol”.

The video of the special operation spread around social networks and news feeds, the media wrote about the criminal case against Karpov on suspicion of “storage of psychotropic substances” without the purpose of sale (Article 296 of the Criminal Code). After a short time, Karpov was released. In early July, the acting prosecutor of the West Kazakhstan region, Alexander Tsurankov, announced that all cases against Nikolai Karpov would be closed, because Tramadol is not a drug. But at the end of July it became known that the charge against Karpov was reclassified, applying a more serious article of the criminal code (297th), in which there is no clarification “without the purpose of sale”.

On September 11, Nikolai Karpov gave a press conference, where he said that he had nothing to do with the illegal sale of Tramadol and that all the videos and photos spread on his behalf were fakes. In an interview, Karpov called the case opened in April for “possession of psychotropic substances” illegal, because at the time of his arrest, “they didn’t find anything” with him at home, except for money, he assured. He stated that he had a pharmacy and had a license, as well as a large number of drugs that he kept on the premises of a friend.

The day after the press conference, Nikolai Karpov was detained again. 400 bottles of Tropicamide were found in his car. The detainee’s lawyer called the incident a “set-up.” The police department again opened a criminal case under the article “Illegal handling of narcotic drugs, psychotropic substances, their analogues without the purpose of sale” and Karpov was released a few hours later.

Nikolai Karpov, a resident of Uralsk, who is called the “king of tramadol”. September 21, 2022

On September 21, Karpov again organized a press conference, at which he claimed that he was being persecuted illegally, in retaliation for what he claimed to be fighting corruption in the police ranks. He said that he is not “the king of tramadol”.

– Where am I “king of tramadol”? Show me where I sell Tramadol? I have a decision where my case is over, a decision to close it,” said Karpov.

The police have not yet commented on this statement.

NOT LISTED

The main problem in the fight against the illegal sale of Tramadol is the imperfection of the law: the drug is not included in the list of narcotic drugs. For its out-of-pharmacy sale cannot be held criminally liable. The maximum is an administrative fine.

Packaging from “Tropikamid”

– At the moment, the drug is sold over the counter, it is a drug, but is not legally included in the summary table as a narcotic drug. In the future, it is proposed to be included in the list. If he is turned on, then we can bring him to criminal responsibility,” Khizmatulla Khamzin, detective of the department for combating drug crime of the police department of the West Kazakhstan region, says.

At a meeting of the Youth Policy Council in August, Interior Minister Marat Akhmetzhanov said drug addiction in Kazakhstan was on the rise. He suggested that Minister of Health Azhar Giniyat strengthen control over the circulation of these drugs.

But the problem of the illegal sale of “Tramadol” is not new. At the end of 2018, the drug was promised to be included in the list of narcotic drugs. The Ministry of Health then said that this would help regulate the sale of Tramadol and bring illegal sellers to justice. However, the year is 2022, the drug was not included in the list.

— Of course, if a law were passed in Kazakhstan to control [the sale of Tramadol], this would be a way out. We have a lot of medicines that are used [as a drug]. The police don’t know what to do,” says Abdikadyr Karabayev, a narcologist at a clinic in Astana.

Opponents of adding Tramadol to the list of drugs believe that simply listing Tramadol will not solve the problem: tomorrow a new drug with a slightly modified formula and a similar effect may appear on the pharmacy shelves. And then – a new stage of struggle. And so on ad infinitum.

“NOTHING TO TREAT”

Meanwhile, the impunity of Tramadol and Tropicamide traffickers leads to the availability of drugs. Yevgeny Makarov, who has been using a pharmacy opioid analgesic for many years, says that it is extremely difficult to “quit” when the drug is available.

– I have such a case. I have been “dry” for two months, I take an order for work, and the work is hard, the thought works: “We need to go get Tramadol, and it will be easier.” And it’s easy to take it,” explains Evgeny Makarov.

The most difficult thing for those who want to give up drugs is to overcome psychological dependence. Makarov tried to quit several times and after a while he returned to Tramadol again, but in a larger dosage.