@mom4twins4me I am sorry to hear of your nighttime pain. You were very brave to have bilateral TKRs. I have had two TKRs but at different times.
I don't recall having your problem. I did find when I tried to fall asleep that I was more conscious of the pain than I was during the day so I took tramadol before bed. Initially I had an opioid also but the doctor only prescribed them for a very brief time. Has your doctor prescribed anything?

@artscaping Roxie looks so much like the Cavalier we had. Does she have the typical Blenheim lozenge on top of her head? They have the sweetest dispositions which is why we chose that breed. My son and daughter were young and there was a constant stream of friends coming and going so I wanted a very non-threatening dog. The worst she would do was to lick a person to death. I had to have her put to sleep in 2006 when she was 14 years old, old for a Cavalier.
JK