I am a member of the decreased sleep club after a TKR. I am only 3+ weeks out but have found a couple of things to help. 1) Sleep with my legs elevated on a wedge pillow I borrowed from a shoulder surgery patient. Picture below. Definitely decreases inflammation and I get compression hose on my leg, with assistance, first thing..2) Only sleep or ice with elevation lying down in your bedroom, do all your exercises elsewhere so you know that place is for trying to sleep, 3) Make sure you are drinking lots of fluids throughout the day. Initially I had issues with constipation and pain pills and my gut was contributing to keeping me awake. 4) My primary care Dr is having me try melatonin and Benadryl, not at the same time, but to see which one works better for me to aid with sleeping. I was taking a tramadol before bed not so much for pain but for drowsiness. Hopefully will be able to use just acetaminophen for pain and kick the narcotics so I can drive with my right knee.
Hope this helps and good luck with your recovery. Definitely not an easy process, especially if you are sleep deprived,