Knee Replacement: Insomnia post-surgery

Posted by auntmarmar @auntmarmar, Sun, Jun 9 8:15am

Eight weeks ago I had total knee replacement. The knee seems to be doing pretty well, however I have been suffering from horrendous insomnia ever since. Most nights I get 0 to 2 hours of sleep. I feel like a zombie and have also been suffering from anxiety and depression. I have tried sleeping pills, pain pills, Xanax, meditation, I am seeing a counselor, I go for PT, I am doing acupuncture… I am currently using melatonin and CBD oil. I am completely beside myself and so frustrated. Anyone else experiencing this problem? Any solutions?

@auntmarmar – Earlier on another thread, I think someone mentioned taking Trazadone. Have you talked to your orthopedic surgeon? If he/she can't help, maybe your primary care doctor could. I hope you get some relief soon. I think time is on your side. Once I passed the 8 week mark with my TKR, I found that I could turn over on my side more easily and had a much higher comfort level in terms of sleeping. Wishing you the best.

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@auntmarmar Is your anxiety due to your TKR? I think you need to figure out what is causing the anxiety and depression before you can tackle it. I know nothing about sleeping pills, I do use melatonin and sometimes Benedryl but have not used any prescription remedies in many years. I tried once a long time ago but didn't like how I felt the next day.
It's good that you are seeing a counselor, hopefully that will help you to sort things out. It does not sound as if pain is what is keeping you awake, if I have interpreted your discussion correctly. I will be interested in hearing what approach is taken to help you because I often have trouble sleeping if I am anxious about anything. These days I do not feel anxious but if I get six hours of sleep I consider it to be a good night.
JK

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@contentandwell

@auntmarmar Is your anxiety due to your TKR? I think you need to figure out what is causing the anxiety and depression before you can tackle it. I know nothing about sleeping pills, I do use melatonin and sometimes Benedryl but have not used any prescription remedies in many years. I tried once a long time ago but didn't like how I felt the next day.
It's good that you are seeing a counselor, hopefully that will help you to sort things out. It does not sound as if pain is what is keeping you awake, if I have interpreted your discussion correctly. I will be interested in hearing what approach is taken to help you because I often have trouble sleeping if I am anxious about anything. These days I do not feel anxious but if I get six hours of sleep I consider it to be a good night.
JK

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Well from my research, anxiety and depression are not uncommon after major surgery, as is insomnia. My surgeons office Said that insomnia is their number one complaint after total knee replacement. They also said that most prescription drugs will not work. At this point, I think the main cause of my anxiety and depression is the sleeplessness. Of course sleeplessness is also a consequence of anxiety and depression! Ugh! Thanks for responding to my post.

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@auntmarmar

Well from my research, anxiety and depression are not uncommon after major surgery, as is insomnia. My surgeons office Said that insomnia is their number one complaint after total knee replacement. They also said that most prescription drugs will not work. At this point, I think the main cause of my anxiety and depression is the sleeplessness. Of course sleeplessness is also a consequence of anxiety and depression! Ugh! Thanks for responding to my post.

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@auntmarmar I have only had insomnia after surgery when I have been in pain. I think it is a vicious circle — sleeplessness makes a person anxious, and anxiety makes it hard to sleep, so I agree with you entirely.
Would your doctor give you a small prescription of lorazepam (generic Ativan)? My doctor gives me a prescription for 10, once a year. It helps me on anxious nights and I do fall asleep when I take it. My prescription is a small dosage also. It just takes the edge off I think.
I hope you manage to get some sleep soon, it's awful to go around feeling exhausted all of the time.
JK

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@contentandwell

@auntmarmar I have only had insomnia after surgery when I have been in pain. I think it is a vicious circle — sleeplessness makes a person anxious, and anxiety makes it hard to sleep, so I agree with you entirely.
Would your doctor give you a small prescription of lorazepam (generic Ativan)? My doctor gives me a prescription for 10, once a year. It helps me on anxious nights and I do fall asleep when I take it. My prescription is a small dosage also. It just takes the edge off I think.
I hope you manage to get some sleep soon, it's awful to go around feeling exhausted all of the time.
JK

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Thank you.

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I think you're normal. I am 4 weeks out of surgery for my second TKR (first one was in February) and insomnia was horrible both times. I am experiencing a ton of anxiety this time as well. I have charted my sleep patterns through my Fitbit. The good news is that sleep issues will start to level out after three months or so. I went from getting an average for 2-3 hours of sleep at night to a period of doing nothing but sleeping. Hang in there- it'll pass. But the anxiety– it's a bear to live with. I admit throwing down ZZ-Quil, Benedryl, and even medical cannabis gummies just to try to sleep! My best advice is to not worry about it. Sleep when your body wants to and know it won't last forever.

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Thank you! I saw my primary care today and she gave me Ativan to try tonight. She also wants me to cut back on my thyroid medicine and go for blood work tomorrow to check it. I sure hope these two things will help along with your encouragement that it should start to get better soon. You sure are brave to have the second knee done so soon! Good luck to you!

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@amytro

I'm 6 weeks out from my second knee surgery and once again, I am having a terrible time with insomnia. And to make it worse, I get a ton of anxiety and just can't get comfortable. It's almost like a panic attack. To top it off, in week 4, I started experience post-surgery nausea and vomiting. I wake up each more and dry heave and even vomit as soon as I get to the kitchen in the morning. This has lasted 2 weeks. (I did get an anti-nausea medication). Has anyone else had these issues? Some nights I'm still up at 3 am, trying to get comfortable. I have loaded myself up with Zzquil, Benedryl, and other over the counter meds to knock me out. I thought with the opioids I'm still on, it would do the trick. Nope. Am I alone?

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I have been struggling with terrible insomnia…10 weeks since knee replacement…no meds work at all…this past week I finally got 5 hours of sleep 3 nights…last night none again. Anxiety and depression are high, and I am exhausted. Haven’t had nausea but eating is difficult at times. Good luck to us both.

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I'm 6 weeks out from my second knee surgery and once again, I am having a terrible time with insomnia. And to make it worse, I get a ton of anxiety and just can't get comfortable. It's almost like a panic attack. To top it off, in week 4, I started experience post-surgery nausea and vomiting. I wake up each more and dry heave and even vomit as soon as I get to the kitchen in the morning. This has lasted 2 weeks. (I did get an anti-nausea medication). Has anyone else had these issues? Some nights I'm still up at 3 am, trying to get comfortable. I have loaded myself up with Zzquil, Benedryl, and other over the counter meds to knock me out. I thought with the opioids I'm still on, it would do the trick. Nope. Am I alone?

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@amytro

I'm 6 weeks out from my second knee surgery and once again, I am having a terrible time with insomnia. And to make it worse, I get a ton of anxiety and just can't get comfortable. It's almost like a panic attack. To top it off, in week 4, I started experience post-surgery nausea and vomiting. I wake up each more and dry heave and even vomit as soon as I get to the kitchen in the morning. This has lasted 2 weeks. (I did get an anti-nausea medication). Has anyone else had these issues? Some nights I'm still up at 3 am, trying to get comfortable. I have loaded myself up with Zzquil, Benedryl, and other over the counter meds to knock me out. I thought with the opioids I'm still on, it would do the trick. Nope. Am I alone?

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@amytro, I moved your discussion and combined it with @auntmarmar's discussion similarly titled, "Knee Replacement: Insomnia post-surgery." I did this so you could meet @auntmarmar and a few of the other members who discussed experiencing sleep issues after their surgery. If I think back to my own knee replacement in 2006, I also experienced sleep issues. Although I don't believe mine was insomnia, my nights did become my days and my days became my nights. The only time I seemed to be more pain free was in the evening and through the night, so I tended to stay up at that point because it was when I felt the best, but then I would sleep during the day. This resulted in mood swings. It took many months to correct, but once I started getting further from the surgery and more in to my PT, I slowly gained the ability to "do" more activities which helped keep me more active during the days.

@amytro, are you aware of any issues you may have with opioids? One of the many side-effects can be nausea, as well as disruption with sleep for some. Have you discussed with your surgeon or provider about the possibility of trying different medications to see if there is something that may help, or help stop the frequent nausea?

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Hi @amytro – I agree with Justin @JustinMcClanahan – I would keep a close eye on the issue of nausea. Three weeks after my last TKR I started having nausea so severely that I had to go to the ER. I, too, had been sent home from the hospital with anti-nausea meds but they didn't touch it. It turns out I was having a reaction to the Celebrex they prescribed as an anti-inflammatory and it was causing internal bleeding. I think your body may be sending you messages that all is not well. To me, the nausea and digestive issues sounds like the issues of greatest concern. If you don't have a doctor's appointment coming us very soon, could you message your doctor through the portal or call?

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@debbraw

@auntmarmar – Earlier on another thread, I think someone mentioned taking Trazadone. Have you talked to your orthopedic surgeon? If he/she can't help, maybe your primary care doctor could. I hope you get some relief soon. I think time is on your side. Once I passed the 8 week mark with my TKR, I found that I could turn over on my side more easily and had a much higher comfort level in terms of sleeping. Wishing you the best.

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Thanks. Yes I’ve tried that drug with no help. Appt with neurologist next week to check that out.

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@contentandwell

@auntmarmar Is your anxiety due to your TKR? I think you need to figure out what is causing the anxiety and depression before you can tackle it. I know nothing about sleeping pills, I do use melatonin and sometimes Benedryl but have not used any prescription remedies in many years. I tried once a long time ago but didn't like how I felt the next day.
It's good that you are seeing a counselor, hopefully that will help you to sort things out. It does not sound as if pain is what is keeping you awake, if I have interpreted your discussion correctly. I will be interested in hearing what approach is taken to help you because I often have trouble sleeping if I am anxious about anything. These days I do not feel anxious but if I get six hours of sleep I consider it to be a good night.
JK

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No pain is not the problem. And yes the anxiety and depression are since the surgery and seizure. Now mostly from the lack of sleep. Continuing with the counselor.

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You aren’t alone!!!! It will be 8 weeks post op for me on Monday. I was told to try Tylenol PM. I may fall asleep after about an hour after taking it but I wake up about 2 hours later and can’t sleep the rest of the night.

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I am 12 weeks out and sleeping better, but I have to adjust so much during the night (back, right side, left side, rearrange pillows) that I am rarely getting more than two hours of uninterrupted sleep. Then it's often a fight to get back to sleep. When I was still taking Tramadol, I think that helped me sleep–or at least stay "groggy" enough that even a trip to the bathroom wouldn't wake me up completely. I've used Tylenol PM and I think it's so-so — takes about an hour to get to sleep but does not get me 8 hours. Before the surgery I invested in good over-the-ear headphones (the ear buds bother my ears). To fall asleep, and if I woke up to get back to sleep, I'd put on the headphones and a podcast. Kept volume low, goal was white noise more than listening, but this did seem to help me get back to sleep. I also used a CryoCuff by Aircast, and the regular "inhalation/exhalation" of the machine actually helped me fall asleep/get back to sleep. But I feel you! Even now, I know that dealing with this recovery would be so much better if I had consistently good sleep. Good luck with your recovery and getting better sleep!

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