What Can You Take for Sleep While on Suboxone?

October 11, 2025 •

5 min read

Up to 70% of individuals on buprenorphine continue to experience sleep problems, which are often linked to underlying mental health needs rather than medication dosage. Understanding what can you take for sleep while on Suboxone safely is critical for a successful recovery journey.

Quick Summary

Managing insomnia on Suboxone requires a cautious approach, focusing on non-pharmacological methods and safe, medically-supervised alternatives like melatonin or certain antidepressants. High-risk medications should be strictly avoided due to dangerous interactions.

Key Points

Consult your doctor first: Before taking any new medication or supplement for sleep while on Suboxone, always speak with your healthcare provider to avoid dangerous drug interactions.
Avoid high-risk sedatives: Strictly avoid combining Suboxone with benzodiazepines, Z-drugs (like Ambien), sedating antihistamines (like Benadryl), and alcohol due to the high risk of severe respiratory depression and overdose.
Consider safe supplements: Melatonin, magnesium, and L-theanine are generally considered safer options for short-term sleep support, but a doctor's guidance is still recommended.
Explore prescription alternatives: If lifestyle changes and supplements aren't enough, your doctor may suggest safer prescription sleep aids like low-dose doxepin, ramelteon, or trazodone.
Prioritize sleep hygiene and CBT-I: Non-pharmacological methods like maintaining a consistent sleep schedule and practicing cognitive behavioral therapy for insomnia (CBT-I) are the most effective long-term solutions.
Adjust your Suboxone timing: Some people find that taking their Suboxone dose in the morning, rather than later in the day, can help reduce nighttime restlessness.

Navigating Sleep Issues While on Suboxone

Experiencing sleep disturbances is a common challenge for individuals undergoing medication-assisted treatment (MAT) with Suboxone (buprenorphine/naloxone). These issues can stem from the body's adjustment during withdrawal, changes in the sleep cycle, or co-occurring mental health conditions. The key to finding relief is to prioritize safety by understanding which sleep aids are dangerous to mix with Suboxone and which alternatives are generally considered safer under a doctor's guidance.

The Dangers of Combining Suboxone with Sedatives

Many common sleep medications and sedatives are extremely dangerous to take with Suboxone due to the risk of additive central nervous system (CNS) and respiratory depression. Combining these substances can lead to severe drowsiness, impaired coordination, coma, or even death.

Key medications to strictly avoid include:

Benzodiazepines: Drugs like alprazolam (Xanax), lorazepam (Ativan), and clonazepam (Klonopin) have a synergistic depressant effect with Suboxone, posing a severe and often fatal risk.
Z-drugs: Non-benzodiazepine hypnotics such as zolpidem (Ambien), eszopiclone (Lunesta), and zaleplon (Sonata) also amplify sedation and increase the risk of respiratory issues.
Sedating Antihistamines: Over-the-counter sleep aids often contain diphenhydramine (Benadryl) or doxylamine. Prescription antihistamines like hydroxyzine can also cause dangerous interactions. Their sedative effects can be dangerously intensified by Suboxone.
Alcohol: Consuming alcohol with Suboxone can cause life-threatening respiratory depression and should always be avoided.

Safer Over-the-Counter and Supplement Options

For many, non-prescription supplements offer a gentler starting point for addressing sleep difficulties. However, even these should be discussed with a healthcare provider to ensure they are appropriate for your specific needs.

Melatonin: This natural hormone helps regulate the sleep-wake cycle and is generally considered a safer, non-addictive option for short-term use. It is recommended to start with a low dose (1-3mg) and use it temporarily. While generally safe, some drug interaction databases classify the combination with buprenorphine as a moderate risk due to potential additive sedative effects.
Magnesium: Magnesium supplements, particularly magnesium glycinate, can help support muscle relaxation and may alleviate restless legs or cramping that can interfere with sleep.
L-theanine: This amino acid, found in green tea, may help calm anxiety and improve sleep quality. It has not been specifically studied for opioid treatment, but some individuals find it helpful for relaxation.
Chamomile Tea: Chamomile is a mild and safe herbal remedy that can have calming properties to help you wind down before bed.

Prescription Medications Under Medical Supervision

In cases of persistent insomnia, a doctor may evaluate the risks and benefits of prescribing a sleep aid that is less prone to misuse and respiratory depression.

Low-Dose Doxepin (Silenor): This antidepressant is used in low doses for chronic insomnia and has a low risk of respiratory depression, making it a viable option for those with substance use disorders.
Ramelteon (Rozerem): This medication is a melatonin receptor agonist with no abuse potential or controlled substance status. It is effective for sleep-onset insomnia and does not cause significant respiratory depression.
Trazodone: An antidepressant often prescribed off-label for sleep, trazodone has a lower risk of misuse than traditional sedatives. It can be used with Suboxone but with caution, as it can cause sedation and, rarely, serotonin syndrome.
Suvorexant (Belsomra): As an orexin receptor antagonist, suvorexant works by targeting the sleep-wake cycle rather than causing overall sedation. Research shows it can improve sleep during opioid withdrawal and potentially reduce drug cravings.

Non-Pharmacological Strategies for Better Sleep

Behavioral changes and lifestyle modifications are often the most effective long-term solutions for insomnia, especially during recovery.

Consistent Sleep Schedule: Go to bed and wake up at the same time every day, even on weekends, to regulate your body's internal clock.
Relaxing Bedtime Routine: Develop a routine to signal to your body that it's time to sleep. This can include a warm bath, reading a book, or gentle stretching.
Optimize Your Environment: Make your bedroom dark, cool, and quiet to promote restful sleep. Consider using blackout curtains or a white noise machine.
Limit Stimulants: Avoid caffeine, nicotine, and large meals in the hours leading up to bedtime.
Get Regular Exercise: Physical activity during the day can promote better sleep at night, but avoid vigorous exercise too close to bedtime.
Cognitive Behavioral Therapy for Insomnia (CBT-I): This is a highly effective, evidence-based therapy that addresses the thoughts and behaviors preventing restful sleep.

Comparison of Sleep Aids on Suboxone


Medication/Supplement Category	Examples	Interaction with Suboxone	Risk Level	Notes
Benzodiazepines	Xanax, Ativan, Klonopin	Dangerous Interaction	High	Severe risk of respiratory depression and overdose. Should be avoided.
Z-drugs	Ambien, Lunesta	Dangerous Interaction	High	Increased sedation and risk of respiratory depression. Avoid.
Sedating Antihistamines	Benadryl, Hydroxyzine	Dangerous Interaction	High	Additive sedative effects can lead to severe drowsiness. Avoid.
Alcohol	Any alcoholic beverage	Dangerous Interaction	High	Extreme risk of respiratory depression and other severe side effects. Avoid.
Melatonin	OTC supplements	Mild Interaction	Low-Moderate	Additive drowsiness possible; use short-term under guidance.
Magnesium	Glycinate, Citrate	No Known Interaction	Very Low	May help with muscle relaxation and restless legs.
L-theanine	OTC supplements	No Known Interaction	Very Low	May help calm anxiety and promote relaxation.
Low-Dose Doxepin	Silenor	Requires Caution	Low-Moderate	Prescription option with lower respiratory risk; requires medical supervision.
Ramelteon	Rozerem	No Abuse Potential	Low	Prescription melatonin receptor agonist; no respiratory depression concerns.
Trazodone	Desyrel	Requires Caution	Low-Moderate	Prescription antidepressant used for sleep; risk of sedation and serotonin syndrome.

Conclusion

Insomnia is a very real and frustrating side effect for many people on Suboxone, but safe and effective solutions exist. It is crucial to be proactive in managing sleep disturbances by first implementing behavioral strategies and exploring safer supplements like melatonin or magnesium after consulting a doctor. Always avoid high-risk sedative medications and over-the-counter sleep aids containing antihistamines, as their combination with Suboxone can have life-threatening consequences. For persistent sleep issues, discussing prescription options with a qualified healthcare provider is the safest path forward. With a careful, medically-supervised approach, restful nights are an achievable part of the recovery process.

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. You can find further guidance on medication interactions from authoritative sources like the National Institute on Drug Abuse (NIDA) or the Substance Abuse and Mental Health Services Administration (SAMHSA).

Frequently Asked Questions

No, it is not safe to take most over-the-counter sleep aids with Suboxone. Many contain sedating antihistamines like diphenhydramine (Benadryl) that can dangerously increase drowsiness and respiratory depression when combined with Suboxone.

Melatonin is generally considered a safer, non-addictive option for short-term use, especially to help reset your sleep-wake cycle. However, you should discuss it with your doctor first, as there is a potential for additive drowsiness.

Insomnia during Suboxone treatment can be caused by the body's adjustment to treatment and withdrawal, disruption of the sleep cycle by buprenorphine, and the re-emergence of underlying conditions like anxiety or PTSD that were previously masked by opioid use.

Some safer prescription options include low-dose doxepin, ramelteon, and trazodone, as they carry a lower risk of respiratory depression and abuse potential than traditional sedatives. Your doctor will determine the best and safest option for you.

Many people find that taking their Suboxone dose in the morning is more effective for improving sleep quality. Taking it later in the day can sometimes cause restlessness or interfere with falling asleep.

Cognitive Behavioral Therapy for Insomnia (CBT-I) is a highly effective, evidence-based therapy that addresses the thoughts and behaviors preventing restful sleep. It is often recommended as the most effective long-term solution for insomnia during recovery.

Yes, combining Suboxone with certain sleep medications, particularly CNS depressants like benzodiazepines and Z-drugs, can lead to severe respiratory depression, coma, and even death.