Sleep Management — SENTINEL

Sleep Challenges in Lyme Disease

Lyme Disease

Challenges

Persistent insomnia during active infection and post-treatment
Night sweats and temperature instability
Neuroborreliosis-related sleep disruption (CNS inflammation)

Tips

Track sleep-symptom correlation during antibiotic treatment cycles
Herxheimer reactions may temporarily worsen sleep -- plan accordingly
Address co-infections (Babesia, Bartonella) that independently disrupt sleep

Sleep Hygiene Checklist

Check off items as you establish each habit. Your progress is saved automatically.

Log Tonight's Sleep

Date

Total Hours

Bedtime

Wake Time

Sleep Quality

Notes

Weekly Summary

No entries in the past 7 days.

Start logging your sleep to see weekly trends.

Medications That Affect Sleep

Cross-reference with your medication tracker. Discuss timing changes with your provider.

TrazodoneMay help sleep

Sedating antidepressant often used off-label for insomnia

Gabapentin / PregabalinMay help sleep

Increases slow-wave sleep; also addresses neuropathic pain

Prednisone / CorticosteroidsMay disrupt sleep

Can cause insomnia, agitation, and mood changes

SSRIs (some)May disrupt sleep

May suppress REM sleep and increase vivid dreams or nightmares

Beta-blockersMay disrupt sleep

Can reduce melatonin production and cause nightmares

Stimulants (Adderall, Ritalin)May disrupt sleep

Avoid after early afternoon; extended-release formulations need earlier dosing

DoxycyclineMay disrupt sleep

GI irritation may disrupt sleep if taken too close to bedtime

Supplements for Sleep

Always consult your healthcare provider before starting supplements, especially with existing medications.

Melatonin

strong evidence

0.5-3 mg, 30-60 min before bed

Start low (0.5 mg). Higher doses are not more effective. Helps circadian rhythm disorders more than insomnia.

Magnesium glycinate

moderate evidence

200-400 mg before bed

Glycinate form is best tolerated. Helps muscle relaxation and may improve sleep quality. Avoid oxide form (GI side effects).

L-theanine

moderate evidence

200-400 mg before bed

Promotes relaxation without drowsiness. May reduce anxiety-related insomnia. Generally well-tolerated.

CBD (cannabidiol)

emerging evidence

25-50 mg sublingual

May help with pain-related insomnia. Check drug interactions. Legal status varies. Start with lowest dose.

When to See a Sleep Specialist

Red Flags -- Seek Evaluation

•Loud snoring with observed pauses in breathing (possible sleep apnea)
•Waking up gasping or choking during the night
•Excessive daytime sleepiness despite 8+ hours of sleep
•Persistent insomnia lasting more than 3 months
•Involuntary leg movements or restless legs worsening at night
•Oxygen saturation dropping below 90% during sleep (if monitored)
•New-onset sleep disruption after COVID infection or Lyme treatment
•Sleep-related headaches or jaw pain (possible bruxism)

Sleep Study (Polysomnography)

Overnight in-lab or home sleep test (HST)
Measures EEG, EMG, EOG, respiratory effort, SpO2
Gold standard for diagnosing sleep apnea, PLMD, narcolepsy
Especially important for Lyme patients with new sleep complaints

CPAP & Treatment Considerations

Auto-CPAP (APAP) adjusts pressure automatically for comfort
Treating comorbid sleep apnea often reduces pain scores
Insurance typically covers with documented AHI ≥ 5 events/hour

Sleep Management & Hygiene

Sleep Challenges in Lyme Disease

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Sleep Management & Hygiene

Sleep Challenges in Lyme Disease

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