Ibuprofen as a sleep aid? WTF!

Factual Questions
41

That’s true. And I strongly suspect that’s partly because many people expect all drugs to make them drowsy. The FDA requires pharma companies conducting trials to report any serious adverse event that could plausibly have been caused by the drug in question. That’s a very low bar, even if a low bar is appropriate in this context.

If it’s odd for Adderall, it’s odd for Ritalin too. Again, these are very similar drugs on several levels. They’re both norepinephrine-dopamine reuptake inhibitors (NDRIs) and their effects are very similar. They’re both used on-label for narcolepsy as well as ADHD.

But isn’t this a paradox? Two drugs used to inhibit sleep might also induce it. How could it be both?

Well, many people “crash” once either drug wears off, feeling unusually fatigued and sleepy perhaps 6-8 hours after their last dose. So drowsiness is a common effect of both Ritalin and Adderall; it just comes after hours of perkiness. But drowsiness without preceding perkiness is quite rare, AFAIK.

If you just read a list of possible side effects, you won’t know that drowsiness is very unlikely until after 4-6 hours of pharmaceutical-grade perkiness. If you expect immediate sleepiness, though, your brain is more than capable of accommodating that expectation for a while.

Most are, especially the human ones. But as Jane Goodall famously observed, lemurs are effing basic.

Human beings are terrible data-acquisition devices—much worse than most assume. Eyewitnesses to crimes routinely get major details wrong. We suck at evaluating risk, routinely mitigating unlikely, short-term risks while ignoring much likelier, much riskier long-term issues. Implicit bias is omnipresent even if we guard against it.

Happily, human beings also invented the scientific method. While it can help address those failings, it’s really hard to apply the scientific method well. Even then, proving causation is extraordinarily rare. Drug trials are harder still because of the ethical constraints that human subjects require. Side-effects lists involve much less certainty than many assume.

42

Ibuprofen definitely puts me to sleep. Tylenol works, too…just not as well or as long as Ibuprofen.

43

Not to discount the placebo affect, but NSAIDs are known to have an effect on the endocannabinoid system. It’s not all in your mind: some of it is in your brain.

44

O.K. I’m an ICU nurse, so I kinda know what I’m talking about… but I’ve never really heard of this before so I’m also wildly pulling this out of my own ass. Maybe just half out of my ass. In short, this is a wild half ass educated guess. Don’t take it with a grain of salt, go find a stable and steal a salt lick from a horse and then take it with that. That’s how little confidence I have in my idea.
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It’s an NSAID, the whole reason it works is because it reduces inflammation (Non Steroidal Anti Inflammatory Drug). So, hmm, maybe the anti-inflamation is reducing her blood pressure and that’s what’s making her sleepy? It’s not really known to do that, (hell, normally it INCREASES blood pressure) but it’s sorta conceivable. You reduce inflammation on the muscles surrounding the blood vessels and the blood pressure drops. Probably not likely, but hey, strange things happen in medicine. I’d be curious to know if her blood pressure drops after she takes it. Again, not likely, but maybe. It’s possible that this is a paradoxical effect.

45

More likely, and also far simpler is simply general anti inflamatory, pain control stuff. Somebody may have low grade chronic pain, but so low grade they just live with it and don’t even notice any more. You relieve that, they are relaxed more than their baseline, and they are out like a light.

46

  1. There is a big psychological component to good sleep. Having daily habits and rituals is helpful. I would guess it is largely a placebo effect. But don’t knock the placebo effect, doctors should probably use it more.

  2. It might help prevent aches and pains if she exercises a lot or has other issues. This is the only way I can see it lowering blood pressure, which should drop with rest and reclining anyway.

  3. NSAIDs may help with depression; so perhaps have some effect on mood or other neurological effects. Many drugs can cause sleepiness.

47

Pain keeps you awake, and Ibuprofen alleviates pain so, indirectly, it can act as a sleep aide.

On the other hand, placebos have proven time and again that even if we only THINK something works, that can be enough to produce the desired effect.

48

Sure, but it’s not a placebo if the ibuprofen or other drug has some beneficial effect. A placebo might work as well, but there is an actual effect from the pain reliever so that any placebo effect may not be strong enough without it. I do wonder how well placebos work for sleep disorders that have a physical basis.

49

By definition, the placebo effect produces some effects. The drug itself produces its own effects.

So you’ve got a mixed bag of effects, some psychosomatic and some pharmacological. How do figure out which cause produced which effect?

If you know, please pipe up—or at least give The SDMB a shout-out when you accept the Nobel prize for medicine. :wink:

50

Non-placebo have a direct physical effect that often can be tested subjectively. The only way to be sure that a pill is producing the placebo effect is if the pill has no ingredients that cause any direct measurable physical effect. Otherwise the question can’t be answered for sure, but testing generally shows greatly different results from placebos and real medications. The more difficult part to determine is how the placebo effect manifests without any sugar pills. There is a lot of info out there on the role of ritual and the placebo effect, just google it to find out more. And the more it’s investigated the deeper the mystery runs.

But my point remains, if ibuprofen alleviates pain and discomfort then it could be a sleep aid without any placebo effect. Trying to untangle this without testing that specifically is difficult. Double blind testing of ibuprofen with placebos included may have produced reports of test subjects sleeping better, and more so when they don’t have the placebo, but those results may not have been significant enough to market ibuprofen as a sleep aid, or even to determine if those results were skewed by any placebo effect.

51

OK, nurse mode here. Besides taking ibuprofen, what else does she do? There’s probably a bunch of medical professionals here, and none of us can ethically give a diagnosis on a message board, but… To have any idea… There’s some questions. Blood pressure. Is she hypertensive? If so, does she take anything to control it? Blood sugar. Is she diabetic? If so, does she take anything to control that? Meds for depression? Antipsychotics? Antianxiety meds like say, xanax? Is there a history of seizures in her family?

The thing is, and what concerns me a bit, is that your wife get’s sleepy at odd times. That’s a bit odd. Maybe it’s not really the ibuprofen?

52

It was 16 years ago. Maybe she’s over it by now.

53

Oh, Good Lord. I didn’t even notice that! Here I am trying to use medical skills on a zombie. The dude’s poor wife probably woke up from her NSAID nap and is eating brains in Majikai. I don’t know where that is, but the O.P.'s location says it’s the land of cheese.

Fuck, the necromancer that brought this back is even called “stillalive”

Has he done this before?

54

He has two posts, both to this thread. I reported him. He’s a troll with a burner account.

55

I don’t know that what I described (husband feeling relieved that he had narcotics available) is precisely the “placebo effect”. More that there’s a link between stress and pain - and knowing he had something to deal with the pain if needed reduced his stress level - which reduced his pain a bit.

It’s a similar effect to my having a small amount of Sonata (sleep aid) on hand. If I’m having a wretched time falling asleep, I tend to stress about that, which makes it harder to fall asleep. Knowing I’ve got pharmaceutical help nearby if I need it can often make enough difference that I don’t need to take anything.

56

Bob Marley and his buddies would get high and go for long runs.