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Cyclobenzaprine for Sleep—Is It Effective?

Cyclobenzaprine for Sleep—Is It Effective?

Meet Benjamin. For the past several months, he’s been wrestling with sleeplessness, spending most nights staring at the ceiling. If you can relate to Benjamin’s struggle, you’re not alone. Statistics reveal that more than one-third of adults in the U.S. sleep less than seven hours per day. 

Benjamin has tried various ways to improve his sleep, from listening to calming music and reading before bed to maintaining a regular sleep schedule and using memory foam pillows with limited success. Like many of us, Benjamin has also heard about sleep disorder medications, but choosing one has been challenging.

Then, Benjamin’s doctor recommends cyclobenzaprine—a medication initially designed for treating muscle spasms but also effective in treating short-term sleep issues. But can the drug help you overcome sleeplessness without causing unwanted reactions? Learn key information about cyclobenzaprine for sleep, including its mechanism of action, dosage, and whether it’s safe and effective.

What Is Cyclobenzaprine?

Cyclobenzaprine isn’t your typical first line of defense against insomnia. It was approved for sale in the U.S. in 2007 to relieve symptoms of muscle injury, including pain, discomfort, and limited motion.

Studies show that over 30% of patients who use cyclobenzaprine experience drowsiness and sedative effects, which has led to its off-label use in managing sleep disturbances.

Check out the basic information on the drug in the following table:

Drug Characteristics

Cyclobenzaprine

Active component

Cyclobenzaprine hydrochloride

Drug classification

Muscle relaxant

Date of FDA approval

1977

Drug form

Tablet

Brand names

Amrix, Flexeril

Average dose

15 mg per day

Maximum dose

60 mg per day 

Suitable for children

Not approved for patients under 15

Suitable for pregnant women

Consult your healthcare provider

How Does Cyclobenzaprine Work?

Cyclobenzaprine acts on the central nervous system by reducing muscle hyperactivity and alleviating symptoms of muscle injury. Interestingly, the drug’s structure is similar to those of tricyclic antidepressants (TCAs), a class of medications used to treat depression and anxiety. The structural similarity allows cyclobenzaprine to have anticholinergic effects, such as drowsiness, which contribute to its sedative properties. 

Clinical trials show that patients who took cyclobenzaprine experienced reduced muscle spasms and tension, improved relaxation, and had more restful nights than those who took the placebo. 

Keep in mind that while the medication can be effective in treating sleep issues related to muscle discomfort, it should only be used under the guidance of a healthcare provider. 

How To Dose Cyclobenzaprine for Sleep

Cyclobenzaprine comes in tablet and capsule (extended-release) forms with the following doses available:

  1. 5 mg
  2. 7.5 mg
  3. 10 mg
  4. 15 mg
  5. 30 mg

The average starting dose of cyclobenzaprine for sleep is 5 mg, and the maximum daily intake is 60 mg. Healthcare providers sometimes prescribe a starting dose of 2.5 mg for patients if the risks of adverse reactions are high. 

How Do You Take Cyclobenzaprine for Sleeplessness?

Source: Kampus Production

You should take cyclobenzaprine as directed by your healthcare provider. Doctors typically recommend taking your dose 1–2 hours before bed and advise you to allocate about seven hours for sleep after administration. 

If you’re taking the capsule form and cannot swallow it whole, you may open it, sprinkle the content over a tablespoon of applesauce, and swallow it in one bite. Drink some water to ensure you’ve swallowed all of the medicine.

You should not cut or crush a cyclobenzaprine tablet—ingest it whole to avoid interfering with your dose.

You can take cyclobenzaprine with or without food. If you experience stomach upsets after the initial dose, take subsequent ones with meals to alleviate the discomfort.

Cyclobenzaprine is typically taken for a maximum of three weeks, so you should inform your healthcare provider if the medication doesn’t provide relief from sleeplessness within the first seven days of treatment.

How Long Does It Take for Cyclobenzaprine To Work?

Cyclobenzaprine typically kicks in within 30–60 minutes of intake. The duration may increase up to two hours if you take the medication with a heavy meal.

If you take immediate-release tablets, expect the effects to last 4–6 hours. The effects will wear off naturally if you follow your doctor’s guidelines, allowing you to proceed with your daily routine.

Keep in mind that while cyclobenzaprine is fast-acting, it may take up to a week to feel the full relaxing effect.

How Long Does Cyclobenzaprine Stay in Your System?

The period your body needs to eliminate 50% of a drug’s dose is called half-life. The half-life of cyclobenzaprine is typically 18 hours, but it can rise to 46.2 hours for patients with liver disease. 

On average, the body metabolizes the drug after 4–5 half-lives—so cyclobenzaprine may stay in your system for 3–4 days after the last intake. 

For elderly patients, the drug may stay in the body for 6–7 days, while the duration increases to 8–10 days for people with liver disease.

Patients who experience the drug’s effects five days after completing the prescribed treatment should consult their healthcare providers for appropriate guidance.

Who Can Take Cyclobenzaprine?

Cyclobenzaprine for sleep is typically recommended for adults (18+) dealing with the following issues:

  • Difficulty falling asleep due to muscle spasms or pain
  • Difficulty maintaining sleep throughout the night due to muscle discomfort
  • Poor quality of sleep due to muscle tension or pain
  • Accompanying problems affecting sleep, such as stress, mood shifts, and impaired cognitive function due to muscle pain

Pregnant women and women planning to get pregnant should use cyclobenzaprine with caution. Clinical studies show that cyclobenzaprine use during late pregnancy can contribute to the risk of respiratory distress in newborns.

The drug is generally avoided in individuals over 65 since it can contribute to the risk of accidental falls—doctors typically prescribe lower doses if the benefits outweigh the risks for this group of patients.

How Can You Get Cyclobenzaprine?

Source: Andrea Piacquadio

Cyclobenzaprine is not an over-the-counter drug. This medication is available only with your doctor’s prescription. You should use the drug as directed by your healthcare provider—do not share your medication with others. 

Does Cyclobenzaprine Help With Sleep?

Cyclobenzaprine can provide relief from sleeplessness due to musculoskeletal pain, but it’s not a one-size-fits-all solution. Sleep issues are typically multifaceted and require a comprehensive approach for effective management. 

Sleep doctors can help patients design tailored treatment plans, but the primary challenge is that these experts are scarce, and you may wait for months before getting an appointment. That’s where telemedicine platforms like Kick come in. With a fantastic program designed by a Stanford sleep specialist, Dr. Alex Dimitriu, the platform connects you with sleep experts within 24 hours, allowing you to start treatment quickly.

Kick—Quick Relief for Sleeplessness

Source: Andrea Piacquadio

Kick offers a swift and convenient solution to patients with sleep issues. Our doctors are well familiar with sleep medicine and combine sleep medications like cyclobenzaprine with cognitive behavioral therapy for insomnia (CBT-I) to help you overcome sleep problems.

The consultation happens online and takes 15 minutes. After a thorough evaluation, our expert will prescribe two trial medications based on your health and medical history. Getting your medication is effortless—you can pick it up from your local pharmacy or have it delivered to your doorstep.

Your dedicated expert will monitor your treatment and adjust it if necessary, helping you solve sleep issues quickly. Our specialist will also offer tips on healthy sleep hygiene to ensure you reach a viable, long-term solution.

How Kick Works

To get started with Kick, follow these easy steps:

  1. Go to the signup page and start your 15-minute sleep visit
  2. Complete the medical intake form to allow us to understand your medical history and design the most effective treatment plan
  3. Enter your delivery and payment information

If our sleep specialist decides Kick is not for you, they will refer you to your primary care physician, and you won’t pay for the initial consultation, according to our Doctor Guarantee.

A flood of positive reviews on Trustpilot is a testament to our commitment to helping patients reclaim their sleep. For a first-hand experience of how our groundbreaking sleep program can help you get better sleep, register on Kick

Is Cyclobenzaprine Addictive?

Cyclobenzaprine is not classified as a controlled substance according to the DEA— it's not considered to have a high potential for abuse and dependence.

Still, clinical studies show that some patients may develop psychological dependence or experience withdrawal symptoms upon treatment discontinuation. The symptoms are:

  1. Malaise
  2. Nausea
  3. Headache

Patients who use the medication as prescribed and for a maximum of three weeks rarely experience these symptoms. Individuals who experience withdrawal symptoms should seek immediate medical help.

What Are Cyclobenzaprine’s Side Effects?

While cyclobenzaprine is effective in alleviating the symptoms of muscle injury and promoting sleep, it carries the risk of side effects.

The most common ones are:

  • Constipation—Eating a diet high in fiber, drinking plenty of water, and exercising regularly can help alleviate this
  • Dizziness—Such issues can typically be managed by getting up slowly from a sitting or lying position
  • Drowsiness—This can often be managed by taking the medication at bedtime
  • Dry mouth—Drinking water frequently, chewing sugar-free gum, and avoiding tobacco can help manage cottonmouth
  • Headache—Over-the-counter pain relievers can often help manage this unwanted reaction
  • Nausea—Eating small, frequent meals and avoiding fatty foods can help with this side effect
  • Fatigue—Resting and sleeping for at least seven hours after intake can alleviate this side effect
  • Stomach upset—Eating bland, low-fat foods and drinking plenty of water can help resolve this issue

Patients who experience the following adverse reactions should contact their doctor immediately:

  • Agitation
  • Chest pain
  • Pain in the jaw or shoulders
  • Difficult breathing
  • Irregular heartbeat
  • Fever
  • Hallucinations
  • Hives
  • Loss of coordination
  • Muscle stiffness
  • Prolonged nausea
  • Shivering
  • Swelling of the face or other body parts
  • Twitching
  • Unexplained weight gain or loss

These side effects rarely occur in patients who follow their healthcare provider’s guidelines. If you miss a dose, you should not double up on the next one. Patients who overdose should contact their primary care physicians for immediate intervention.

Keep in mind that the lists above are not exhaustive. Contact your doctor if you experience other unexplained physical or cognitive changes.

Who Shouldn’t Use Cyclobenzaprine?

While cyclobenzaprine is generally safe for most adults, certain medical conditions may prevent patients from taking the medicine. Individuals with the following conditions should approach the drug with caution:

  • Hyperthyroidism—People with an overactive thyroid should avoid using cyclobenzaprine
  • Heart conditions—Individuals with heart rhythm disorders, congestive heart failure, or those who have recently had a heart attack should not use cyclobenzaprine
  • MAO inhibitors—If you’ve used monoamine oxidase (MAO) inhibitors, such as certain types of depression medications, within 14 days, you should not use cyclobenzaprine
  • Glaucoma—Individuals with high eye pressure should consult their doctors before using the medication
  • Urinary retention—Patients with difficulties in passing urine should consult their doctors before using this medication
  • Liver disease—Individuals with liver disease should consult their doctor before using cyclobenzaprine
  • Children—Cyclobenzaprine is not approved for use by children and adolescents under 15

The above list is not exhaustive—you should consult your healthcare provider before starting the medication. It can help your doctor design the most effective treatment based on your health history and the current medications you're taking.

Which Medications and Food Interact With Cyclobenzaprine?

Cyclobenzaprine can interact with other medications or food, which can increase the risk of side effects or reduce the effectiveness of the drug. Here’s a table detailing some of the potential interactions:

Medication/Food

Interaction With Cyclobenzaprine

Recommendation

Antihistamines

Can contribute to side effects like drowsiness, blurred vision, and irregular heartbeat

Use carefully and under the guidance of a healthcare provider

Alcohol

Can contribute to side effects like drowsiness and headaches

You shouldn’t mix alcohol with cyclobenzaprine

Anti-seizure medications

Can increase the risk of side effects like drowsiness, confusion, and poor motor coordination

Consult your primary care physician before use

Blood pressure medication

Can increase the risk of side effects like irregular heart rhythm

Your healthcare provider may suggest reducing the dose or taking the drugs at different times of day

Heart medication

Can increase the risk of side effects like irregular heart rate

Consult your healthcare provider for specific guidance

Herbal supplements

Can increase the risk of side effects like drowsiness and confusion

Your doctor may recommend taking the supplements at a different time of the day

Infection medications

The potential for interaction with antibiotics is low but hasn’t been ruled out

Consult your healthcare provider before use

Muscle relaxants

Can contribute to the sedative effects, increasing the risks of drowsiness and accidental falls

Your doctor may recommend reducing the doses or taking other relaxants at different times of day

Opioids and CNS depressants

Can add to the sedative effects, increasing the risks of drowsiness and accidental falls

Ask your doctor before using opioids and CNS depressants

Sleep or anxiety medications

Can contribute to side effects like dizziness and headaches

Discuss with your healthcare provider before use

Specific drugs cyclobenzaprine may interact with include tramadol, ibuprofen, baclofen, and gabapentin.

Before taking cyclobenzaprine, you should inform your healthcare provider about any medications, supplements, or food you consume to help them determine whether it’s safe and effective.

What Are the Alternatives to Cyclobenzaprine?

Source: Аlexander Polepkin

Depending on the cause of your sleeplessness, your doctor may suggest the following cyclobenzaprine alternatives:

Alternative

When Doctors Typically Recommend It

Ativan (Lorazepam)

Recommended for sleep issues that stem from anxiety or stress

Benadryl (diphenhydramine HCl)

Often suggested for sleep problems related to allergies

Buspirone

May be used when sleep disturbances are linked to anxiety disorders

Clonazepam

May be prescribed for sleep issues associated with seizures and panic disorder

Doxylamine

Commonly used as a sleep medication for temporary insomnia

Gabapentin

Can be recommended for sleep problems associated with nerve pain

Pregabalin

Often suggested for sleep problems due to fibromyalgia or nerve pain 

Propranolol

May be used for sleep issues related to anxiety or panic disorders

Tricyclic antidepressants

Can be used for sleep problems in individuals with certain types of depression

Trazodone

Often prescribed for sleep disturbances associated with depression

Valium (Diazepam)

Typically used for sleep problems related to anxiety disorders

Xanax (Alprazolam)

Commonly used for sleep disturbances associated with anxiety and panic disorders

Zoloft (Sertraline)

May be used for sleep issues related to depression, obsessive-compulsive disorder, panic disorder, and posttraumatic stress disorder

This list isn’t exhaustive. Your doctor will assess your health history and decide whether you need to combine different medications to optimize the treatment quickly. 

Featured image source: Andrea Piacquadio