How Do You Titrate Low Dose Naltrexone (LDN) for Sleep Disturbance?

How Do You Titrate Low Dose Naltrexone (LDN) for Sleep Disturbance?

Titrate for sleep?  One of the side effects is sleep disturbance.  More often, vivid dreams and sometimes problems falling asleep.  What we do then is to not give the last dose after 4 pm and if that's still too late, not afternoon, and if that's still too late, give all the dosing in the morning when they wake up.  Generally, that will take care of it.  The other major side effect is GI disturbance, and when we get either of these side effects we do not continue the titration.  We stay at that dose, and the patient seems to acclimate to that dose, and then you can go on with the titration.