Does Suboxone Make You Tired or Sleepy?

Reviewed by Josie Desmarais, PMHNP-BC · Board-Certified Psychiatric-Mental Health Nurse Practitioner · Last updated June 2026

Yes — fatigue and sedation are among the most common side effects of Suboxone, particularly in the first two to four weeks of treatment. This is a normal response to buprenorphine’s activity on the central nervous system, and for most people it resolves substantially by week four. What matters is distinguishing expected adjustment fatigue from the kind of sedation that signals a genuine safety concern.

Dose and timing adjustments within medication-assisted treatment often resolve daytime fatigue.

Why Buprenorphine Causes Fatigue

Buprenorphine, the primary active ingredient in Suboxone, is a partial opioid agonist. It works by binding to the mu-opioid receptors that full agonist opioids — heroin, oxycodone, fentanyl — bind to, but it activates them only partially. That partial activation stabilizes patients in MAT: it prevents withdrawal, reduces cravings, and blocks the euphoric effect of illicit opioids. For more on this, see our guide to whether Suboxone shows up on a drug test.

The naloxone component in Suboxone is not responsible for sedation. Naloxone is poorly absorbed through the sublingual route and does not meaningfully reach the brain at prescribed doses — it is present primarily to deter injection misuse.

The CNS activity of buprenorphine itself produces the sedation. Its degree varies by:

• Dose. Higher buprenorphine doses produce more sedation. Starting at 16mg/day produces more initial fatigue than starting at 8mg.
• Timing in treatment. The nervous system of someone entering MAT has been dysregulated — by either chronic use, tolerance, or withdrawal. As buprenorphine stabilizes opioid receptor activity, the recalibration often produces deep fatigue. This is not the medication failing; it is the body adjusting.
• Sleep debt from active use. Many people entering MAT are chronically sleep-deprived. Early fatigue on Suboxone may partly reflect the body finally catching up.
• Individual metabolism. CYP3A4 enzyme variation affects how quickly buprenorphine is processed, which determines how long sedation lingers after each dose.

When Does the Fatigue Resolve?

For most people, Suboxone-related fatigue is most pronounced in the first one to two weeks and resolves substantially by week four. Options that help:

• Shift your dose timing. If you take a single daily dose, try moving it to the evening. Many patients report that daytime fatigue resolves when they switch from morning to bedtime dosing.
• Split dosing. Some patients do better with half the dose in the morning and half at night. This distributes the sedation effect more evenly. Your prescribing provider can adjust this — do not self-adjust without discussing it first.
• Avoid driving immediately after dosing until you know how Suboxone affects your alertness at your specific dose.
• Report persistent fatigue at your follow-up. Fatigue that significantly impairs your ability to work, drive, or care for your family beyond week six is a clinical signal worth evaluating — not something to push through silently.

FDA Black Box Warning: Benzodiazepines and Suboxone

This combination carries serious risk. It requires explicit disclosure to every prescriber involved in your care.

The FDA has issued a black box warning — the most serious warning category — on the combination of opioids or buprenorphine with benzodiazepines (Xanax/alprazolam, Klonopin/clonazepam, Valium/diazepam). Combined, these medications dramatically amplify CNS depression. This combination can cause respiratory depression, loss of consciousness, and death. We cover how long Suboxone blocks opiates in a separate article.

If you are currently prescribed a benzodiazepine and starting Suboxone, both your MAT prescriber and your benzodiazepine prescriber need to know about both medications. This is not optional — it is a patient safety requirement.

Alcohol and Suboxone: Alcohol is also a CNS depressant. Combining alcohol with buprenorphine increases sedation and raises respiratory depression risk. If alcohol use is part of what you’re managing, discuss it with your provider — it will not disqualify you from care, and addressing it is part of treatment. If that applies to you, read more about how to maximize Suboxone absorption.

Other CNS depressants to disclose:

• Muscle relaxants (carisoprodol/Soma, cyclobenzaprine/Flexeril)
• Sleep aids (prescription or over-the-counter)
• Antihistamines with sedating profiles (diphenhydramine/Benadryl)

Signs of Dangerous Sedation — Call 911

Normal fatigue is not an emergency. The following symptoms are:

• Breathing that is slow, shallow, or irregular
• Inability to stay awake or be roused
• Lips or fingernails turning blue or gray (cyanosis)
• Severe, sudden confusion or loss of consciousness

These indicate respiratory depression. Call 911 immediately. Do not wait to see if it resolves.

Talking to Your Provider About Fatigue

Persistent sedation beyond the adjustment period has identifiable causes and clinical solutions. Common options include:

• Adjusting the timing or splitting the dose
• Dose reduction if you are clinically stable at a higher dose than necessary
• Full medication review for additive sedation sources
• Evaluation for underlying contributors — untreated depression, sleep apnea, hypothyroidism — that may compound buprenorphine’s sedation

MAT treatment at Trust Psychiatry in West Palm Beach includes ongoing medication management visits, not only the initial prescription. Dose adjustments, timing changes, and interaction reviews are routine parts of the program.

Frequently Asked Questions

Is it normal to feel tired on Suboxone?
Yes. Fatigue and drowsiness are common in the first two to four weeks of treatment. They are a normal CNS response to buprenorphine and improve as your body adjusts.

How long does Suboxone make you sleepy?
Most people find initial fatigue resolves by week four. If significant sedation persists past six weeks, talk to your provider about dose or timing adjustments — it is a solvable clinical issue.

Can I drive while taking Suboxone?
Exercise caution during the adjustment period. Until you know how Suboxone affects your alertness at your prescribed dose, avoid driving immediately after dosing. Once stabilized, most people drive without impairment. Our team also explains taking gabapentin with Suboxone in detail.

Is it dangerous to combine Suboxone with a sleep aid?
Do not combine Suboxone with any sedating medication — including over-the-counter sleep aids — without your prescribing provider’s knowledge. CNS depressant combinations increase respiratory depression risk. The FDA has specifically warned about this class of interaction.

Why does Suboxone make me tired but not high?
Buprenorphine’s partial agonism means it activates opioid receptors enough to produce CNS effects including sedation, but not enough to produce the euphoria of full agonists — particularly in people with opioid tolerance. The tiredness is a dose-related CNS effect, not intoxication. Learn more about who can prescribe Suboxone here.

This article is for educational purposes only. Suboxone (buprenorphine/naloxone) requires a prescription and ongoing medical supervision. Contact Trust Psychiatry & Wellness at (561) 849-4449 to discuss MAT treatment options.

Managing Side Effects Is Part of Good MAT Care

Fatigue is the side effect people in MAT programs notice most in early treatment — and it is manageable. At Trust Psychiatry & Wellness in West Palm Beach, Josie Desmarais, PMHNP-BC, manages your full treatment trajectory from the first appointment, including dose timing, adjustment strategies, and medication interaction reviews. You may also want to understand getting Suboxone at urgent care.

Learn more about our Suboxone and MAT program or call (561) 849-4449. Telehealth consultations available to Florida patients statewide.

Related reading: Suboxone on a drug test and how to stop taking Suboxone. If symptoms are affecting your daily life, our medication management services can help.

Ready to Schedule a Psychiatric Evaluation?