I started the fentanyl patch three weeks ago and am very happy with it. My doctor would prefer to keep me on a lowish dose and have me continue my norco for breakthrough, while keeping a log as to how much I need daily on average. The problem is that norco keeps me awake at night (apparently an unusual reaction). That is why I was so happy to find the patch- it is constant, even, pain relief and it did not keep me awake or zonk me out. I tend to go to sleep in pain and wake up in pain due to not medicating in the late afternoon and after for fear of sleeplessnessThe patch has helped a lot but is not quite enough and I am wondering if there is a similar shorter acting breakthrough med you have tried or recommend. I expect ultimately I will end up going from 12.5 to 25 with the patch but in the meantime I do need the pills too. Thoughts?