Is it that the ultram of 50 mg isn't strong enough? But it keeps me awake at night, i just can't sleep. I HAVE BEEN ON THE TRAZODONE FOR YEARS FOR SLEEP AND BEFOR THIS SURGERY I TOOK 50 OR 100 MG OF TRAZODONE EACH NIGHT AND i was sleeping LIKE A BABY, but now i think it is the pain am having from this total knee replacement revision