I'm so sorry you are having such a hard time, but I kinda know what you mean. I thought it was just me but I guess not. Like you, I'm back to not really sleeping at night, and as I'm having a flair now, it's hard to remember breakthru pain, but I know I have it. I'm taking 5 mg Opana IR, for the breakthru and it does seem to work. I haven't been taking it like I'm suppose to, so I guess I only have myself to blame. When taken as I should, the 5 mg does make a difference. I wonder if that is something that your dr. would give you? It is such a great drug, that it has to work.

Hugs
Mary