Sleep issues are my middle name. I had this issue pre rsd and now with it when my pain is high it is even worse. My psych used to say I am on sleep meds for the size of a horse. Have you been to a psych? To me they are with better knowledge of sleep then gp or pain docs. I know it helped for a short time for me trazedone and my pain doc suggested that again for me. Have you asked about a lower dose of remeron? Be careful about tylenol pms too often because that can impact the liver.