Treatment Options for ADHD-Related Sleep Problems
If the patient spends hours a night with thoughts bouncing and his body tossing, this is probably a manifestation of ADHD. The best treatment is a dose of stimulant-class medication 45 minutes before bedtime. This course of action, however, is a hard sell to patients who suffer from difficulty sleeping. Consequently, once they have determined their optimal dose of medication, I ask them to take a nap an hour after they have taken the second dose.
Generally, they find that the medication’s “paradoxical effect” of calming restlessness is sufficient to allow them to fall asleep. Most adults are so sleep-deprived that a nap is usually successful. Once people see for themselves, in a “no-risk” situation, that the medications can help them shut off their brains and bodies and fall asleep, they are more willing to try medications at bedtime. About two-thirds of my adult patients take a full dose of their ADHD medication every night to fall asleep.
Good luck convincing my doctor of this. 🙁
It is what the science would predict
For most people it does the opposite.
For adhd persons the dopamanergic effect of low dose stimulants would be way more powerful than the stimulation effect and can cause drowsiness. This is for persons with a naturally abnormally low dopamine level. So, not most persons true
Got it. Thanks for elaborating!
I mean, it is exactly as you figured. Whatever your doctor is on about is some old fashioned stuff from before we understood the actual cause of adhd type presentstions
My doctor asks if I’m sleeping well and I say “yes”, because if I say “actually my sleep pattern is very irregular” she’ll try to reduce my dosage, even if I explain that my insomnia is due to racing thoughts and hyperfixations that are cured by more of the stimulant. My sleep pattern was irregular for twenty years before I ever took one nanogram of Adderall.
I’m currently on Vyvanse (again) for the first time in 8 years because it’s finally available as a generic. It’s much more effective than Adderall XR on me. Unfortunately, I had to take 90 mg (three times the 30 mg capsules I currently have) in order to feel different* (tolerance couldn’t have been an issue because I had been without stimulants for a week prior to receiving the new prescription). The maximum my clinic will prescribe is 70 mg, which I think is the FDA limit, so I may be SOL. I’m determined to find my optimal dosage before I die, having never known my true potential.
For years and years I was too scared to experiment with a 1.5 or 2x dose, but now I’m beginning to think that the higher dosages are what I need. I read in this same publication that researcher clinicians typically end up giving their patients about twice the dosage of non-expert doctors (as high as ~200 mg at the extreme end IIRC). My hypothesis is that this is because the DEA and American drug culture at large cause most physicians to be overly cautious and conservative.
*I can tell my stimulant medication is working when I am able to manage my THC addiction.