Using Stimulants to Improve Sleep in Adults with ADHD

Hey Terry,

Interesting study. Is the study available for public viewing on the internet?

I remember reading that a psychologist who treated ADD adults in northern California reported that his patients found taking a quarter dose of their stimulant medication before bedtime helpful. That was fifteen years ago.

I can't remember if this applied equally to hyperactive-impulsive adults and inattentive adults. Did the study indicate whether or not they included inattentive type only adults in the study?

I never tried taking a stimulant in the evening or partial dose at bedtime because I've always slept well and worried that the stimulant would keep me awake - (I'm a combined type; stimulants don't have a calming affect on me, probably because of my anxiety disorder).

Grandma Lise

I am thrilled to see this research being done on any scale, and glad you posted it, Terry. I might well have missed it otherwise.

I hollered, "Hallelujah!" on reading it and my daughter (with AD/HD) asked, "Uh, mom? Whassup?" So I told her that science has finally proved, provisionally, what she and I discovered as unpaid researchers several years ago. She slept fine through about age 6 I think, at which time getting to sleep was a major problem. She was diagnosed with AD/HD as she turned 8, so it was obvious it wasn't the meds keeping her awake.

Oh we tried everything, though I must have had a hunch, because one thing I did not try was to have her stop taking them earlier in the day. I began to notice the occasions when she got to sleep more quickly and kept a log of meds, food, hours of sleep, and bedtime. Pretty soon the pattern emerged: on nights when she took her last dose later than usual, or went to bed earlier, she got to sleep sooner.

Meanwhile, a family friend who is a pediatrician and treated AD/HD before it was much mentioned even, suggested I try giving her some coffee with milk (yes, and sugar, if she wanted it) at bedtime to see if it helped. It DID. (He did say some kids "are not responders," and some are. I was glad mine was.

One morning, which was the third in a row after a completely sleepless night (I mean she did not go to sleep all night long - and neither did I), she began at 5:45 am, to hallucinate. Not long after that she fell asleep. Our alarm awakened us at the usual time (7:00, I think) and my husband found us stumbling around the kitchen at 8:00 am getting ready for school. What was I thinking? I wasn't. Nor was she. He packed us both off to bed and called the school.

So finally she took a small dose (of Adderall, then) around bedtime; got very good at guesstimating whether her last dose would carry her into sleep, or not; and if not, she'd take a "booster" dose. Her doctor, bless him, who had been trying to help and didn't want to add another medication, not only understood her experience, but commended her and rewrote the prescription.

I myself, with AD/HD, too, have never had trouble sleeping, so it's a non-issue for me. However, I do know I can be two hours into a full doe of my regular stimulant dosage and go have a nap without any getting-to-sleep problems.

We are all so similar, yet so different in the quirky ways. There is an excellent article I have written by William Dodson, MD of Denver, Colorado, entitled "The New Standards of Care" (or something close to that) in which he blows most of the medication treatment assumptions/myths out of the water and goes so far as to recommend that for some people, 24-hour medication is a good idea. (My daughter, now 15, has switched to Vyvanse and takes it three times a day at 8-hour intervals. She's always had to be awakened an hour before really getting up, in order to take meds (in order to be fit to live with and fit to begin her own day), so when you figure she needs stimulant to sleep and to wake up, well, there aren't too many hours in between. She's a lot more steady of temperament and cognitive function at both ends of her day this way.

Betsy

...long enough?

Betsy