Using Stimulants to Improve Sleep in Adults with ADHD

Patient Expert

It may seem counter-intuitive to suggest that taking stimulant medications at night might help adults with ADHD fall asleep and stay asleep, but a new study points to just that.

The study, published in the March 1, 2008 issue of the journal Sleep, discovered that adults with ADHD suffering from sleep disturbances found relief when treated with methylphenidate (the main ingredient in Ritalin).

Lead author, Esther Sobanski, MD, of the Central Institute of Mental Health in Mannheim, Germany, followed two groups of adults with ADHD. The first group of 34 adults had ADHD but was not receiving medication. Of this group, 24 did not have co-morbid psychiatric disorders.

The second group, the control group, included adults without ADHD or any psychiatric disorders and who were not taking psychotropic medication.

Dr. Sobanski found that those with ADHD slept less, fell asleep later and woke up more often than those without ADHD. In addition, the quality of their sleep was poorer than the controls, with less REM sleep and REM density.

Further, adults with ADHD showed identical sleep problems to children with ADHD, including a longer time to fall asleep, more nocturnal activity and awakenings, reduced sleep efficiency and decreased REM activity.

Using methylphenidate for sleep problems in adults with ADHD had never been studied before, and though the number of adults in this study was small, it seemed to demonstrate that the medication had beneficial effects on those with sleep disturbances due to their ADHD and in addition, improved daytime functioning.

Dr. Sobanski found that ADHD adults treated with methylphenidate reported a number of benefits, including less time falling asleep, fewer awakenings, less psychosomatic symptoms while falling asleep and improved evening mood. They also reported better sleep quality in general.

Many parents, under the guidance of their child's physician, have found that adding a stimulant before bedtime can help their child fall asleep. This new study confirms that the same protocol may be helpful in the treatment of ADHD related sleep problems in adults. Of course, whether using stimulants in adults or children for sleep problems, it is essential to discuss this with your physician, as one of the side effects of stimulant medication can actually cause insomnia.

If adding stimulants to your bedtime regime is not recommended by your doctor, here are some tips to help you fall asleep:

  1. Write down all the thoughts, concerns, brainstorms and to-do lists on a piece of paper before going to bed. This will help to free your mind of cluttered thoughts.
  2. Practice good sleep hygiene: get to bed at a reasonable hour consistently, every night, regardless of weekends or vacations.
  3. Consider using "white noise" to help you fall and stay asleep. There are gentle sound machines that one can consider, or CDs with nature sounds. Others find falling asleep with the TV or radio on to be helpful.
  4. Eliminate bedtime snacks. A full stomach can make falling asleep more difficult. Reduce your caffeine intake towards the end of the day.
  5. Take a warm bath or shower to relax yourself.
  6. Engage in activities that bore you to sleep, like reading a long, complicated novel. Stay away from the computer or gripping TV shows that hold your attention.

If sleep continues to be a problem, see your doctor who might recommend a sleep study.