ADHD and Sleep Medication
People with ADHD struggle to sleep. When they finally do sleep they are agitated and often awake at night.
Objective measures like polysomnography and actigraphy show that children with ADHD have longer sleep time and lower sleep efficiency, as well as shorter real sleep time than controls. However the sleep quality measures that are objective improve by methylphenidate (MPH) treatment.
1. Treatments to calm restlessness
ADHD can make it difficult to rest well. Many people with ADHD suffer from insomnia because they struggle to stop the wakefulness that keeps them awake even when they're asleep. This can result in a an inability to sleep well and inability to get up fully, making it more difficult to focus and leading to a worse day. The combination of ADHD and sleep issues can also increase the risk of anxiety, depression and other mood disorders.
ADHD medications can cause insomnia, but they can also improve it. Certain pain medications and signs of anxiety or depression can cause trouble falling asleep or staying asleep. A person with depression and ADHD might have more trouble sleeping when they take antidepressants such as nefazodone (Anxil) and mirtazapine (Remeron) or trazodone (Desyrel).
The majority of people with ADHD suffer from a variety of sleep-related issues, such as trouble with getting to sleep, difficulties staying asleep and waking up in the middle of the night. These symptoms can be triggered by a variety of factors, such as medication, alcohol or caffeine. People who are sleep deprived are likely to have a lower quality of life, and are more prone to heart disease, obesity and other physical health issues.
Medications used to treat the hyperactivity component of ADHD can also cause sleep issues, especially in children. The sedative effect of these drugs may promote sleep in young ADHD children. Clonidine in small doses-- 0.05-0.1 mg -- may have sedative effects on adults. It is recommended that this be taken in the evening, one hour before bedtime.
Certain ADHD patients are prescribed Lisdexamfetamine (LDX) an effective, long-acting oral stimulant, for insomnia. Both are effective for up to 12 hours durations and are recommended for the patient population in doses ranging from 1 to 4 mg per day. It is crucial to distinguish between different types of insomnia and analyze sleep patterns using objective measures (polysomnography and actigraphy), as well as self-rated or parental-rated questionnaires and diary entries.
2. Medicines to Help You Fall Sleep
People suffering from ADHD struggle to fall asleep at night. They may be in bed for hours in a twirl or wake up at the sound of disturbance or noise. This can cause sleep deprivation that can cause an increase in ADHD symptoms and decrease mood. Studies have revealed that prior to puberty, 10 to 15 percent of children who suffer from ADHD struggle to get to sleep. Fortunately, there are treatments that can help adults fall asleep.
It is interesting to note that many of the stimulant drugs prescribed for ADHD can also help with sleep problems. In one study, children with ADHD who had a history of problems with sleep reported better sleep when they were taking methylphenidate prior to bedtime. It is important to discuss your sleeping problems with your doctor prior to attempting a medication for insomnia however. It's possible to have a co-occurring illness like depression, sleep apnea, or anxiety, which can cause the same symptoms as ADHD.
You can also practice good sleeping hygiene, in addition to an examination for medical reasons. Avoid nicotine, caffeine, and alcohol. Regularly exercise. Practice meditation or mindfulness techniques. Progressive muscle relaxation (in which you contract and relax muscles one by one) and deep breathing exercises have been shown to help with sleep issues.
A psychiatrist may prescribe an antidepressant like Trazadone or a benzodiazepine like temazepam to adults insomniacs who are unable to improve on their own. These antidepressants have proven to help with insomnia and are less likely to interact with other sleep medications than stimulant medications.
A melatonin-agonist, such as ramelteon, can aid in falling asleep. It is effective in treating both primary insomnia and sleep disorders that are comorbid for adults suffering from ADHD. This drug is also effective for refractory insomnia in adults with ADHD who do not respond to other treatments, such as antidepressants or behavioral therapy.
This treatment is also safe during pregnancy. If your doctor recommends you try this treatment, they will be monitoring the blood levels to make sure there are no side negative effects. If they are, your doctor will decrease the dosage to a dose that is safe for you to consume during pregnancy or breastfeeding.
3. Medications to Help You Wake Up
When people suffering from ADHD wake up, their racing brains often hinder their ability to return to sleep. If they aren't able to go back to sleep, the lack of restful sleep can make them feel tired and sluggish during the day. It could also impact their ability to learn to concentrate, pay attention and focus.
It's important to know that a variety of stimulant medications prescribed for ADHD symptoms can also help with sleep disorders. A study found that people suffering from ADHD who had preexisting sleep disorders experienced fewer sleep disturbances when they started taking a low dose of methylphenidate.
Several types of stimulants are used to treat ADHD, including both extended-release and fast-acting medications. Most often, these medications are taken in the morning and last for six to eight hours. They can lessen the "ups and downs" that people encounter throughout the day. This could improve their school and work performance and avoid them from having to take additional medication later in the evening or during the day.
Many people with ADHD also use melatonin to help them sleep at night. Melatonin has been proven to help people sleep better. However, iampsychiatry.com to take it at the correct time. If not, it's unlikely to work.
Another alternative is benzodiazepines. These powerful depressants can aid those suffering from ADHD to sleep and remain asleep. This kind of medication is addictive and should be used only as needed.
More research is required to determine the most effective way to address sleep problems in those suffering from ADHD. It is essential to conduct large-scale cohort studies to determine the prevalence of sleep disorders and prescriptions for people suffering from ADHD, both during childhood and adulthood. It is also crucial to differentiate between the presence of ADHD-related sleep symptoms and a diagnosis of an individual sleep disorder.
Alcohol can be used to treat sleep problems in people who do not have ADHD. This can make sleep even difficult because alcohol acts as a depressant and disrupts normal sleep.
4. Stay alert with these Medications
A variety of stimulant medications used to treat ADHD also improve alertness. This is because these medications alter the chemicals that are present in your brain.
However, this does not mean that people suffering from ADHD do not suffer from sleep issues. Many sufferers with ADHD struggle to sleep. In my personal practice, I've observed that more than 80 percent of adults I see report sleep disturbances. They are able to spend the entire night with their thoughts bouncing and their bodies tumbling, sometimes awakening multiple times before going back to sleep. Upon awakening they feel exhausted and drained from this unrestful sleep.
In some cases, sleep disorders are a direct manifestation of hyperactivity and nocturnal motility that are associated with ADHD. In other cases, sleep disturbances are caused by a lack of sleep and the inability to control the arousal of daily activities. It has been shown that treating sleep disorders can improve both ADHD and insomnia symptoms.
Certain stimulant medications may affect sleep for those with ADHD. However they can also help with sleep disorders and insomnia by easing symptoms that hinder with sleeping (Spruyt & Gozal 2011,). In addition, certain long-acting ADHD medications have an insufficient duration of effect, leading to a worsening of behavioral and hyperactivity at night, as drug concentrations decrease (Cortese and colleagues. 2013a, b; Lecendreux and Cortese 2007).
Ask your doctor if a sleep study can be done to identify other conditions underlying your difficulty sleeping or staying asleep. Your doctor can prescribe a medication that will treat both the ADHD as well as the sleep disorder.
In the meantime, you can try to lower the dose of your stimulant medication before going to sleep by taking it in the morning instead of the afternoon or using a lower dosage or other stimulants. This will keep you alert throughout the day and help you fall asleep easier at time of night. Make sure you take your medication exactly as prescribed to avoid any side negative effects.