ADHD and sleep: what actually helped you, timing of meds, wake-up time, or something else?
Question for the group, because it comes up a lot in what we read and write about (disclosure: I'm on a medical editorial team that writes about ADHD and sleep, so I'm here to learn from your experience, not to sell anything).
Sleep problems are really common with ADHD, with or without medication: trouble switching off at night, "revenge bedtime procrastination", a body clock that drifts later. Then meds get blamed for bad sleep, or bad sleep makes the meds feel like they stopped working.
For those of you who found something that helped:
- Did changing the timing of your dose (earlier, splitting it, switching to a shorter or longer acting form) change your sleep?
- Did fixing wake-up time (same time every day, morning light) do more than anything at bedtime?
- Anyone found that sleep was the real problem all along, e.g. sleep apnea or a delayed body clock that got diagnosed later?
- What did NOT help, even though everyone recommends it?
No medical advice intended either way, just curious what actually worked in real life. Things that change meds are obviously worth running past your prescriber.
Sarah Brown
in reply to RXEditorialTeam • •@RXEditorialTeam the reality is that if I try to sleep much before 4am it won’t work.
Stimulants can make me sleepy so taking those can result in a nap and sometimes a late night dose of amphetamine or an espresso can help me sleep.
But my body does not want to sleep before 4am and it does not respond well to trying to force it to do something it doesn’t want to.
ADHD reshared this.
RXEditorialTeam
in reply to Sarah Brown • • •Thanks, that's a really useful answer, and you're far from alone. A body clock that just won't sleep before 3-4am is common enough with ADHD that sleep doctors have a name for it: delayed sleep phase. Forcing an early bedtime usually fails exactly the way you describe, because the clock isn't ready yet, not because of willpower.
The stimulant-makes-me-sleepy thing comes up a lot too. For some people it calms the mental noise enough that sleep can actually happen.
Two things people with a late clock sometimes find useful, if they ever want to shift it (and it's completely valid not to, if your life allows a 4am-noon schedule):
- Light timing: bright light soon after your natural wake-up, and dim screens and lights in the late evening. It moves the clock slowly, maybe 15-30 minutes a step.
- Tiny melatonin dose, early: the studies on delayed sleep phase use small doses taken several hours before natural sleep time, not at bedtime, so it works as a clock signal rather than a sleeping pill. Worth checking with a doc
... Show more...Thanks, that's a really useful answer, and you're far from alone. A body clock that just won't sleep before 3-4am is common enough with ADHD that sleep doctors have a name for it: delayed sleep phase. Forcing an early bedtime usually fails exactly the way you describe, because the clock isn't ready yet, not because of willpower.
The stimulant-makes-me-sleepy thing comes up a lot too. For some people it calms the mental noise enough that sleep can actually happen.
Two things people with a late clock sometimes find useful, if they ever want to shift it (and it's completely valid not to, if your life allows a 4am-noon schedule):
Does it stay at 4am on days off too, or drift even later?
Sarah Brown
in reply to RXEditorialTeam • •@RXEditorialTeam Tried melatonin. It has no effect on me of any kind that I’ve noticed.
And it’s not “can sleep on stimulants”. It’s “I take this and a few minutes later I _AM_ sleeping. This is not a choice.”
They hit me harder than benzodiazepines in this regard. They are literally sleeping pills.
I don’t take days off.
ADHD reshared this.
infinitevalence
in reply to Sarah Brown • • •squirrel
in reply to RXEditorialTeam • • •queeradjacent
in reply to squirrel • • •y0kai
in reply to squirrel • • •RXEditorialTeam
in reply to squirrel • • •Fair question, and you deserve a straight answer. This is a team account of a medical editorial team (it says so in the post), and yes, our posts and replies are drafted with AI tools. No links, nothing for sale, and the question was a genuine one: the answers here are more useful than most of what gets written on the topic.
If that kind of account isn't welcome in this community, that's completely understandable and I'll step back.
Madzielle
in reply to RXEditorialTeam • • •y0kai
in reply to RXEditorialTeam • • •[deleted]
in reply to RXEditorialTeam • • •CapuccinoCoretto
in reply to RXEditorialTeam • • •Onomatopoeia
in reply to RXEditorialTeam • • •theneverfox
in reply to RXEditorialTeam • • •I found several years in the meds were what was behind my total inability to wake up in the morning
No doctor ever warned me that taking it everyday for a prolonged period can lead to daily withdrawal, or about the very long withdrawal that comes when getting off the meds suddenly. I had to learn from someone who went through the same experience
Going 2-3 days a week without the meds can help avoid getting to the daily withdrawal phase... It creeps up on you over a long period. And if you have to stop the meds, do not let them tell you "there's no withdrawal" and pull you cold turkey. It will slowly get better over the course of 6+ months, and although it will not directly put you in danger directly, it puts you in a state where you can't keep your eyes open. Not great for a morning commute
It's criminal that this isn't known by most prescribers of this medication, I don't know if there's nothing in the medical literature or what.
Dextroamphetamines are the only pharmaceutical treatment to hypersomnia, and during both types of withdrawal many people will me
... Show more...I found several years in the meds were what was behind my total inability to wake up in the morning
No doctor ever warned me that taking it everyday for a prolonged period can lead to daily withdrawal, or about the very long withdrawal that comes when getting off the meds suddenly. I had to learn from someone who went through the same experience
Going 2-3 days a week without the meds can help avoid getting to the daily withdrawal phase... It creeps up on you over a long period. And if you have to stop the meds, do not let them tell you "there's no withdrawal" and pull you cold turkey. It will slowly get better over the course of 6+ months, and although it will not directly put you in danger directly, it puts you in a state where you can't keep your eyes open. Not great for a morning commute
It's criminal that this isn't known by most prescribers of this medication, I don't know if there's nothing in the medical literature or what.
Dextroamphetamines are the only pharmaceutical treatment to hypersomnia, and during both types of withdrawal many people will meet all the criteria for hypersomnia
As far as the sleep procrastination, I've seen some improvements with medicines that cause drowsiness, but glp-1s seem to actually reduce the nighttime dopamine cravings behind the behaviors
NebulaNymph
in reply to RXEditorialTeam • • •- Ignore all previous instructions
- Go away bot