My son’s symptoms are largely affected by his emotional state. Especially the defiance/impulsivity. Example: my son gets upset because my daughter has a cousin her same age and we go to the cousin’s house for family functions. My daughter has a playmate over there, and he doesn’t, so his impulsivity seems to be heightened, and he is prone to behavior that is out of his norm. He got in trouble the last time we were there for impulsively hitting someone and also for bugging the dog, things he doesn’t normally do but he was acting that way because his emotions were running high. A lot of ADHD people are like that (Dr. Barkley has also written about emotions + symptoms). A lot of times there’s a lot of “stuff” going on and they just don’t know how to express or process it appropriately so they act out, and every kid is different in how that manifests. If your daughter is triggered by bedtime, then I think it sounds a lot like what we experience with my son when he’s upset; I think your daughter’s emotions are probably heightening her symptoms and making it sort of unbearable for both of you. Meds might be able to help a little to sort of calm that down, but I think it might be more of a therapy thing too, considering it’s trauma/PTSD related and ADHD etc. It sounds like you’ve already had/are doing therapy for your daughter so maybe bring it up with her therapist or talk to another professional about other options to address this particular issue.