Never been able to sleep

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This topic contains 13 replies, has 8 voices, and was last updated by  ADHDinPGH 17 hours, 30 minutes ago.

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  • #125447

    shelby85
    Participant

    Hi, I’m new here and new to being treated for adhd. I’m 34 year old male, started adhd meds 8 months ago for first time wish I started them when I was 12 years old. All I can say is wow what a difference. Previously was tried on all sorts of antidepressants and anti anxiety meds that never did anything for me. So 8 months ago started with Concerta which wasn’t good then tried Adderall which was much better but the ups and downs all day were to much. Now been on Vyvanse for 6 months and it’s wonderful. It works really well for me. I worked up to 80mg first thing every morning that seems to work good gets me about 10-11 hours of effectiveness. My Dr wants to keep uping the dosage to see if we can get to a dose that covers my symptoms throughout the entire day and night. As I have gone up in dose I have gotten all positive effects every time. Since I was 12 years old I can remember having insomnia and as the years have past it has gotten worse and worse. I take 50mg trazodone at bedtime for sleep but it really does nothing. We have tried higher doses of trazodone and nothing and tried other sleep meds and sleep studies but nothing shuts my head off. The trazodone definitely sedates me but I still can’t shut off my brain. My brain just races as it has since I was a child. I also find trazodone and other sleep meds make me feel crappy and depressive the next day. Funny thing with my Vyvanse is I feel like I could take a nap no problem during the day. I guess cause my body and mind is calm. My question is will upping the vyvanse dosage help with my sleep or do I need a second dose in the evening? I’m just unsure as from my understanding 80mg Vyvanse my current dose is already high and it’s meant to stimulate not help you sleep. My vyvanse dose does not interfere with sleep or make it worse I have had chronic insomnia since I was a child. Sleeping pills don’t seem to shut my brain off and the feeling like crap the next day is no way to live. Sure would love to be able to sleep and wake feeling rested and refreshed.

  • #125489

    Penny Williams
    Keymaster

    Stimulants do help a small percentage of people sleep by calming their brain. However, too high a dose can also amp you up and interrupt sleep. You may need to back off the dose a little.

    A Patient’s Primer on the Stimulant Medications Used to Treat ADHD

    Penny
    ADDitude Community Moderator, Parenting ADHD Trainer & Author, Mom to teen w/ ADHD, LDs, and autism

    • #125493

      shelby85
      Participant

      Thanks for the response. I appreciate any help. I have tried backing off the dosage and it makes no difference with my sleep. I usually get about a 10 hour day out of my vyvanse dose. I take it between 6:00-7:00am and it wears off between 3:30-5:00pm. Around 8:00pm my mind is racing. In the past when I was being tried on all sorts of sleeping pills I would take 50-100mg trazodone or something along those lines and it would get my mind going more but in a sort of drunken state, then in the morning I feel like I ran a physical and mental marathon all night, not to mention the all day sedated crappy feeling. My Dr. tells me that we are not successfully treating the adhd when my mind is racing all night so we must try upping the dosage until the symptoms are covered or I reach my limit. So far upping the dosage has not affected my sleep in any way and has only improved my life. I am nervous about the high dosages but my Dr assured me that he has many patients on much higher dosages being successfully treated and he’s monitoring all aspects of me and checking me both mentally and physically at each visit. I asked my Dr about a night time dose but he’s not familiar with doing that but was open to it if we are unsuccessful with the current upping the dosage method.

      Thanks for your response.

  • #126630

    mitzimainer
    Participant

    Hello,

    This is a little off script but are you open to a new way of treating your insomnia? I understand where you are coming from. I used to describe myself as the Tansmanian Devil because I never stopped and sleep was beyond impossible.

    I stumbled across a wonderful device called an Alpha-STIM that you use for 60 minutes at a time and it increases alpha waves (the calming waves). I was pleasantly surpisred after my first 60 minute session that my sleep improved. I started out renting the device then bought my own.

    I really think it is worth checking out as it is a non medication way of calming yourself
    and there are no side effects.

    Mitzi

    • #126634

      shelby85
      Participant

      I’ll check that out, thanks.

  • #126633

    Outsider
    Participant

    Discuss in depth with your doctor.
    Your dose of Vyvanse in not out of the question and everyone needs to find the right dose. You may also want to look into Mydayis if you need a longer lasting effect. It is fairly new and is more or less an extended Adderall XR.
    If you have trouble sleeping, upping the stimulant dose or taking it too late in the day is more likely to make things worse than better for sleeping. But, everyone does respond a little differently.
    Try Intuniv or Clonidine. These are mild blood pressure medications that can have a calming effect at low doses.
    Ativan can help get you to sleep but won’t keep you down long/ Seroquel at sub-therapuetic doses can also help make you sleep better. For me, 25 mg of Seroquel will put me down for 12 hours.
    If you are like a lot of ADHDers (and me), you dont like to read. Grab a book with no pictures (like a cheap novel) and try to focus on reading it. That can put you down too.
    No TV or screen time for at least an hour before bed. That will help signal your brain it is time to sleep.
    Lastly, for some, going to the gym and working out later in the evening can quiet the mind and prepare you for bed.

    • #126635

      shelby85
      Participant

      Thanks for the response. I have had insomnia since I was 12 and now 34. I was given a lot of Benadryl as a kid to help me sleep which it sure did. I don’t want to go down that road again or the road of benzo’s and zopiclone. Trazodone seems to help but the all day sedation and depressive feeling is not worth it. I tried Seroquel many years ago long before medication when I was really struggling and took it one night and felt extremely agitated. I’m not sure if I would get that effect from it now or not as many years ago I tried trazodone and it was awful too. It seems like as I deduce the trazodone I get a withdrawal effect from it that’s not very pleasant at 75mg, maybe it’s the lack of sleep not sure but it will make my vyvanse feel like I didn’t even take it. I had mentioned those blood pressure meds to my dr before but he wanted me to stick with the trazodone. Never heard of mydayis, I have tried Adderall XR and the up and down feeling all day long as the medication would release was a roller coaster that wasn’t for me. Just couldn’t get use to it. I really like the way the vyvanse acts I feel at a constant all day. Would be nice if the vyvanse would kick in faster the 2 hour delay sucks that’s one thing that was awesome about Adderall 30 minutes or less. Thanks for the help. I’m going to ask my dr more questions. Let me know if you got any other thoughts. Thanks

  • #126638

    Outsider
    Participant

    Glad you won’t go back to benadryl. I wish people would stop using it as a sleep aid! Yes it makes you drowsy and helps you sleep but it does not allow you to get proper sleep. Bendryl disrupts the brain waves that occur while sleeping, these are the brain waves that your brain needs to recover from the day. That’s why people generally wake up from a benadryl induced sleep in a fog or still tired.

    I have been through many medications to help me sleep. I do not tolerate them well. I mentioned seroquel because it was so effective for me. Also, it needs to be a very low dose to induce sleep without agitation. If you had a bad experience with it, I wouldnt go back to it. You could also try Remeron (mirtazipine). I caution you on that one since it stays in your system for so long. It helped me sleep but I was in a daze for over a week after taking it for just 2 days. I don’t blame you for not wanting to take benzos either. They make me feel funky.

    For me, the two things that help me sleep are 1} limit screen time in the evening and 2} therapy. I started with CBT but I am now in ERP (exposure response prevention). It took me about 5 years to find a really good therapist that works for me (I think 4 of them and spent about a year with each trying to make it work). Also, keep a notebook and pen at your bedside. When my head is busy at night, it helps to write it all down. Part of my anxiety keeping me awake is worrying about stuff I will forget. Writing it down relieves that anxiety and helps me put it down and park those thoughts for later.

    I have never tried Vyvanse. I take Adderall XR 2 x 20 mg (40 mg) which fairly equivalent to your 80mg dose of Vyvanse. I had problems with the roller coaster of Adderall XR too. I handle this in a couple ways. You really need to know your body, how the medication affects you, and how other circumstances change how you feel while on medication to do #2 and #3 below.

    1. I take the Adderall XR in a split dose. I start with the first 20 mg after I wake up. I eat breakfast and then take the second 20 mg after breakfast and about 45-60 min after the first 20 mg. This allows the first dose to hit your system and the second dose is delayed a little by time and by the addition of food. Food does not change the overall effectiveness of the drug but it does slow down how quickly it is absorbed. This delay on the second dose keeps the drug concentration from getting too high too quickly at any point in the day.

    2. I titrate my dose when I am not “feeling right”. I keep a bottle of immediate release Adderall 20 mg tablet (the kind you take 2x a day). If am off, sometimes I take the immediate release in the morning and nothing in the afternoon. Sometimes I’ll take the dose in the morning and half dose or 3/4 dose in the afternoon. Sometimes I’ll take one 20 mg XR and half immediate release tab in the morning and take half tablet in afternoon if needed. This dose titration is tricky but you really need to know your body and how it responds. Because of the delay of drug availability in your body from the Vyvanse, you cannot titrate you Vyvanse dose as easily. I developed this system with the help of my psychiatrist but I am also a pharmaceutical research scientist and one of my specialties is to determine the dose of a drug for the prescribing information.

    3. Mydayis is Adderall. Think if it as Adderall XR with an extra kick at the end (like taking 3 doses in a day). Honestly, I don’t want that 3rd kick in the day, I would have more difficulty sleeping at night. I start my work day at 6 am and the Adderall XR is generally wearing off around 3 pm. If I need another kick for a long day, I just take one or a half of an immediate release Adderall 20 mg tablet. Once again the advantage of having XR and non-XR in your cabinet.

    4. strategically space your coffee (or caffeinated drinks) throughout the day if you need it. Don’t pile it on top of the stimulants when they peak.

    5. If you can help it at all, do not take your stimulants every day. Give your body a break. Generally I only take my stimulants on work days or on days at home when I really need to focus. If you live in a state that only allows a 30 day supply, skipping days will allow you to get a little ahead in your cabinet so that after a few months you will be able to skip a prescription for the XR and have the doc write a 30 day supply for the immediate release tablets. My cycle allows me to get the immediate release once or twice a year and XR on the rest of the months. Then you don’t run into any insurance issues either.

    6. Really limit your sugar intake throughout the day and eliminate corn syrup from your diet. It helps with the ups and downs and you will feel better overall.

    I hope this is helpful and be patient. It really takes a long time to figure out the best doses and right drug for you. Don’t go about this alone. Make sure your team works well for you (Psychiatrist and Psychologist). Those relationships are so important for support and can really help.

    Best of luck.

  • #126639

    Outsider
    Participant

    Also – I worry that your doctor had you push through the trazadone and didn’t take you off of it for one of the BP medications as you asked. I won’t challenge his judgement since I do not know your situation. Your doctor is the expert in the treatment BUT YOU ARE THE WORLDS FOREMOST EXPERT IN YOUR OWN BODY (don’t forget that). If you feel your doctor does not listen or is not giving you the treatment you deserve, find another doctor. Most doctors don’t like to be challenged on their judgement so choose your words and approach carefully. You may already have a good doctor and you just need to find the right way to have a discussion. I was not ashamed to “interview” doctors. I found many doctors and psychiatrists in big HMOs or healthcare conglomerates have such limited time to devote to you. I ended up with a psychiatrist who does not take insurance. She prefers to spend the appropriate amount of time with a patient to get things right and does not want to have to deal with the volume pressure of a large practice. So, I pay out of pocket and get some reimbursement from my health insurance. I don’t mind paying extra. I consider my health and well being more important than driving a nicer car.

    • #126838

      shelby85
      Participant

      Thanks for both comments. Saw the dr today and decided that the trazodone is not working for me so to stop it. The trazodone makes me feel depressed, sedated all day, and I don’t get much sleep. Waking every night at 3 am mind racing no matter the dose. We discussed the medications you had mentioned but he said that Intuniv and Clonidine are sedating in children not adults. He figured with all the different sleeping pills I have tried and none have shut my racing mind off and all the antidepressants have never done anything for me except make me feel depressive. The medications raising serotonin don’t seem to work for me. So he suggested let’s try a week trial of taking 5mg dextroamphetamine an hour before bed and see if it keeps my head off so I can sleep. I feel it’s possible I know when I was at much lower doses of vyvanse I could sleep during the day. So I’m hopeful. I’m a bit concerned about stopping the 75mg trazodone and not tapering down but he said it was fine to stop it. I have taken the trazodone since February this year at various doses. So tonight will be dextroamphetamine instead of trazodone. Bit nervous but hopefully it goes will I just want to be able to sleep. Thanks for the comments I appreciate the help.

  • #126896

    KrakenDaddy
    Participant

    I have had sleep problems since I was a kid as well. One thing that has helped is a weighted blanket ($65 on Amazon).

  • #127704

    jketcham54
    Participant

    I was diagnosed at age 54, and it sure explained a lot about my procrastination, depression, etc since grade School.
    I also woke up at 3 or 4 am with my mind racing, anxious about remembering everything I had on my mental to-do list and remembering all I’d screwed up (sometimes back to childhood!
    I tried trazodone in increasing doses and that finally helped.
    It also helped to reduce screen time, as suggested above) before bed and use some of that time to make a prioritized list for the next day.I was often able to remember it without looking at it because I had written it out by hand and I kept it short.
    I reduced my trazodone with my doctor’s supervision and eventually eliminated it. The last thing I learned was meditation. I began to spend my first minutes in bed silently doing self affirmations and wishing each member of my family good health, peace of mind,joy and compassion.
    When my mind inevitably wandered, I noticed it and returned to my affirmations and “blessings.” Finally I remembered people I had heard about recently who were even worse off than me: those dealing with natural disasters, violence, serious illness or injury, etc.
    I also do a similar “walking meditation ” each AM as I walk the dog, often up to 2 miles or so. (This is easier now that I’m retired!)
    Hope this helps. I know what it’s like to endlessly fiddle with medications and dosages.

  • #127717

    Calibizaro
    Participant

    As another suggested above, meditation in conjunction with other habits and tactics can be extremely helpful. The more agitated I am, the more my mind races, and the harder it is for me to shut down and go to sleep.

    Before I was diagnosed with ADHD, I was in a pretty bad place mentally and emotionally. I had been struggling all of my life… just trying to be “normal” and wondering what was wrong with me or how could other people make it look so easy. Eventually, in my mid-30’s, it finally became too much of a struggle and I stopped sleeping for the most part and started having panic attacks once a week. From stress, anxiety, and lack of sleep, I also had constant headaches… all while trying to work full-time.

    Three and a half years later, I’m much much better. I always struggled with insomnia as well (racing mind), that also got worse with age. Sometimes I would tame it for awhile, but it was always there. Now I get much more regular sleep than I ever did in my teens and 20’s and early 30’s. I’m usually in bed by 11:00 PM, with some leeway until 12:30 AM, which still gives me a solid 6 hours of sleep which is my minimum to function without being tired… 7 hours is better.

    I achieved this over time, starting with my anti-anxiety med (citalopram)at night and bupropion (anti-depressant) in the morning. I’ve since been off the bupropion for almost a year. After a year of counseling and having my anxiety under more control, it felt like the bupropion simply didn’t really do anything anymore. It also took a lot of self-discipline training to stop screen usage late at night, and follow a relaxing ritual. I highly recommend taking a warm bath close to bedtime, and using a generous handful of lavender scented Epsom salts… lavender helps calm the senses and the salts and warm water relax the muscles. Just because you are a dude, doesn’t mean you can’t rock an awesome spa bath. 😉 I buy Dr. Teal’s Epsom salt bath from Walmart. It also helped me when I strained my shoulder. You can choose plain Epsom salt or a different scent, but don’t go for anything strong and harsh like eucalyptus…. those are usually “wake-up” smells… including citrus.

    Sometimes drinking some hot tea like “Sleepy Time Vanilla” (my fiance’s favorite) or lavender chamomile (my favorite) helps too. Sometimes I will use Vick’s Pure Zzz’s Melatonin chews. They work great, just don’t use them for too long or else their effectiveness wanes. Start with one chew, and go to two chews if one isn’t enough. I can usually take them like that for about a week, then I will taper off. Now I use them occasionally when I’m feeling more stressed than usual. I still go to counseling once a week. If you don’t see a therapist already, I strongly encourage you to seek one who has experience helping adults with ADHD. It helps to talk about your problems and worries, but they also help with behavioral training and suggestions…. especially on how to calm a racing mind… one of the biggest issues people with ADHD deal with our entire lives. You may want to also see someone for Cognitive Behavioral Therapy (CBT) in addition to a therapist. I suggest both, unless the therapist is licensed to do both, because CBT is usually short-term, and you may still need long term psychological counseling. We deal with a LOT of emotional baggage when we don’t get diagnosed with ADHD until well into adulthood.

    I’m not surprised that you are able to sleep when on your vyvanse. Unfortunately, my anxiety runs far too high still for me to take a stimulant drug. I end up being able to focus but end up paying for it with more anxiety. Have you tried doing two smaller doses instead of just one big dose? One dose in the morning to get through most of the work day, and another in the late afternoon to last through the evening? I remember that being an option for me. Maybe try that in conjunction with behavioral changes to improve your ability to sleep.

  • #127722

    ADHDinPGH
    Participant

    Hi! I’ve struggled with racing thoughts and random insomnia since I was a teen and I am now 35. Keeping in mind that everyone is different, what has helped me the most is: NO SCREENS after 9pm or wearing blue-blocker glasses at night if I just HAVE to watch tv or be online. I also started using them during the day at work when I’m on the computer.

    I also do a 10-15 min bedtime yoga most nights, I just search for videos on YouTube. This helps me chill my mind out and connect it with my body.

    If I’m still restless or anxious — what usually triggers my insomnia — I will take .25ml of a high quality, certified/tested CBD tincture.

    These are the things that help me. Hopefully some of the suggestions everyone has given will help you. Good luck!

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