‘Ask Ned’ All Your Pressing Questions About ADHD — in Real Time
Join Dr. Ned Hallowell every other Thursday on Facebook for free, interactive sessions where viewers ask questions about ADHD in children, teens, and adults in real time.
It is remarkably difficult to find a doctor who specializes in ADHD, and even harder to find one who will any and all questions about ADHD in real time.
Which is why I started a series of Facebook Live events, in partnership with ADDitude magazine, called Ask Ned. This free, interactive Q&A session takes place every other Thursday at 1 p.m. ET. To register for these events, go to www.facebook.com/DrHallowell/
During each event, I talk briefly about a topic related to attention deficit hyperactivity disorder (ADHD) and then take participants’ questions for nearly an hour. Below are a few questions from our talks to give you a sense of the topics and concerns we tackle. We hope to see you at the next session!
Too Old for Stimulant Medication?
Q: “I’m 74 and have been taking a stimulant for ADHD for 20 years. My family is afraid that I’m too old to still be taking a stimulant. What do you think?”
What matters when taking stimulants is not a person’s chronological age but their physiology. ADHD medications should always be given under medical supervision — at any age. If you’ve been taking a stimulant for 20 years, then there’s no reason to stop simply because you’re now 74, or older for that matter.
As long as you continue to have a normal EKG, your heart rate and blood pressure are stable on the meds, you’re getting good sleep, you don’t feel agitated or “loopy,” and your weight is stable, then you’re fine to take stimulant medication and reap the benefits they can provide.
Solving ADHD Sleep Problems
Q: “I take stimulants for my ADHD during the day and at night, but I have a lot of trouble getting to sleep. Do you have suggestions that could help?”
Regardless of treatment plan, it is common for people with ADHD to experience sleep problems — and this symptom can be made worse by stimulants.1 To remedy the problem, first make sure you practice good “sleep hygiene.” This means:
- Don’t bring your cell phone or other devices with a screen to bed with you.
- Don’t eat a meal just before bedtime.
- Make sure your bed and room temperature are comfortable.
- Have an agreement with your bed partner, if you have one, about what is or isn’t okay for each of you to be doing while the other is trying to fall asleep.
Second, time the dosing of your medication so that it wears off before you try to sleep. This is a process of trial and error. While we can estimate how long a given stimulant will last in your system, there’s tremendous individual variation. To assess this, take the medication at different hours to try to time your dose so that it wears off when you want to sleep.
Third, if your medication still prevents you from sleeping no matter when you take it, or it’s worse than if you had not taken the medication at all, then talk with your doctor about trying a different remedy. Getting adequate sleep is very important to your overall health.
CBT for ADHD?
There’s a good chance that it will. CBT has been shown in studies to help a variety of problems, including many of the associated challenges of ADHD. 2 3 But it should never be the only intervention — education, coaching, structure, exercise, proper nutrition, good sleep, and regular doses of positive human interaction should all be included, or at least considered, in every treatment plan. But CBT is an excellent adjunct for many people of all ages.
Questions About ADHD: Next Steps
- Free Download: The Ages & Stages of ADHD — Key Solutions from Childhood to Adulthood
- Read: Answers to the ADHD Questions You Didn’t Know You Had
- Read: Expert Answers to Common Questions About ADHD
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View Article Sources
1 Hvolby A. (2015). Associations of sleep disturbance with ADHD: implications for treatment. Attention Deficit and Hyperactivity Disorders, 7(1), 1–18. https://doi.org/10.1007/s12402-014-0151-0
2 Young, Z., Moghaddam, N., & Tickle, A. (2020). The Efficacy of Cognitive Behavioral Therapy for Adults With ADHD: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Journal of Attention Disorders, 24(6), 875–888. https://doi.org/10.1177/1087054716664413
3 Drechsler, R., Brem, S., Brandeis, D., Grünblatt, E., Berger, G., & Walitza, S. (2020). ADHD: Current Concepts and Treatments in Children and Adolescents. Neuropediatrics, 51(5), 315–335. https://doi.org/10.1055/s-0040-1701658