Can I overcome insomnia caused by medication without sleeping pills?
March 29, 2021 6:02 AM   Subscribe

I am 2 months in to a new ADHD med that has improved my quality of life to a degree I never thought possible. The only catch is that I sleep very badly now.

I have tried loads of sleep aids including OTC, natural & prescription. I practice belly breathing & and not stressed or worrying or overloaded at night. The only thing that has worked so far is Ambien but my psych will not prescribe it for nightly use.

I am not really looking for general insomnia advice, Ask has lots of good threads for that. What I really want to know is:

Have any of y'all managed (or tried) to overcome insomnia caused by essential medications without taking prescription sleeping pills?
posted by i_mean_come_on_now to Health & Fitness (14 answers total) 4 users marked this as a favorite
Response by poster: FYI I am taking Straterra for ADHD
posted by i_mean_come_on_now at 6:05 AM on March 29, 2021

What time are you taking your meds? Taking my meds earlier in the day tends to relieve insomnia for me. I don't like to take extended release meds for this reason - if I forget to take my meds before 10 am at the latest, I tend to have a hard time falling asleep at night. So now I do two doses of regular (not extended release) per day, and I aim to take my second dose before 1 PM. If I forget, I can just say screw it, no second dose today. It has completely eliminated my insomnia problem.

If you're already doing your timings right, like, taking an extended-release dose at 6 am or whatever, then perhaps look into taking the dosage down a notch? Your body will acclimate to these meds, so temporarily lowering your dosage and then climbing back up may be all you need to do.

Other strategies range from loading up on carbs at night (this is my "great but terrible" idea) or speaking to your doctor about trying a different medication (the boring, sensible way).
posted by MiraK at 6:10 AM on March 29, 2021 [1 favorite]

Best answer: Straterra (extended release) seemed to give me sleep issues when I went from 40mg to 80mg (in the morning) and I wasn't really sure the 80mg was doing anything more than the 40mg so I went back down and the sleep issues went away. 40mg is a low dose but I'm already not a great sleeper so for me trying to stick it out at 80mg didn't feel worth it.
posted by needs more cowbell at 6:19 AM on March 29, 2021

I came here to say what MiraK said. I don't take Straterra specifically (I take one of the other ones), but if I take my meds between 7 am and 8 am, then I'm okay. Any later, and I can't go to sleep on time. Also, I started taking magnesium at night for unrelated reasons, and it helps a little for falling asleep too.
posted by umbú at 6:35 AM on March 29, 2021 [1 favorite]

2-5mg of melatonin (in different parts of the year) helps our resident ADHD human sleep better on the reg after they switched to an extended release medication.

Exercise also seems pretty vital for them to get decent rest; they can do without, but it isn't the best for their sleep.
posted by furnace.heart at 7:02 AM on March 29, 2021

Best answer: For someone I know, avoiding all caffeine is a necessary (but sadly sometimes insufficient) condition for a good night's sleep.
posted by oceano at 7:25 AM on March 29, 2021

Best answer: I haven’t been able to thread the needle. I have to take a lower dosage of the stimulant than I would like, and following the advice of a previous mefi post, I wake up at 4-5 am, take med and usually go back to sleep. (Here we go, tel3path’s comment) That’s where I am right now, after a couple of years or switching meds, trying different times, and stints on and off sleep meds.

I feel like the meds just stay in my system longer than they’re supposed to, and I don’t have an explanation for that, so I have to take them before 8 am. (Also, I’m taking them for depression, not adhd.)

I will add that I’ve recently started on a low dosage of Trazadone (an antidepressant, and in lower dosages, a sleep aid) and have found it very helpful. I’ve been struggling with sleep and stimulants for several years now, and I don’t feel like a prescription sleep med is the way I want to go. I might be deluding myself, but since I do have depression/ anxiety issues, and Trazadone is an antidepressant, I feel better about taking it. (I don’t mean to ignore you bolded question, if this falls clearly under ‘prescription sleep meds’, I apologize.)
posted by queseyo at 8:30 AM on March 29, 2021

Most ADHD medicines are stimulants. They try to keep the dopamine and norepinephrine around longer in your brain. They simply "manage" your ADHD symptoms and help you cope better. As a result, you probably should follow the directions.

Stratera is supposedly non-stimulant, and more of an inhibitor that (slows) the reabsorption of norepinephrine. But most stimulants (Adderal, Ritalin, etc.) have that function as well. Basically, ADHD medications do both encourage the release of the neurotransmitters (dopamine and norepinephrine) while inhibiting their reabsorption, albeit in different "mixes".

Talk to your doctor and see if you can try different ADHD med at different doses to work out the best dosage for you. See if you can decrease your dosage slightly and if that helps your sleep patterns.
posted by kschang at 8:33 AM on March 29, 2021

Medication timing as mentioned above, and melatonin + l-theanine before bed.
posted by Iris Gambol at 9:11 AM on March 29, 2021

I had to switch from XR to fast release adderall for this reason.

Also, taking melatonin three or four hours before bedtime rather than the package-directed half hour was much much more helpful.
posted by showbiz_liz at 9:53 AM on March 29, 2021 [1 favorite]

Agree with medication timing, and exercise.

I have found that getting daylight/sunlight in the middle of the day and trying to avoid screens before bedtime helps. Also, my doctor recommended GABA which I take in the evening an hour or so before bedtime.

Also, managing adhd symptoms means I'm just less exhausted at the end of the day because I didn't have to work as hard to manage all the things, so it took some adjustment to recognize what tired felt like. I have started using a sleep meditation app to focus on relaxing into sleep.
posted by Maude_the_destroyer at 11:49 AM on March 29, 2021 [1 favorite]

Best answer: Nothing mitigated my sleep issues on ADHD meds, including prescription sleeping pills. But I have pre-existing sleep issues, so it’s possible the ADHD meds were just making them exponentially worse. Every doctor I asked replied with a big old shrug.
posted by The Underpants Monster at 12:16 PM on March 29, 2021

Best answer: This is really tough! A friend of mine would wake up around 5am to take his meds and then go back to sleep for a bit.
posted by bluedaisy at 5:03 PM on March 29, 2021 [1 favorite]

Best answer: I took Strattera at 80mg for a number of years. What helped with the sleep issues:

(1) taking the Strattera as early in the morning as possible.
(2) Melatonin periodically
(3) Taking a low dose of Wellbutrin alongside the Strattera (at the advice of my doc), which was partly for low-grade depression. However, she explained to me, the combo also has an effect in many people where it doesn't make the fitfulness of sleep much better, but the quality of sleep while you're asleep is improved. I still had the periods of wakefulness and trouble getting to sleep, but I was nowhere near as tired during the day as I was otherwise, which downgraded the fitful sleep to "annoyance" from "problem.".

I also found, shortly before I went off Strattera for side effects unrelated to sleep issues, this AskMe from February about the waking-up-at-3AM-with-a-sense-of-doom problem, in which someone mentioned that waking up in the wee hours can happen due to a blood sugar crash and the accompanying cortisol spike to get it up again, and recommended eating some protein shortly before bed to stave off the crash. Which actually worked for me for the 3 weeks I was taking Strattera after that, and the times I did wake up at 3AM, I no longer had the DOOOM feeling and random anxiety running through my brain, which helped me get back to sleep faster.
posted by telophase at 1:53 PM on March 30, 2021

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