stimulants and intolerable insomnia

[Anonymous]

saw my doc. We talked about my insomnia and it is as complicated as I thought! The sleep issue has turned into quite the complicated puzzle. the insomnia is most likely not caused by Vyvanse. My doc and I are unsure about how much my newly discovered hyperthyroid contributes. another factor is confusion about whether I am in a slight hypomanic state. I don’t really feel like I am, but if the episode is minor then I often don’t notice until after it is over. My doc said that I look more scattered than manic. I’m a naturally bouncy emotionally reactive person so hypomania is difficult to differentiate. Right now, I am still interested in my boyfriend and don’t need to keep busy every night nor am I searching the city for some entertainment.. so if it is hypomania then super minor. but makes stimulant use kind of risky. I am definitely overwhelmed in balancing work and school (part time work and part time school) because I am not used to balancing anything. usually it is either just school or work, and I’m still stressed and overwhelmed, but not so hanging by the seat of my pants feeling like this. the Vyvanse was not giving me insomnia the first 3 months I took it. However, perhaps my sleep is so sensitive that if it is disturbed then it cannot handle Vyvanse. and well my sleep is sensitive. We decided to do fast acting dextroamphetamine as that may be a little less insomnia risky. more sleepy meds added. I brought in all my pill bottles to show that I still have a bunch left of everything because I was worried she was going to think I was some kind of addict with all the controlled rx I take!!!

my doc signed my sleep study referral and thought it was a fantastic idea and glad I came up with it. She also liked the facility I chose. so I just need to finish the form and contact them.

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[Anonymous]

sugargremlin, so glad your doc is referring you for a sleep study. It’s crazy that no professional has suggested it to you!

Krazykat, my situation may be different than yours, but stimulant medication actually helps my sleep. I don’t know why, maybe it’s because of the narcolepsy. The night I came back from my sleep study followup, I took 10mg of ritalin and I slept all night. I started my new med the next morning, but I was so frustrated with the lack of sleep that I was desperate and knew that ritalin had worked for me before. I wouldn’t do that if I’d been taking it during the day, the most I ever took was 4 doses and the last was 6:30 pm at night. But it never disturbed my sleep, on the contrary, it helped a great deal. Most curious!

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[Anonymous]

sugargremlin, just saw your post here, modafinil is a narcolepsy drug and I don’t think it’s prescribed for ADD. But it seems to have settled down many of the ADD symptoms I was experiencing. I’m just grateful to have a diagnosis and medication, it’s really making a big difference for me. The fine-tuning of med doseage is challenging, and I’m a bit worried about tolerance down the road, but so far things are looking much better. I wish I could have another sleep study just to see what might have changed with the meds, or whether it’s just influencing the daytime wakefulness.

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[Anonymous]

modafinil can be used off-label for ADHD. it was in a high stage of research, but some children got steven-johnson’s rash (life-threatening) from it so the study was discontinued.

I once took the vyvanse too late and.. sleep was not going to happen. i was so organized and had everything ready and was in bed by 11pm (because the med was still working lol). then…just laid there…and laid there….. >_<.

everyone is so unique and complicated. what really complicates my picture is bipolar disorder. apparently, it is why i cannot wind down at night. even when I am not in a mood cycle. just a trait or something.

i talked to my mom about the sleep study and she got excited and said “oh i want one too”. she does not have bipolar and neither did my grandfather (suggesting it is separate from bipolar). surprising that she has never been suggested to have one. life time sleep issues, worst in her late 20s (I’m 28). she said that she had tried every hypnotic on the market. takes ambien every single night like I do. problem is that she has the same insurance that i do so probably not going to happen .

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[Anonymous]

Oh yes, the sleep doc wrote out the prescription for modafinil and then proceeded to take the next 5 minutes or so going over how to take it and detailing all of the possible side effects. Of course, he said many of them were common to psychostimulants, but he did mention the rash and possible anaphylactic (sp?) shock. In short, if I have any of the more severe symptoms, get me to an emergency department ASAP since just stopping the med will not stop the reaction. So far I am doing well on it, one day after I’d had half a beer at lunch I thought my tongue was swelling up so I stopped drinking the beer, probably not a good idea to mix the two anyway. I’d rather be properly doctor-supervised medicated than slightly intoxicated any day

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[Anonymous]

Yeah, no meds + alcohol for me as well. I don’t know the effects as I have not yet tried to do so. I’ve really just lost interest in any substances. My sleep meds make me feel kind of drunk every night before I go to bed. It makes alcohol much less fun/novel and I associate the feeling with bedtime.. so yeah no partying. stimulants= focus and concentration and getting things done..work etc. no party there. I am glad that is how I feel about substances . During my last doc appointment, I got paranoid that my doctor was going to think I am abusing my medication as I have had so much trouble sleep and using more. and also that I am on a lot of controlled substances. I brought in all the nearly full bottles, but she said that she did not need to see them.

on thursday, I get my sleep consultation! my sleep has actually been improved since my pre-sleep sleep med. and upping another one. still freaks me out about how many meds I take to go to sleep. I am this petite person who takes medication which could knock out a large man for like 20 hours. 3 strong sleeping medications. 2 are controlled substances. still feels awesome to get the first few 8 hours of sleep in a long time.

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[Anonymous]

Marijuana, in my early 20s, was my sleep drug. Didn’t take much to get me to sleep. Ahhh, the good ol’ days.

YAY for your sleep consultation coming up so soon! That’s terrific. Glad you are getting a fuller night’s sleep. The whole world looks so different from an alert, well-rested perspective.

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[billd]

Started Adderall XR Saturday morning (it’s now Monday AM) I think 20mg.

It’s the generic,

I’ve not slept since.

Two VERY VERY restless nights, never fully “dozing off”. Can remember almost all of both nights.

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[Anonymous]

That doesn’t sound good, bill. I know that only too well. I realize that some of the side effects of stimulant meds are insomnia, but two days of no sleep is dangerous. Be careful with those power tools and driving! Can you go back to your doctor to talk about a different dose or a different drug?

I’m still working out the bugs with my meds. I’m waking up at night one or two times, sometimes it’s a bit hard to get to sleep the first time, but I think it’s because I am overworked as well as taking them later than I could. So today I took my first dose at 7 am instead of 8, and the second at 11:30 instead of noon to 1 pm (the time varies depending on when I find myself near to a drink of water). I can live with the sleep patterns I’m experiencing right now, but if I can improve it slightly so I am not wired going to bed, that would be ideal. The sleep doc said I’d have to forgo being alert in the evening and to be careful not to drive if I’m sleepy.

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[Anonymous]

bill,

my drug book says that the usual starting dose of adderall XR is 10mg. maybe it is just too high? maybe it comes in 5mg pills? I know that not sleeping two days is the very more potent way to destroy any focus I am already have had. I say down done on the dosagijg see what happned.

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[billd]

It’s single 20 mg pills. She said that for some reason she’s not able to do the smaller pills then change or something like that – I dunno, so she said she’d start me on a medium dose, middle of the road. I slept pretty well last night, but note that these wear off pretty quickly……….

And so far, I can’t say they have helped the ADHD stuff at all! Just that I am more likely to stay awake and do have more energy. So maybe the sleep issues will be more controlled? The assistant was shocked when I called and said ” I still can’t get back into a project once I’m interrupted – it can take an hour or longer, or I might just have totlaly lost interest” She asked “and you have been taking this? YUP – exactly like you said, but I can’t focus, get distracted and would rather do other stuff. Don’t stop me to ask a simple question – I won’t get back to my project. I think they are dumbfounded. She said the Adderall should have an INSTANT effect and be helping that already.

Well, at least I’m sleeping again!

Man, I really like chatting with the folks here – I learn so much and folks are SO nice and understanding.

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[Anonymous]

Good to hear you are sleeping again! You have probably adjusted to it in your system. My son had minor side effects for a couple of days, and then they vanished. Does the XR mean extended release? Because if the insomnia keeps cropping up, then you may be better off with short acting stuff, so that it well and truely wears off by bedtime. It sucks that you aren’t getting much benefit though. Maybe another drug, or a different dose might be better. Fingers crossed.

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[nellie]

I’m not sure this qualifies as insomnia but my problem is that now that I’ve been on the Vyvanse for a while ( about 5 -6 months) my sleep hasn’t really improved at all. Partly because I go to bed too late ( say 1 oclock and then have to get up at 7ish depending on the day) but I have been trying to get better. Haven’t made a log but I’ll guesstimate and say I get to bed between 10:30 and midnight 4 days a week. Anyway, while before hand I would toss and turn all night and not feel rested in the morning, now I wake up several times and in addition seem to be dreaming all night which I hadn’t done in years. So I’ve traded the constant dialogue in my head before falling asleep with more of it all night long! Or at least it seems that way. Maybe I’m just waking up during the REM phase. Falling asleep takes at least an hour or more as well.There have been days where I feel rested but they are few and far between although the days where I go to bed earlier obviously I feel better the next morning. Just not as great as I think I should.

Anyway, anyone else have a similar experience?

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[billd]

Dreaming all night? Not good. That’s my problem – dream state or REM is NOT the refreshing deep sleep.

You should sleep about 90 minutes before you get to REM. I’d go to sleep and as I’m drifting off I’d already be dreaming – almost before my eyes closed. All night.

I’d wake unrested. I could nap any time, and as soon as I’d lay back in a chair and close my eyes, I’d be asleep and into dreams. I was told I MUST get a full 8 hours, and I needed to get up at the same time EVERY morning, that to vary the go to bed time, not the wake up time for best results. So that means 7 days a week get up at 4:30, add the sleep onto the other end.

I have sleep issues, severe ADHD, etc. I’d fall asleep in meetings, in boring discussions, in classes, and even if I was bored at work, I’d find myself starting to dream even before I was actually asleep with eyes closed.

Bad, very bad.

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[Anonymous]

I should never be posting on this thing after I’ve taken my sleep meds!!!!!!!! embarrassing! but the drug book thing is true lol. i did look it up.

bill, maybe the short acting would be a better idea? as you could start lower. I felt pretty weird after first taking stimulants. I got used to feeling weird, then figured it was doing nothing but keeping me alert. however, over time, I realized more subtle changes.. i cleaned my house for the first time in 9 months (still took me about a week and a half a little here and there). (i mean of course I had been things like dishes and de-cluttering before 9 months but it was still gross). I bought organizers and no longer felt completely overwhelmed by piles of loose papers. At work, I was able to chart in between people. less tangential interviews. Still spent the same amount of time at work (='( ) but at least got more done with that overtime. I stopped a long-time compulsive gum chewing habit (ie. used to chew to help me focus when at home). seemed like nothing at first. but at the same time, i was obsessed with this site and actively using strategies talked about on here. It has never helped me with hyperfocus.. ever. only difference noted is that hyper focus time is a bit more useful like job field research vs. wikipedia random link jumping. and i have a bit more control on topic. may even worsen one aspect of hyperfocus. makes hyperfocus time more quality ie. i learn more due to better focus lol. I noticed that I was doing more with the day versus lounging in pjs half the day and being upset that my day was wasted.

nowadays, it is a little different. the vyvanse pretty much stopped working and I found myself almost back to square one. very frustrating realization. i switched to short acting dextoamphetamine, hoping less sleep interruption and that maybe it would still work. Has had partial efficacy. and my skin cleared up. i think vyvanse increased my acne issue. weird.

I think I either need more dextroamphetamine or to switch. my doc and i want to see my insomnia clear before doing anything. insomnia= crap focus.

also horrible insomnia- due to a variety of causes.

sounds like my sleep, Nellie . The only difference is that I fall asleep immediately due to high dose sleeping medication (s). I deal a lot with that awake dreaming crap. but I’ve had sleep issues since childhood. My sleep has been awesome lately, but not awesome to be 28 and needing 3 sleeping medications (ambien maxed) every night.

I get a sleep consult tomorrow.. which reminds me that I was going to write a summary document..and have well procrastinated it!!!

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[Author]

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