View Full Version : Sleep: My Archnemesis


KDLMaj
02-07-09, 04:24 AM
well, it's 12:11 AM, and I need to be asleep...oh an hour or so ago. Now, I swear after this post I'm going to bed (no really).

But I've been thinking a lot about sleep and ADHD, particularly about how it impacts my life. I'd like to hear what people are doing to deal with the subject of sleep.

So some background info:

First- Science

It's long been known that ADHD and sleeping issues traveled together. The big question has always been- is ADHD actually just a symptom of a sleeping disorder in someone? Someone who is consistently deprived of sleep (say from sleep apnea) will eventually meet the criteria for ADHD based on the effects of sleep deprivation. Now, there's increasingly evidence that the ADHD itself causes sleep disturbances. (Not shocking- the one thing virtually every psychiatric disorder has in common is disturbed sleep patterns) We take longer to fall asleep, we wake more often in the night, and we move around more in our sleep than other people do. Recent studies also show that, oddly enough, our qualify of sleep improves after being treated with methylphenidate during the day **long after the medication has actually left our systems**. Interesting stuff. We're also far more likely to have a delayed sleep phase cycle disorder- our internal clocks, if you will, tend to be askew. Many of us already know this- our bodies don't actually go into sleep mode until midnight or even later, and they certainly don't want to wake up before noon.

Second- Me

I'm in the delayed sleep phase group. My internal clock has decided that 4AM is the perfect time to sleep and that noon is the perfect time to wake up. I've been like this all of my life. Additionally, I struggle with a kind of hyperfocus every single night. I think a lot of people here can relate to it (and I discussed it in another thread already). The gist? Every single night, I settle down to my computer or my TV and get into "the zone". I calm down considerably, I lose my hyperactivity (only when it's the computer), and I begin to just do "things". It's usually 5 things at once with 15-20 windows in the browser. I'm often researching something exhaustively. It isn't uncommon for that "something" to turn into "somethings" as the hours progress. I lose all awareness of time, and my restlessness is all but gone. I don't notice how tired I am, and I don't notice that I'm hungry. It really does accomplish all of the same things medication accomplishes- ADHD symptom relief. My mind isn't going in a hundred directions at once, it's very contained and only going in one or two. I'm not fidgeting like crazy. I don't wander around the apartment. And to say I am almost addicted to this time at night and this focus would be pretty accurate. The problem is, it'll just keep going and going until ridiculous hours. Eventually the exhaustion sets in, and I just get to the point where I'm on the verge of passing out. Then I go to bed and am either horribly sleep deprived the next day or just lose the entire day to sleep. And the cycle continues.

The very thought of breaking out of this (And once it starts, it really is virtually impossible to get out of it anyway) makes me cringe. My brain is totally going and wants to keep going the way it is, and I know that it'll be mighty uncomfortable sitting there in the dark, wide awake, while my brain continues to tinker away. It'll be...boring. And I hate boring. More than anything else in the world.

Now, a few things I've developed to help:

1. For a while I had sleeping pills I would take. I knew that once things set in, I was stuck. So if I took a sleeping pill before it started, I would pass out before it began. Problem is I don't have them any longer, and I don't like needing those to sleep.

2. I time my stimulant to not wear off until the wee hours of the night. Stimulant medication doesn't cause insomnia for me. On the contrary, it makes it much easier to sleep. And as long as the meds are going, I'm far less likely to slip into my nightly hyperfocus-y thing. And if I do slip into it, I can pull myself out. The problem? If I don't pull out of it before my meds wear off, I'm stuck. Also, while the meds don't make it hard to sleep, they do make it easier to stay awake. So sometimes it's a push-pull effect.

I know I'm not the only one who struggles with this. I'm curious as to how the rest of you have managed with this issue? And for now, I'm off to sleep (I hope)

Jesse

roseblood
02-07-09, 07:24 AM
Found a good article about this recently, though you've probably already seen it: ADHD Sleep Advice -- End Bedtime Battles! (http://www.additudemag.com/adhd/article/print/757.html) This person claims that his patients find methlyphenidate 45 minutes before bed to be useful. Also mentions research suggesting that most people with delayed sleep phase syndrome have ADHD, while the reverse isn't true (DSPS is rarer). My issue isn't that bad, just a degree of initial insomnia.

'...more than 70 percent of adults with ADHD report that they spend more than one hour trying to fall asleep at night.'

This is me. I've been this way for as long as I can remember and didn't know it was unusual until recently. I'm told I was a bad sleeper from the time I popped out of the womb, but I don't remember ever being tired in the day. It doesn't seem to matter what time of night I lie down or how tired I am when I do - always over an hour and sometimes well over. I'm lucky that provided I go to bed soon enough to allow for a few hours spent awake I usually get enough sleep by morning, it's just frustrating to lie there feeling so tired and yet so alert, and to have to go to bed so early for several days before having to get up early in the morning so that I'll get enough sleep. It's bad for my social life and used to be bad for my academic life too because I couldn't stay up as late as most people my age unless it wasn't going to matter what time I woke up for a while. The worst though is when I wake up a few hours early, because it seems even harder to get back to sleep then and I don't even feel tired until shortly before I have to get up. And none of this seems very dependent on my mood, either.

-----------------------------------------------------------------------

Anyway, what do I do about it? Well usually just go to bed early, but recently I had the idea of trying to meditate, as I remembered that I'd feel like going to sleep when I used to do it in the day. In my case I forget what I'm supposed to be doing before I actually fall asleep and find myself just daydreaming or thinking again, but it's early days yet and might work for others as a lot of people complain of accidentally falling asleep during meditation.

Same problem with the trick of telling my body parts starting with the feet to go to sleep, until not aware of them any more and working my way up my body. It worked a few times but when it wasn't novel any more my mind would wander.

Counting sheep has always been a hopeless exercise and I assume it works only if you're the kind of person who falls asleep when you're bored. When I'm bored I just forget what it is I'm supposed to be doing and start daydreaming involuntarily. Also, keeping track of the sheep and numbers is actually challenging for me and so forces me to stay alert (which in turn forces me to move about more).

Something that seems to get me off to a better start as far as not furiously yet involuntarily thinking and imagining dialogue and stories instead of...whatever else is supposed to happen, is listening to very, very slow, and not too emotionally rousing music, with no words. I still have to take the iPod off afterwards so don't go to sleep, but it does at least slow down my brainwaves. Keeping them slow requires discipline but at least it gets you off to a good start.

I'd love to try going to sleep to the sound of a fan or other whiring/humming noise, because noises like traffic outside my window (which isn't usually there) or rain, seem to lull me into that nice quiet state (increase dopamine levels in the brain apparently, so you don't feel in need of stimulation), but nights at my house are quiet. I can't think of anything that wouldn't disturb others in the house, need too many batteries or heat the room up (like leaving the PC on). But it's an idea I know some people have success with.

KDLMaj
02-07-09, 11:13 AM
I actually found that article to be really fantastic. I've never stumbled on that particular one before, and while mostly it just confirmed a lot of other research I've done, it also added a few new facts.

I'm switching to Vyvanse in a few weeks. When I go to see my doctor, I'm going to bring that article (he's never worked with anyone with adult ADHD before) and request a second prescription for short acting dexedrine to help with mornings and sleep.

I've definitely put the two alarm/meds an hour before waking plan into effect with great efficacy. Sadly, that's not as much an option with Vyvanse since its onset is so slow.

Still looking for more advice and stories!

ADHDTigger
02-07-09, 02:46 PM
I've had sleep issues for years. I think that is par for the ADHD course. I could really relate to your computer fix- I have been guilty of that one myself. Google may be a great and wonderful tool but in my ADHD hands it is as insidious as crack. I've tried reading but find that if I like the book, I will be up until it's finished. A boring book will just set up irritation.

For awhile, I was using L-Tryptophan (naturally occurring amino acid- milk, turkey, tuna) with moderate success. I know people who swear by Melatonin but I never had much success with it.

What marginally works today is to walk away from the computer early in the evening- 6 or 7 or so. My computer is in a place where I can shut the door if I need to. This keeps a visible barrier up so that I am less inclined to sit in front of it again. After supper, I will watch TV until bedtime. I do bead weaving while watching TV so that my hands stay occupied with something. When it is time for bed, I leave the TV on at a low volume. While not nearly 100%, so far it seems to be helping.

When I can find a schedule that works, I stick to it as closely as I can. Even on weekends, I need to stay with the pattern. Deviation will only cause me to start all over again and I rarely find that the same thing works twice. I generally have to find all new coping mechanisms.

I'm sure I am not alone in saying this, but if you find a solution, share with the class! I would love to find a way to sleep that works dependably.

roseblood
02-07-09, 05:29 PM
I actually found that article to be really fantastic. I've never stumbled on that particular one before, and while mostly it just confirmed a lot of other research I've done, it also added a few new facts.

I'm switching to Vyvanse in a few weeks. When I go to see my doctor, I'm going to bring that article (he's never worked with anyone with adult ADHD before) and request a second prescription for short acting dexedrine to help with mornings and sleep.

I've definitely put the two alarm/meds an hour before waking plan into effect with great efficacy. Sadly, that's not as much an option with Vyvanse since its onset is so slow.

Still looking for more advice and stories!
Cool, glad it was so helpful! :)

Good luck. I can't share any medication experiences as they aren't options for me yet but there seems to be a wide range of responses. There is a board on here for sleep issues if you wanted to read more.

warwickl
02-08-09, 08:16 AM
Melatonin dropped me like a stone. Problem solved. Something that can also help is to wear soft foam earplugs. If you have a problem with fluctuating body temprature (common with ADD) try blankets made from towelling material in the hot season.

KFC in CA
02-09-09, 03:21 PM
Found a good article about this recently, though you've probably already seen it: ADHD Sleep Advice -- End Bedtime Battles! (http://www.additudemag.com/adhd/article/print/757.html)

That's a great article. It so very much describes me!

Thank you for posting.

justcallmedorie
04-08-09, 12:36 PM
I have an alarm clock that has different soothing sounds that can be set for 15-30-60 minutes or left on all night. Rainfall turned on all night helps me tremendously.

APSJ
04-13-09, 06:48 PM
Every single night, I settle down to my computer or my TV and get into "the zone". I calm down considerably, I lose my hyperactivity (only when it's the computer), and I begin to just do "things". It's usually 5 things at once with 15-20 windows in the browser. I'm often researching something exhaustively. It isn't uncommon for that "something" to turn into "somethings" as the hours progress. I lose all awareness of time, and my restlessness is all but gone. I don't notice how tired I am, and I don't notice that I'm hungry. It really does accomplish all of the same things medication accomplishes- ADHD symptom relief. My mind isn't going in a hundred directions at once, it's very contained and only going in one or two. I'm not fidgeting like crazy. I don't wander around the apartment. And to say I am almost addicted to this time at night and this focus would be pretty accurate. The problem is, it'll just keep going and going until ridiculous hours. Eventually the exhaustion sets in, and I just get to the point where I'm on the verge of passing out. Then I go to bed and am either horribly sleep deprived the next day or just lose the entire day to sleep. And the cycle continues.

The very thought of breaking out of this (And once it starts, it really is virtually impossible to get out of it anyway) makes me cringe. My brain is totally going and wants to keep going the way it is, and I know that it'll be mighty uncomfortable sitting there in the dark, wide awake, while my brain continues to tinker away. It'll be...boring. And I hate boring. More than anything else in the world.


I've never really thought about it before, but I do this as well. I have a pretty set routine at night, which I need to follow to get to sleep at a reasonable time, but now and then, I'll stop to check my e-mail right before going to bed, and I'll still be at the computer five hours later. If I notice the time, I'll think "what harm can five more minutes do?" and go on for hours more. It is extremely hard to break out of it, and if I do, its often very hard to sleep. For me, medication makes sleeping impossible, and when this happens, I tend to feel as if I've just taken medication.

I've actually had sleep problems for as long as I remember. As a little kid, I can remember my parents insisting I go to bed despite my protestations that I wasn't tired. I learned to turn off my light and lie in bed until I saw their light go out, and knew they were asleep, and then turn on my light and read for two or three hours. I still can rarely sleep without reading first, and it has to be something that won't draw me in too much, like a magazine with short articles, rather than a novel.

I can rarely sleep when I need to without medication, and sometimes I still can't. I wake up only with the help of seven alarm clocks placed around my room. I've been contemplating getting one that requires me to solve a puzzle before it will shut off, but I'm pretty sure I'd just unplug it.

VanReal
04-14-09, 11:25 PM
I've always had trouble sleeping and the only difference I notice since I started stims is that my eyes start burning/feeling irritated around 9PM or so, but that doesn't stop me!!:) I obviously don't have the skewed internal clock though because even on the weekends I wake at the crack of dawn and cant' stay asleep. I am not really raring to go though and often lay around in bed until the very last minute, especially on work days and hate that I run late so often when I've been awake for four hours!

My head-shrinker suggests melatonin to her clients that don't like sleeping pills (I could never take it early enough so there's no point). She has warned though that a lot of melatonin on the market actually has no melatonin in it at all. Because it's not regulated they can market it as melatonin even though it contains none, so if any of you have tried it and it did nothing you may have had a bad brand. She gets her's and recommends the melatonin from GNC, it's pricey but real and she swears by it.

I feel like I have survived 35+ years on four hours of sleep and I take enough pills every day I don't want to add another one. Really though I just am lazy and have never gotten around to actually going to GNC to try it....uugghh.

APSJ
07-22-09, 01:48 PM
We're also far more likely to have a delayed sleep phase cycle disorder- our internal clocks, if you will, tend to be askew. Many of us already know this- our bodies don't actually go into sleep mode until midnight or even later, and they certainly don't want to wake up before noon.

Second- Me

I'm in the delayed sleep phase group. My internal clock has decided that 4AM is the perfect time to sleep and that noon is the perfect time to wake up. I've been like this all of my life.

As I mentioned in my earlier post in this thread, I've been this way too, but always thought of it in terms of difficulty sleeping. I've been studying for an exam for a couple of weeks, and have been really struggling to stay motivated and focused, despite taking stimulant medication. Yesterday, after another relatively unproductive day, I decided I'd just keep trying to work into the night, even though my medication had worn off, and see what happened. I literally got more done, unmedicated, from 11:00 PM -3:00 AM than I have been able to in the last week.

I've always worked best at night, but I've always assumed this is because I procrastinate, and can only start focusing the night before something needs to be done. This experience is quite disconcerting, as it suggests that I have a capacity to focus at night without medication that I don't have during the day. Its also not an issue of getting enough sleep...I had been up for a long time when I started working last night, and had slept fine, and on a normal schedule the week before.

I've tried various things to make myself naturally fall asleep at normal times, including staying up all night so I'd be tired earlier the next night, and taking melatonin, but its never been remotely successful.(Melatonin sometimes makes me sleep, but then I wake up an hour or so later; staying up all night makes me tired during the following day, but I frequently still can't sleep when night arrives).

I take a small dose of mirtazapine every night to sleep, and it works about 80% of the time, but it doesn't change the fact that I naturally seem inclined to sleep at 5:00 AM and wake up at noon, as I discovered after running out of it recently.(I keep doxylamine succinate(unisom) on hand for such emergencies, but its far less effective)

I am certainly going to bring this up with my psychiatrist at my next appointment, but I am very curious as to whether it sounds like delayed sleep phase cycle, and if anyone has any suggestions for shifting this nighttime hyperfocus to a more useful time.

manismom
04-04-12, 01:47 PM
I know that this is an ancient post, but I am going to resurrect it anyway.

Been dealing with sleep issues myself since I was born (so says my mother). As a child, I walked and talked in my sleep. I would apparently wander around the house, then go climb into my parents bed. No memory of it the next day. For the longest time, I thought they would come get me out of my bed and put me in theirs. LOL

I also had horrific nightmares almost every night and would wake up with scratches all over. The nightmares led to INTENSE anxiety when I woke up during the night that lasted into my 20s.

Throughout my life, it always took me an hour or more to fall asleep, even when extremely tired. There were a couple of mental aerobics I did to help fall asleep during those times (before meds!!). If a particular subject, say a test, was running through my mind, preventing sleep, I would visualize, in as much detail as possible, writing the name of whatever was bothering me on a scrap of paper, wadding it up, and throwing it away. The important part was the detail. If I focused on what kind of paper and the visualization of s-l-o-w-l-y writing out the words, I would STOP focusing on whatever was stuck in my mind.

If it was just random excitement or sleeplessness, I would go to my happy place (in my case, a field of wildflowers in the mountains of Colorado) and do the same visualization, trying to imagine as much detail as possible. What kind of flowers, what is the weather like, etc.

The visualizations may not have made me sleepy (although they usually did distract me, so I could fall asleep), but at least I was thinking about something pleasant.

However, since I started taking stims, it takes me like 5 minutes or less to fall asleep. Most of the time, I don't even remember trying to fall asleep.

I have taken sleep meds in the past, but they really wreck me the next day. And if I am in the midst of a hyperfocus, I can power right through them until they aren't effective.

My daughter and Husband both take melatonin and it knocks them right out without the daytime sleepiness. But I didn't find it effective at all.

I also have Delayed Sleep Phase, although I always just thought it was my "Artistic Tempermant". :D It has been a while since I could endulge the late night party monster, but I used to stay up til 4 or 5 and sleep til whenever. Of course, I was drinking back then, so the hangovers didn't help me get up any earlier.

I also find myself hyperfocusing on the computer after I put the kids to bed. I will INTENSELY & EXHAUSTIVELY research some obscure and usually completely unimportant topic or get hung on a computer game until after 1am, then I somehow piddle away another HOUR in the bathroom brushing my teeth and getting ready for bed. When I am unmedicated I have no sense of the passage of time whatsoever. I know that its a hallmark / defining feature of ADHD, but I mean completely absent time sense.

When I am on effective stimulants, I generally know what time it is within 1/2 hour. Even when waking up from a dead sleep. The first time it happened, I felt like I had done a magic trick. Before meds, I couldn't tell you if an hour or a minute or 6 hours or 15 seconds had passed. I only knew the time by looking at a clock and had to set timers for EVERYTHING so I wouldn't get stuck and forget that I needed to be somewhere.

I also take Vyvanse and I am still dealing with delayed sleep phase. I wake up at 7:30 to get the kids to school, take my medicine, and go back to sleep for 2 - 3 hours. I also tried Concerta and Ritalin and Vyvanse is the only thing that seems to work to make me WANT to get out of bed and get stuff done. Of course, the lovely nap means that I will not be going to bed at a reasonable hour. :)

Right now I am trying to decide if I should fight it and try harder to get to bed at a reasonable hour and get up in the morning without the nap. Or if I should just give up and accept my night owl nature. It doesn't help that I have a 6 year old with some bigtime sleep issues. Even if I do get to bed at a reasonable hour, there's still a good chance that I will be woken up at LEAST once during the night and usually more.

Ahhh sleep. I love you I hate you.