His dose is typical for his weight, and is only about 1/2 of the maximum dose for his weight. Many children on stimulants have sleeping problems. If the child is benefiting from the stimulant in other ways, often the sleep problem will be addressed by adding a small dose of another drug that counter acts the wakefulness side effects of the stimulants. Also, you can not compare the mg dose of one drug with a different drugs. Its an apples and oranges thing as they do not directly relate to each other. For many patients, Adderall would be considered a more potent drug, so 10mg of Adderall might be stronger in its effects than 20mg of Ritalin.
Also, stimulants work best to improve the cognitive ability to focus and direct attention in persons with ADD, but they aren't so great at treating the physical hyperactivity and impulse control issues some affected people with the ADHD variant have. The same drug I mentioned above that is used to counter act the sleep problem also works well to tame down some physical hyperactivity and impulsiveness during the day. Your sister may want to ask the doctor about trying a little clonidine to see if it improves his sleep quality and possible hyperactivity/impulse control behavior issues.
Good Luck!
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