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  • ADHD and sleep disorder

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    Old 08-29-2010, 03:19 PM   #1
    fADHoDy
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    ADHD and sleep disorder

    Hi,
    This is my second post here "Awesome forum, by the way!"
    you can read my story by reading this post : http://www.healthboards.com/boards/showthread.php?p=4313680#post4313680
    (I'm currently taking 15 mg of Dexedrine spansule "long time" release)

    The main reasons why I have known that i'm ADHD, it's because I have a sleep disorder since I am young...
    My shrink said that I am not insomniac, and by taking care of my ADHD it will solve both problems...

    1- Is this is your case? How many of you have both sleep disorder and ADHD?
    2- What is your medication for that? what did you tried, and what's the pos/cons? what's your story?

    By sleep disorder I mean BIG difficulty to get asleep, and some time, BIG difficulty to wake up. (not narcoleptic)The same with my father, but it seems that it's my mother who «gives» me her ADD. (interresting hum!?)

    3- in addition, I need 2-3 hours each day to fully start my activities... it were always this way... even with the medication...(but, I just began last month...) Any tough about that?

    And for sure all of what I write in this forum is known by my shrink or will be... I want the «user» perspective here

    quote, my personnal research lead me to the possibility that all my problem is related to a "too much" high concentration of certain enzyme... I'll post something about it later, but if anything songs bell for you, please report!

    4- (i.e. did I read something that methylphenidate is an inhibiter of certain enzyme?)

    Thank you in advance!

    fADHoDy

    quote 2, if there is something wrong in my spelling or grammar, any advice is welcome, english is my second language... tks

     
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    Old 08-30-2010, 08:58 AM   #2
    Rorer714
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    Post Re: ADHD and sleep disorder

    fADHoDy,
    To address your three questions....here is my story.
    1. No sleep disorder, before I got diagnosis of ADHD 16 years ago.
    I developed a sleep disorder immediately when I began use of
    stimulants.

    2. I started out with 20 mg. of Ritalin instant release (methyphenidate)
    times 3 tabs per day, one every 4 to 6 hours. My M.D. also started
    me out with 1 mg. of Xanax (Alprazolam) take at bedtime to help me
    "wind down". I developed a tolerance to the Xanax, which worked at
    the beginning, but my dose requirements increased to 2 mg. @ bedtime,
    by 18 months the Xanax would only put me to sleep for about 4 hours,
    and I would wake up and could not go back to sleep, now I have
    middle of the night chronic insomnia. I take increase dose of Xanax to
    another 2 mg. "bar" and that puts me back to sleep for another 4 hrs.
    Within 24 months, my tolerance increases to 6 mg. of Xanax per day,
    as I take 1 mg. doses twice during the day from the up and down
    regiment of the Ritalin, to try to balance out my mood swings. My M.D.
    places me on a 4 month detox (tapering down of the Xanax) until I get
    completely off all Alprazolam. Reduce dose of Ritalin to 10 mg. x 3 daily.
    After 3 years of Ritalin, and withdrawal from Xanax, I substitute the
    anti-depressant Desyrel 150 mg. at bedtime. Pro's? Within 1 hour, I
    go to sleep and stay asleep 8 hours minimum. Con's? I have now a
    negative, syrup like hangover, in a stupor for 90 minutes every day at
    awakening. I reduce dose to 100 mg. of Desyrel (Trazodone) and my
    M.D. allows me to switch stimulants to Dexedrine Spansule 15 mg. ,
    I further reduce Trazodone to 75 mg. at bedtime and take Dex Spansule
    at awakening. I also begin taking one 10 mg. Adderall instant release tab
    between 4PM and 6PM at the latest. Pros's When Dexedrine Spansule
    wears off gradually late in afternoon, I get scattered and unmotivated,
    the Adderall 10 mg. usually lasts for 4 to 5 hrs, thus, by 10PM to 11PM
    I go to bed, but still need the Trazodone. Con's? I still need at least 75
    mg of Trazodone to go to sleep (a minimum) eventually go back to 100
    mg. to put me to sleep and keep me asleep for 8 hours, but the next
    day hangover's return. Drink coffee to jump start the Dexedrine Spansule
    This routine I keep for about 10 to 11 years. I develop Anxiety & issues
    with Depression, due to a Divorce, and loss of employment, my M.D.
    observes my struggles with inability to adjust, in the meantime, I have
    also, been taking Ambien 10 mg (Zolpidem) at bedtime, beginning about
    2002 until the present. Pro's? Aids to helping me go to sleep without
    having to take 150 to 200 mg. of Trazodone, thus Ambien+Trazodone
    combination works until I develop lifestyle changes I describe earlier.
    M.D allows me to substitute the atypical anti-psychotic "Seroquel" for
    the Trazodone for 6 months. Pro's, No more Anxiety issues, but I sleep
    12 to 14 hours per day on 200 mg of Seroquel at bedtime, and my next
    day hangovers, are worse than Trazodone, I am a zombie for 2 1/2 hrs
    after waking up and taking Dexedrine Spansule, now, I add on 10 mg.
    of Adderall with the Dexedrine Spansule together, to try to clear the fog.
    Pro's I reduce the hangover from 2 1/2 hrs to 1 hour, but, now I need
    a 2nd Adderall 10 mg. by 6PM to function. Con's: I develop a serious rash
    Urticaria and now need Atarax (hydroxyzine) 20 to 30 mg. + Allegra 180mg
    to control persistant itching on face, and scalp and arms.

    3. About 6 months ago, the side effects of Seroquel are unacceptable,
    my M.D. allows me to try Klonopin 2 mg (Clonazepam) at bedtime +
    10mg. of the Ambien (Zolpidem) for my insomnia. Pro's: Hangovers,
    are only about 45 minutes long at awakening, sometimes only 30
    minutes. Cons: I develop a need to increase dose of Klonopin to 4 mg
    at bedtime. I still take Dexedrine Spansule 15 mg at awakening, and
    my sleeping time has more normal from 12 hours per day to 9 hrs per
    day. My anxiety levels and depression still continue, inability to adjust
    to loss of a marriage, and only a part-time job of 2 days a week. I
    continue to take 10 mg. of Adderall with AM Dexedrine Spansule, and
    a 2nd Adderall between 4PM to 6PM at the latest, due to inability to
    focus in late afternoon, scattered, as the stimulants wear off, and
    the Klonopin has a mild mood elevator effect (good) but tolerance is
    increasing again. I most recently have been rotating one week of
    nighttime Ambien, then one week of 10 mg. of Valium (diazepam) to
    aid in my need to treat my insomnia. Seven to eight years of using the
    Ambien makes it seem to not work much anymore, even dosing up to
    20 mg. at bedtime, with the 4 mg. of the Klonopin. I rotate the 10mg
    of Valium, every other week for 7 days, then go back to Ambien for
    7 days to avoid the danger of building up a tolerance. I have recently
    stopped use of allergy medications Atarax (hydroxyzine) and Allegra
    (fexofenadine).

     
    Old 08-30-2010, 04:07 PM   #3
    addprogrammer
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    Re: ADHD and sleep disorder

    fADHoDy,

    Dude, no disrespec, but your handle just doesn't parse in my deranged head.

    Let's go with "fahoodie"

    "The main reasons why I have known that i'm ADHD, it's because I have a sleep disorder since I am young...
    My shrink said that I am not insomniac, and by taking care of my ADHD it will solve both problems... "


    Yes. Your shrink is on target. I'm busy as hell currently and you deserve much more to your most intelligent post.

    Later,

    Bob

     
    Old 08-31-2010, 12:25 PM   #4
    addprogrammer
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    Re: ADHD and sleep disorder

    fADHoDy,

    I've visited your fine city of Montreal a number of times. Great food. Great place. I never encountered a French speaking Canadian that couldn't speak English well. You are no exception. The fine folks in Montreal just switch to English as soon as they see the "duh" look on my face.

    I read Roger's detailed reply. I've always resisted "stop" pills to stop the effects of "go" pills. Perhaps in some cases there is no alternative.

    Let's go back. Yes, I've had a life-long problem with insomnia. ADHD is the cause. Insomnia greatly exascerbates ADHD symptoms which increase the insomnia. One vicious cycle ensues.

    The dynamics are complex and beyond my understanding well. So let's restrict ourselves to possible solutions. Dexedrine CR worked the best for me. It controlled my ADHD and I slept like a log. (Does the idiom translate?)

    You mentioned you have been prescribed "15 mg of Dexedrine spansule."

    Is the problem solved?

    A little titration up in dose may be needed otherwise.

    Maybe be nothing more to it than to do it.

    Bob

     
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