Adderall

How to Sleep Better While Taking Adderall (Doctor’s 6 Tips)

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Dr Albert Stezin Profile Picture

This article was written and researched by Dr. Albert Stezin (MBBS, Ph.D – clinician and neuroscientist) to ensure maximum factual accuracy and unique content.

Adderall is a combination drug containing amphetamine and dextroamphetamine and is a powerful central nervous system stimulating drug used to treat attention deficit hyperactivity syndrome (ADHD).

Clinical studies have consistently demonstrated an improvement in focus and attention span in people with ADHD using Adderall but its use is associated with significant sleep problems in up to a quarter of users.

So how can you sleep better whilst taking Adderall?

The most effective ways to sleep better on Adderall are to use the lowest effective dose; take the medication earlier in the day; avoid substances like caffeine that may worsen insomnia; ask your doctor to prescribe melatonin; and follow a relaxing sleep routine.

The rest of this article expands on these points to give you a more comprehensive way to tackle and prevent insomnia caused by taking Adderall.

However, although this article was written by a medical doctor, you should ALWAYS consult with your doctor before taking Adderall, changing your dose, or combining it with any other medications – since some drug interactions with Adderall can be fatal.

Related: find out if kiwi can help you sleep better here.

6 Ways to Sleep Better While Taking Adderall

unPHILtered: How Adderall Affects Sleep

Here are 6 ways that can help you sleep better whilst taking Adderall:

1: Use the Lowest Possible Effective Dose by Slowly Scaling Up

Adderall should be started at a low dose and carefully increased up until the lowest effective dose is reached in order to avoid taking too much of the drug that may otherwise cause insomnia.

The optimal dose is decided on the basis of your clinical improvement and side-effect profile.

The desired target dose of Adderall is usually achieved only after a couple of weeks, or even months.

This does not mean that the clinical benefits would only come later.

In my experience, even at a low dose, most patients have some clinical benefits beginning within 30 minutes to one hour of taking the medicine.

Unfortunately, this minimal benefit prompts the users to incorrectly assume that a higher dose of Adderall, and taking it more frequently, would give them maximal clinical benefit in a shorter span of time.

The development of problematic side-effects such as insomnia is, unfortunately, the usual outcome of this fast-paced titration.

Hence, you should start low and go slow.

However, even if you follow your doctor’s advice strictly, you may still develop a few side effects.

If these are tolerable, your doctor may advise you to slow down the titration.

However, if the side effects are severe, your doctor may reconsider the use of Adderall.

How Does Adderall Affect Sleep?

With regards to sleep, the most common side-effects of Adderall are insomnia, frequent awakenings, waking up feeling fatigued, and a decrease in REM sleep.

These sleep disturbances are seen in 8 to 33% of people using Adderall and are usually mild to moderate in severity. 

They are also dose-dependent side-effects, which means that at higher doses, the probability of developing sleep problems is higher, and will increase as the dose increases.

What Are the Other Side Effects of Adderall that May Disrupt Sleep?

The other side-effects of Adderall that may disturb sleep include headaches (~26%), anxiety (7 – 8%), agitation (2 – 8%), dizziness (2 – 7%), irritability (6%), fast heart rate (6%), fatigue (2 – 6%), twitching (2 – 4%), depression (3%), palpitation (2%), and jitteriness (2%).

Aggressive behavior, dysphoria, euphoria, exacerbation of vocal tics, formication, outbursts of anger, overstimulation, paraesthesia, psychosis, restlessness, and talkativeness, are less prevalent side effects.

How Should You Take Adderall to Avoid Sleep Disruption?

To get optimal sleep, you should take the medicine in the morning if you are on a once-a-day regimen, and in the morning and early evening if you are on a twice-a-day regimen, to prevent sleep-related side effects.

I usually start my patients on an initial 5 mg once- or twice daily regime, and increase the dose on the basis of clinical response and tolerability, at 5 to 10 mg weekly increments, to a maximum of 40 mg/day (based on weight).

Some experts also recommend waiting up to at least one month before increasing the dose. 

If you are on an extended-release preparation, you will be started on a single 10 to 20 mg tablet, to be taken once daily in the morning.

Depending on the clinical response, the dose may be increased by 10 to 20 mg increments at intervals of one week or one month.

Although doses more than 40 mg/day will rarely be necessary, doses up to 60 mg/day may be required for optimal response in some adult patients.

However, be warned that the frequency and severity of adverse effects will also increase as the cumulative daily dose increases.

The strength of doses given above has to be titrated based on age, weight, and many other factors.

So, instead of fiddling around with the dose by yourself, let the health professionals take care of it.   

Click here for 7 doctor-advised ways to sleep better whilst taking Cymbalta.

2: Avoid Drug Interactions that Worsen Insomnia

Adderall has significant clinical interactions with other commonly used medicines that may cause insomnia and much more serious adverse effects.

Hence, you should avoid mixing Adderall with these medications.

I have compiled a list of medicines that you should avoid – or limit the dose – if you are taking Adderall.

Clinically significant drug interactions are known with duloxetine (Cymbalta), escitalopram (Lexapro, Nexito), fluoxetine (Prozac), sertraline (Zoloft), tramadol, levothyroxine, and omeprazole.

This is not a complete list, and I have included only those medicines which are commonly used and have moderate to severe interaction.

If you are on multiple medications you should inform your doctor to personalize your prescription to avoid these interactions.

You may also use online resources to identify any possible interactions between the medicines you may take. 

These online resources may be exhaustive, but some theoretical interactions may be clinically irrelevant.

Hence, they are not a substitute for your doctor’s advice.

Potentially Lethal Interactions – Serotoninergic Drugs and CYP2D6 Inhibitors

Potentially life-threatening serotonin syndrome or drug toxicity is a possibility when Adderall is used in combination with drugs from pharmacological classes such as the following:

SSRI (Celexa, Lexapro, Prozac, Paxil, Zoloft, etc.), SNRI (Pristiq, Cymbalta, Effexor XR, etc.), MAOI (Marplan, Nardil, Emsam, and Parnate), triptans (Imitrex, Maxalt, Zomig, Frova, Amerge, and Axert), tricyclic antidepressants (Alavil, Sinequan, Tofranil, Pamelor, etc.), fentanyl, lithium, buspirone, and CYP2D6 inhibitors (Bupropion, terbinafine, quinidine, etc.).

While a detailed list of these medicines is out of the scope of this article, ensure that you have received a detailed list of drug interactions from your doctor or pharmacist.

If the concomitant use of Adderall and serotonergic drugs or CYP2D6 inhibitors is a medical necessity, start Adderall at a low dose, and monitor yourself closely for signs and symptoms of serotonin syndrome and drug toxicity. 

The symptoms of serotonin syndrome include altered sleep patterns, shivering, diarrhea, agitation, confusion, high heart rate and blood presse, dilated pupils, muscle twitching, sweating, severe muscle rigidity, fever, and seizures.

If left untreated, serotonin syndrome is potentially fatal.

Avoid Alcohol

Avoid alcohol while taking Adderall, as the cardiovascular effects of amphetamines may be exacerbated by alcohol.

This interaction may lead to an increase in the heart rate, cardiac workload, and oxygen consumption.

This is particularly more pronounced in people with pre-existing cardiovascular diseases.

A few patients have also reported myocardial infarction (heart attack) after taking Adderall with alcohol. 

The use of stimulants can also mask the usual effects of alcohol, and symptoms of alcohol poisoning.

This may predispose users to consume more alcohol than usual, causing poisoning.

Avoid Recreational Drugs

Synthetic versions of amphetamine such as MDMA and meth are commonly used and abused as recreational drugs.

Concomitant use of Adderall and MDMA/meth can cause amphetamine toxicity.

The symptoms of amphetamine toxicity include agitation, sleep disturbances, hyperactivity, seizure, psychosis, delusions, paranoia, aggressive behavior, suicidal or homicidal ideations, excessive sweating, hypertension, palpitation, and chest pain.

Whereas death from amphetamine toxicity alone is rare, the concomitant use with other recreational drugs increases the chance of overdose and fatality.  

Limit or Avoid Caffeine

Limit caffeine use while on Adderall. 

Caffeine intake from coffee, tea, cola, chocolate, and herbal supplements should be curtailed as much as possible, due to their stimulant effect.

You should also avoid medicines containing additional caffeine whenever possible.

The usual side effects of Adderall, such as insomnia, awakenings, nausea, nervousness, palpitations, rapid heartbeat, and tremor, may get worse if you take excessive caffeine.

You should try to replace caffeine with decaffeinated beverages.

Try these 15 ways to sleep better after drinking coffee.

Limit Acidic Foods

Limit acidic foods in your diet.

Fruits, such as orange, lime, lemon, and grapefruit, and their juice, are known to decrease the absorption of Adderall, and should be avoided at least one hour before and after taking the Adderall tablet.

Acidic urine also increases the renal excretion of active components of Adderall.

Examples of foods that acidify urine are cranberry, orange, or any fruit or juices that contain vitamin C (ascorbic acid).

A decrease in the absorption, or excessive renal excretion, may lead to therapeutic failure, leading to uncontrolled symptoms of ADHD, and may decrease the quality of your overall sleep.

Be Careful With Alkaline Foods

Alkaline foods obviously have an opposing action to acidic foods.

Foods that alkalize urine, such as beets, dairy products, kale, and spinach, may slightly slow down the urinary excretion of amphetamines.

Although it does not cause any clinically appreciable effects, people who are very sensitive to dose-effects of Adderall, such as people with cardiovascular diseases, glaucoma, liver diseases, substance use disorders, and psychiatric disorders, should avoid or limit the use of these food items.

If in doubt, talk to your doctor.

Find out if chamomile tea can help you sleep here.

3: Treat Sleep Disturbances Caused by ADHD and Adderall

ADHD and its treatment with Adderall can both cause significant sleep disturbances that may need specialist treatment from your doctor to resolve.

Studies show that 19.3% of children with ADHD have moderate to severe sleep problems at least once a week.

Almost 50 – 60% of adults with ADHD have sleep problems.

Sleep disturbances in ADHD include increased sleep latency, decreased sleep duration, excessive daytime sleeping, bedtime resistance, and specific sleep disorders, such as restless leg syndrome, periodic limb movement disorder, and sleep-disordered breathing.

The use of Adderall is also associated with insomnia, early awakenings, a decrease in REM sleep, and fatigue.

Conversely, a few patients also report that taking Adderall makes them very sleepy.

People with ADHD and on Adderall may also have uncommon sleep-related problems, such as restless leg syndrome and periodic limb movement disorder.

These require special investigations to diagnose, and pharmacological treatment using medicines that have known interactions with Adderall.

I advise you to visit a neurologist or sleep specialist.

If none of these treatments work, or there are very severe side-effects of Adderall, your doctor may stop Adderall, and substitute with medicines with lesser sleep side-effects, such as methylphenidate, or non-stimulants, such as atomoxetine.

I advise you to keep your doctor in the loop and trust his judgment.

Keep a Sleep Journal to Identify Sleep Issues

To understand the effects of Adderall on sleep, it is first necessary to determine the base rate of sleep problems in the untreated ADHD patient. 

There are many ways to do this.

The best way is probably by the use of sleep logs, parent/self-reported ratings of side effects using validated questionnaires, and actigraphy monitoring.

Actigraphy objectively assesses a number of sleep parameters relevant to Adderall usage, including sleep onset latency (SOL), sleep duration, and nighttime awakenings.

Studies using actigraphy on patients with ADHD have demonstrated insomnia, or delayed sleep onset greater than 30 minutes, to be the most common adverse events associated with Adderall.

However, this should be distinguished from bedtime resistance, which is when the patient (usually children) refuses to go to bed.

Another important problem is delayed sleep phase syndrome.

This is a disturbance in the circadian rhythm that involves a phase shift in the sleep-wake cycle, such that the patient goes to bed late and sleeps late, sometimes to the point of day/night reversal.

This can have a devastating effect on school/work performance.

One can consider that delayed sleep phase syndrome has the same effect as being in a state of chronic jet lag.

Talk to Your Doctor to Devise the Best Treatment Plan

Treating sleep disturbances is a tricky business, due to a large number of known and unknown interactions of Adderall, and the numerous side effects attributed to it so consulting with your doctor is likely the best option.

In my practice, I first start by assessing if the sleep disturbances have any functional implications on work, studies, or life in general.

If yes, interventions are planned.

The first step is to ensure that sleep hygiene is followed very strictly.

If this fails or doesn’t provide the necessary sleep, behavioral interventions are tried.

Clinical studies have demonstrated that a five-session manualized behavioral intervention for sleep problems significantly improved the sleep quality at 2 months, and 6 month follow-up.

Combining sleep hygiene with behavioral techniques also led to fewer sleep disturbances at 3- and 6-month checkpoints.

This has been proven in children, as well as in adults.

In children with ADHD and on treatment, it was demonstrated that parental involvement in the behavioral intervention helped the child even more.

You may be referred to a sleep specialist or a clinical psychologist to learn these behavioral interventions.

Your Doctor May Prescribe Melatonin to Help You Sleep

For people with severe sleep disturbances, pharmacological interventions are attempted.

The best and the safest medicine, in my opinion, is melatonin.

Melatonin is the natural hormone that regulates the sleep cycle.

Clinical studies have established that melatonin supplements at clinical dosages are useful in negating sleep disturbances.

It also helps establish a circadian rhythm in people with ADHD.

Studies on exogenous melatonin supplementation have shown that it can improve the quality of sleep in people with other sleep disorders, as well.

There is no known interaction between Adderall and melatonin.

This makes it ideal for use as a short-term solution for insomnia caused by ADHD and Adderall. 

Melatonin supplements are available in strengths between 3 to 10 mg in pharmacies and can be obtained without a prescription in some regions.

Find out more about taking melatonin here.

400 mg of L-theanine May Improve Sleep Quality in People with ADHD

Another pharmacological supplement is L-theanine.

It is a physiologically relevant, sleep-promoting molecule that is relatively safe, even in high doses, and well-tolerated without any significant adverse events.

A study has demonstrated that 400 mg daily of L-theanine improves sleep quality in people with ADHD.

However, this supplement is not available widely.

L-theanine is naturally found in green and black tea, and in certain types of mushrooms.

You may use decaffeinated tea supplements and add mushrooms to your diet.

Avoid Experimenting

Beyond these sleep supplements, I do not advise my patients to take any other non-pharmacological supplements or herbal supplements, as their interactions with Adderall are still under research, and not conclusively proven.

I did not find any relevant studies which reported sleep benefits in patients with ADHD while using common sleep remedies, such as glycine, magnesium, primrose oil, fenugreek, flaxseed, 5 HTP (tryptophan), feverfew, fish oils, omega 3, flaxseed, ginkgo, ginseng, nutmeg, red clover, SAMe, willow bark, glucosamine, and horse chestnut seed.

Use them sparingly, or better yet, avoid them totally.

Click here to find out if Afrin can keep you awake at night.

4: Treat the Non-Sleep Related Side-Effects of Adderall

Adderall also has side effects that may disturb sleep indirectly.

These include symptoms of the central nervous system (headache, anxiety), and gastrointestinal symptoms (abdominal pain, xerostomia, diarrhea, and constipation).

Not everyone gets them all, however, some patients may develop moderate to severe symptoms that may indirectly affect sleep.

I have jotted down a few simple ways you can avoid these side effects, or treat yourself at home.

Headache

Headaches may affect up to 26% of patients on Adderall.

It is usually mild to moderate and clears up within a few hours.

If it disturbs sleep, you may take paracetamol tablets.

However, if you have migraine headaches, inform your doctor instead of self-medicating.

Migraine medicines such as triptans have known moderate interaction with Adderall.

Anxiety

Anxiety may feel like butterflies in your stomach or a racing heart.

You may feel out of control and may have nightmares or panic attacks.

People with anxiety have insomnia and poor quality of sleep.

Relaxation techniques such as mindfulness meditation, exercise, or biofeedback, may be useful for you.

I do not recommend the use of anti-anxiety medicines unless the anxiety is debilitating.

Click here for 8 ways to control OCD thoughts at night.

Abdominal Pain and Constipation

Constipation can cause abdominal discomfort, pain, and bloating, which can affect sleep.

If you have constipation while taking Adderall, it is time to change your diet.

You should include fiber-rich foods, such as fresh fruits, vegetables, and cereals in your diet, and drink plenty of water.

Mild to moderate exercise on a regular basis can also help to get your gut moving.

If none of these helps, talk to your doctor about starting stool softeners or osmotic stimulants to relieve constipation.

Try these 6 ways to sleep better with stomach ache.

5: Take the Adderall as Directed by Your Doctor

Adderall is a controlled substance and is available only with a doctor’s prescription in most countries.

However, there are places where drug regulations are laxer.

My advice for you is to strictly adhere to the regimen prescribed by your health care professional.

Adderall is a double-edged sword.

The excessive and irrational use of Adderall may cause physiological and psychological dependence, which may affect sleep significantly.

On the other hand, under-dosing can cause sleep disturbance due to uncontrolled symptoms of ADHD.

Adderall can also be a scary medicine, since its chronic use at therapeutic doses may also cause dependence – missed doses can lead to major withdrawal symptoms, such as insomnia, anxiety, paranoia, hallucinations, delusions and confusion, episodes of violence, mood disturbances, and intense craving for Adderall.

Furthermore, you may lose interest in recreational, social, and work-related activities, which could put significant strain on your personal and professional life.

Prolonged use and abuse of Adderall is known to cause sudden death or permanent brain damage, with cognitive changes, strokes, and epilepsy.

Hence, you should stick to your doctor’s orders.

Before prescribing, your doctor may assess your risk of drug abuse, and will also monitor for signs of abuse and dependence while on therapy.

However, it is imperative that you monitor yourself as well, to ward off dependence and abuse.

You should inform your doctor about any problems you have with regard to sleep, such as difficulty falling asleep, sleep schedule, waking or unusual behaviors during the night, snoring, difficulty getting up in the morning, or tiredness during the day.

Additional sleep studies may be required in those with suspicion of obstructive sleep apnea or symptoms of restless leg syndrome.

Sleep studies may also help in studying the baseline for parameters such as sleep onset latency, night-to-night variability, and total sleep duration.

These factors will be reassessed at follow-up.

The most common cause of physical and psychological dependence is the frequent or long-term use of Adderall.

Also, some people are more genetically predisposed to addiction than others.

If you have depression, bipolar disorder, anxiety disorders, schizophrenia, or even a stressful lifestyle, you are more predisposed to amphetamine dependence.

Once dependent, you may find it difficult to stop using amphetamine, and develop withdrawal symptoms once you miss a dose.

The easiest way of preventing addiction is by taking Adderall in the prescribed manner, including strength, time, and duration of use.

Keep your doctor informed of your progress, to help him/her personalize your drug regimen and minimize the abuse potential.

If you feel that you (or your loved ones) are psychologically or physically dependent on Adderall, seek professional help immediately.

In my experience with patients, it is almost close to impossible to beat this addiction on their own.

6: Create a Non-Stimulating Bedroom Environment

ADHD is a chronic condition that begins in childhood and may continue into adulthood.

The affected person may be unable to sit still, fidget continuously, have difficulty waiting for their turn, or have a poor attention span with excessive physical movements.

While there are no specific recommendations for the type of bed or sleep props to be used, you should consider creating a comfortable bedroom environment to improve sleep.

The bedroom of a child or adult with ADHD should be set up, and used almost exclusively, for rest and sleep.

Choose Sleep Friendly Decor and Sleep Aids

It should have minimal furnishings and non-stimulating color combinations.

The mattress should be the center of attention in order to facilitate better sleep.

The mattress, bed covers, and pillows should be comfortable enough and should suit the child/adult’s body and sleeping style.

Investing in a good mattress topper, full-length body pillows, and soft bedding can all help you sleep better.

These are the 5 most calming bedroom colors for autism.

Follow a Sleep Routine

You should commit to a set schedule to be followed daily without fail.

An erratic sleep schedule can alter and wreak havoc on the circadian rhythm.

You should go to bed at the same time every night, and wake up at the same time, including on the weekends.

A rigid schedule would help in keeping you on track with bedtime schedules, and also help the brain to prepare the body in anticipation of sleep.

Avoid desks, gaming systems, televisions, and toys that may serve as distractions.

The one hour before sleep should be kept relatively free from any source of excitement and overstimulation.

I ask my patients (adults and children) to count sheep, or perform mundane, repetitive mental tasks to help them fall asleep.

Plan Naps for Children and Avoid Naps for Adults

Take only monitored naps.

Naps can be good, especially for young children, if they are structured and time-limited.

Older children and adults should not take naps, as they can do serious damage to their sleep patterns.

If you are sleep-deprived and need to get a nap in the daytime, ensure that you don’t indulge in prolonged naps.

If required, I recommend taking a power nap of about 20 to 30 minutes. 

Find out if DayQuil can keep you awake here.

Adderall and Sleep FAQs

Below are the answers to some common questions relating to sleep and Adderall:

How Does Adderall Affect Sleep?

Many clinical studies have demonstrated patients with ADHD to be affected by a decrease in the norepinephrine, dopamine, and serotonin levels in the brain. 

Adderall is a central nervous system stimulant drug, that works by modulating the levels of these neurotransmitters.

The major neurotransmitter systems which are manipulated by Adderall include the norepinephrine and dopamine systems.

Norepinephrine is a neurotransmitter that also acts as a stress hormone.

Dopamine is a neurotransmitter that underlies reward and motivational behavior patterns.

Adderall affects the release and reuptake of norepinephrine and dopamine in the nerve terminals and increases their levels at the nerve terminals which may affect sleep.    

Why is it Hard to Sleep After Taking Adderall?

The relationship between sleep and Adderall is a complex one, and research into the mechanism of sleep disturbances due to Adderall and its side effects are ongoing.

It is presently understood that Adderall increases the levels of norepinephrine and dopamine in the brain, which causes and worsens sleep disturbances in ADHD patients.

What Can Help You Sleep After Taking Adderall?

To avoid or minimize sleep problems, you should take Adderall in the early evening, and follow your doctor’s orders strictly.

You should go to bed and wake up at the same time every day, avoid drinking alcohol and caffeinated beverages, and eating heavy meals before bedtime.

You should also avoid watching TV or using a smartphone before bed.

Conclusion: Professional Medical Guidance is Essential

To sum up, sleep disturbances are very common in patients taking Adderall.

You should follow your doctor’s instructions strictly to avoid these side effects and addiction to Adderall.

The drug dosage should be escalated slowly, and you should avoid taking medicines and food items that may interact with Adderall.

Optimal treatment of ADHD should also include the promotion of sleep hygiene and pharmacological adjustments to minimize the adverse effects on sleep.  

Up next: try these 21 ways to sleep better if you have lower back pain and sciatica.

Sources and References

1: UpToDate https://www.uptodate.com/contents/sleep-in-children-and-adolescents-with-attention-deficit-hyperactivity-syndrome. Retrieved on 10-22-2021

2: Drugs.com -Drug Interactions Checker https://www.drugs.com/interaction/list/. Retrieved on 10-04-2021

3: Shaheen E Lakhan and Annette Kirchgessner. “Prescription stimulants in individuals with and without attention deficit hyperactivity disorder: misuse, cognitive impact, and adverse effects”. Brain Behav. 2012 Sep; 2(5): 661–677.

4: Leslie Briars and Timothy Todd. “A Review of Pharmacological Management of Attention-Deficit/Hyperactivity Disorder”. J Pediatr Pharmacol Ther. 2016 May-Jun; 21(3): 192–206.

5: Anna C Nobre, Anling Rao, Gail N Owen. “L-theanine, a natural constituent in tea, and its effect on mental state”. Asia Pac J Clin Nutr. 2008;17 Suppl 1:167-8.

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