Uncommon Issue

[Pugsy]

Hmmm...
Not going to debate the need for Adderall and the diagnosis of ADD or ADHD being the right or wrong way to to address those theings.
That's between the doctor and the patient.

The problem is the insomnia that happens when the mask is put on and there's no problem with insomnia when the mask is not put on.

Even if there were no Adderall in the mix...I am betting there would still be insomnia with mask on.
She/he was on Adderall at the beginning of therapy and for the first few weeks things were fine and going along quite nicely.
It's not like Adderall was added recently...

Let's see...
Problem sleeping with cpap and mask on.
No Problem sleeping when no cpap.
One would assume that the no sleeping problem is related to the cpap stuff...probably mental most likely unless there is some comfort stuff going on that wasn't mentioned.

Another problem is figuring out how to fix it so the mask and machine doesn't cause insomnia.....that's the really tough one.

[ChicagoGranny]

The problem is the insomnia that happens when the mask is put on and there's no problem with insomnia when the mask is not put on.

That is not the whole story. It overlooks an important part of the OP's post:

I have been using a CPAP machine for about 10 months or so. At first, it was good and I was getting somewhere around 4 to 6 hours of sleep every night according. Gradually, the number of hours decreased over time.

When he started CPAP, he was likely severely sleep deprived. This drove him, in spite of the Adderall, to be able to sleep with CPAP.

Over time, the CPAP therapy allowed him to begin a slow, partial recovery from sleep deprivation. Now that he is partially recovered, the Adderall side effects create insomnia.

[Pugsy]

Now that he is partially recovered, the Adderall side effects create insomnia.

Ahhh...but how do you explain the fact that now...with no cpap but with Adderall...there is no insomnia?
If there was insomnia now without cpap...yeah, I would be the first one to point the finger at Adderall.
But there is no insomnia without cpap and the Adderall dose is the same.

[ChicagoGranny]

He says he is getting very little sleep without the mask.

then i just take the mask off and then go sleep, i have no choice because i need the rest and as little sleep as i get, it's still better than staying up all night in the mask and staring at the ceiling.

Exactly what he means by this is not clear. It's hard for a person to make a subjective determination of the quality or quantity of his own sleep.

The description of Adderall reads like "insomnia". https://en.wikipedia.org/wiki/Adderall#Side_effects

[lark]

Hello everyone,

I take adderal early in the morning before going to work, usually at 6 AM. Normally i go to bed at 10 or 11 PM. I don't drink any type of caffeinated beverages at all after 2 PM.

When I go to bed, I put the mask on and turn the machine on. I feel relaxed laying down on the bed but no matter how long I stay laying on the bed, I cannot make myself fall asleep. Eventually (after about 30 to 45 minutes), I get frustrated of not being able to fall asleep and take the mask off. Once the mask is off, it usually takes me anywhere between 5 to 15 minutes to fall asleep. I know I am snoring because I've recorded it many nights. Also, I wake up many times during the night, clearly not getting any deep sleep time. Also when I first started using cpap, I was dreaming and could clearly remember my dreams. however, these days since I go to sleep without the mask, there are no dreams that I can remember. Clearly, not getting any deep sleep.

I've read all of your posts and it's interesting. Do you think if I switch to Ritalin, this is a better approach and will have less of an impact on the onset of sleep? Thanks.

[Pugsy]

I've read all of your posts and it's interesting. Do you think if I switch to Ritalin, this is a better approach and will have less of an impact on the onset of sleep? Thanks.

Don't now. Something to talk over with your doctor.

But remember...with the mask you can't seem to fall asleep even after 45 minutes...without the mask it takes about 5 to 15 minutes to fall asleep.

You've got the same dose of stimulant in your body with or without the mask.

[DeadlySleep]

What have you been taking? Ritalin is bad for nervousness and insomnia. What about trying no drugs? What do you think would happen? You might get better.

[TASmart]

There are multiple types of ADD not all have a hyperactivity component. Personally, I did not find Ritalin to be helpful, but amphetamine was. I took a low dose when I really needed to focus, and it never affected my sleep. Of course, at the same time, I drank a lot of coffee, that only seemed to keep me awake if I drank it after 3 PM or so. I do believe that any stimulant has the potential to mess with sleep stages though so that even if you manage to get to sleep, abnormal steep architecture still is not restful. SO I have in addition to the faithful use of CPAP, I have grossly reduced my intake of caffeine, and take no other stimulants. Sleep doc has also suggested that I take my antidepressant as early in the AM as possible, because of their effect on sleep architecture.

[Soothest Sleep]

Hmm. Relaxed and willing to sleep with mask, but don't; frustration ensues. Easily fall asleep without mask; apnea symptoms ensue. Is the mask/cpap the only variable at play here?

Medication side-effects have been discussed.

What about what's going on in your head at bedtime?--what thoughts do you have while lying in bed with your mask on? versus: what thoughts do you have while lying in bed without your mask? "I hope I darn well get to sleep!" or "Thank goodness, I know I'll fall asleep." Positive affirmations may help to change your mindset, if your thoughts are preventing acceptance of the mask.

Have you reviewed your other sleep hygiene practices lately? Maybe it's time to go back to basics, and see if you can fine-tune something there.

Jean

[lark]

I have thought about not taking the ADD meds for a while and see what type of impact it will have on my sleep. I don't drink and/or take any other caffeinated beverages or foods. Normally, just a cup of coffee in the morning and another after lunch, that's it, i don't drink soft drinks of any kind either.

it's been two days now since i've stopped ADD meds; however, still not able to sleep with the mask on. surprisingly, sleeping better without the mask and seem to be better rested. i'll keep trying.

[AMK]

It's possible that you are responding differently both to meds and the caffeine after a period of time on cpap. My own experience has been that I now respond to meds much differently. Prior to cpap, twice I tried starting Provigil, and couldn't tolerate it. The side effects were horrible. But after I was on cpap for a while, my doctor convinced me to try it again and now I have a normal response to it and I'm taking it every day. Why this would be, I can't say. With you, in addition to possibly having a different reaction to stimulants, it's possible that you have enough stimulants on board that your threshold for disturbance is very low, so that the mask and cpap are enough to tip the scales into insomnia. Would it be possible for you to forgo the afternoon cup of coffee?

[chunkyfrog]

In the past, it was reported that ADD was the diagnosis, but the real disorder was apnea ALL ALONG.
If you have been taking meds for ADD for a long time, make the doctor double-check your original dx.

[ChicagoGranny]

In the past, it was reported that ADD was the diagnosis, but the real disorder was apnea ALL ALONG.
If you have been taking meds for ADD for a long time, make the doctor double-check your original dx.

+1
Doctors make this mistake frequently, even more often than not. A very few doctors have caught on and are sending children with ADD or ADHD for sleep studies. Guess what. They are finding most of the children have sleep apnea.

I have thought about not taking the ADD meds for a while and see what type of impact it will have on my sleep. I don't drink and/or take any other caffeinated beverages or foods. Normally, just a cup of coffee in the morning and another after lunch, that's it, i don't drink soft drinks of any kind either.

it's been two days now since i've stopped ADD meds; however, still not able to sleep with the mask on. surprisingly, sleeping better without the mask and seem to be better rested. i'll keep trying.

As AMK suggests, I would go to one cup of coffee in the morning. Try that for a week. Then you may have to taper down to no caffeinated beverages. Also, watch out for chocolate - caffeine. Caffeine has a much longer half-life than most think.

How well are you functioning during the day since stopping the Adderall?

[lark]

An update on my uncommon issue(s):

It's been now more than two weeks that I"ve stopped meds. I am sleeping much better, getting 4 or 5 hours of deep sleep every night (yoo hoo). I don't feel anxious anymore after i put the mask on and before going to sleep. Hard to believe that those meds were affecting my mind that much.

I dialed back the pressure to 8.4, temperate to 72, full ECR at 3. Things are much better; surprisingly, i don't even feel like I need the ADD meds either because I am alert in the morning when i wake up with ample sleep. In the past, a lot of times, I'd get out of bed feeling like I was hung over, sometimes with headaches etc. I have not experienced that in the last couple of weeks since I stopped the pills. I stopped the pills over a period of a week, decreasing dose and then stopping it.

This forum has been a great help to me and I appreciate everyone's input specially ChicagoGranny's.