Does Adderall affect sleep?

In this article:

• Does Adderall affect sleep?
• Adderall sleep problems: Why they occur
• What to do about sleep problems and other Adderall side effects

In this article

• Does Adderall affect sleep?
• Adderall sleep problems: Why they occur
• What to do about sleep problems and other Adderall side effects

Adderall is a controlled prescription medication commonly used to treat attention deficit hyperactivity disorder (ADHD). It is also approved by the Food and Drug Administration (FDA) to promote wakefulness in people with narcolepsy, a sleep disorder. The standard, immediate-release Adderall is usually taken two or three times per day, while extended-release Adderall XR is taken once daily. Both contain a mixture of two central nervous system (CNS) stimulants—amphetamines and dextroamphetamine—which increase levels of dopamine, serotonin, and norepinephrine in the brain.

Like other ADHD medications, Adderall is not without side effects. If you or someone in your care experience sleep problems on Adderall, you’re not alone. There have been many reports of Adderall impacting sleep wellness. Below, two sleep medicine physicians unpack how and why Adderall affects sleep—and what to do about it.

Does Adderall affect sleep?

Sleep disturbances are commonly reported Adderall side effects. In clinical trials of Adderall XR, insomnia was reported in 17% of children (ages 6–12), 12% of adolescents (ages 13–17), and 27% of adults.

Insomnia, which the National Institutes of Health (NIH) defines as trouble falling or staying asleep, is the most common sleep-related adverse effect associated with prescription stimulants such as Adderall. Delayed sleep phase syndrome (DSPS) has also been reported with stimulant medications. An example of DSPS is when a person’s sleep is delayed by two hours or more beyond what is considered a conventional bedtime, making it difficult to wake up at the desired time. Essentially, it is a disrupted circadian rhythm (the sleep-wake cycle) that can cause daytime sleepiness and a sub-optimal sleep schedule.

It is also important to note that some Adderall users’ sleep problems might be caused by the reason they’re taking the drug in the first place: ADHD. People with ADHD have an increased risk of developing sleep disorders. A population-based study in Sweden found that 7.5% of people with ADHD also had a sleep disorder, and another study of 252 adults with ADHD found that 44.4% of them had insomnia. 

Adderall sleep problems: Why they occur

“Adderall is a powerful stimulant that can raise blood pressure, heart rate, and energy levels,” says Alex Hakim, MD, a Los Angeles-based sleep physician quadruple board-certified in sleep, critical care, and internal and pulmonary medicines. All of these factors are additive and increase wakefulness. That’s bad news if Adderall is still active in your body when it’s time to go to sleep.

Another reason for Adderall sleep problems is that it tends to stay in the body for a long time after it’s ingested. Adderall has a half-life of 10–14 hours, according to Alex Dimitriu, MD, a double board-certified physician in psychiatry and sleep medicine and founder of Menlo Park Psychiatry & Sleep Medicine. That means it takes 10–14 hours for the body to eliminate half of the medication. “Because of the longer half-life, Adderall has a greater chance of causing insomnia and reducing deep sleep as well as REM (dream sleep) in the morning,” he says. 

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“Ultimately, Adderall’s stimulating effects can make it hard for a person to relax enough to fall and stay asleep—especially if not much time has passed since taking Adderall or if the dose is too high,” Dr. Harkim says.

What to do about sleep problems and other Adderall side effects

There’s no denying that people on Adderall have a higher-than-average risk of sleep problems. The good news is that there are ways to help prevent insomnia and other Adderall side effects.

Take Adderall first thing in the morning

The best way to prevent sleep problems while taking Adderall is to take it as early in the day as possible. If your work schedule prevents you from sleeping at night, you can take it as far in advance of your anticipated sleep window as possible. 

“The goal is to limit the effects of the drug to the hours where it is needed most and provide an adequate time buffer for the start of anticipated sleep,” Dr. Hakim says.

Ask about decreasing your dosage

Adderall dosage varies according to each person’s needs. Dr. Hakim also suggests working with your healthcare provider to determine your “lowest effective dose” can mitigate sleep problems and other Adderall side effects. 

Standard Adderall dosage for adults and children ages 6 and older is 5–40 mg once per day or divided into 2–3 daily doses every 4–6 hours. Adderall XR is taken just once per day. Adderall XR dosage is 20–60 mg for adults, 10–40 mg for adolescents 13–17 years old, and 5–30 mg for children 6–12 years old. 

If you are experiencing trouble sleeping on Adderall and are not at the lowest recommended dosage for your age group, talk to your healthcare provider about the benefits versus risks of decreasing your dosage.

Avoid other stimulants 

Stimulants such as caffeine and nasal decongestants may make Adderall side effects like insomnia worse. It’s a good idea to limit or avoid coffee, tea, energy drinks, caffeinated soda, and other stimulants while on Adderall.

Ask your prescriber about switching medications

Adderall is not the only ADHD treatment available. Dr. Dimitriu says Ritalin (methylphenidate) is “somewhat gentler” than Adderall, which might mean fewer side effects for people who are sensitive to stimulants.

If you are having trouble sleeping while taking Adderall, tell your healthcare provider. They can determine whether to switch you to a lower dose or try a different prescription medication for ADHD or narcolepsy.

Practice good sleep habits

One of the best things you can do to mitigate the risks of Adderall affecting your sleep is to develop good sleep hygiene.

Dr. Dimitriu stresses the importance of getting sufficient sleep—at least seven hours a night—and avoiding the use of stimulants. He says that, without sufficient sleep, “the benefit of the stimulant soon gets lost or diminished, and an unhealthy pattern of poor sleep and need for more stimulants can emerge.”

Dr. Hakim agrees and emphasizes that, with a thoughtful sleep strategy, it’s possible to avoid relying on sedatives and sleep aids for better sleep. “When Adderall is used recklessly, the need for powerful drugs for insomnia can develop, leading to a potentially escalating cycle of polypharmacy and dependence,” he warns.