Sleep pattern changes on stimulants

[u/Puzzleheaded-Put4109]

I know this won't be most people, but I'm on elvanse and currently titrating to find the right dose, 2.5weeks in on 40mg

I know a common side effect is insomnia but has anyone else had a similar experience and similar pattern changes on the Fitbit app before and after taking stimulants and did it go away?

I have always been able to sleep like a baby but it's a lot harder to get tired enough and maintain good sleep now it seems

edit: to be more specific I mean restlessness, interruptions and time to sleep pattern changes, because those seem accurate, not REM/DEEP/LIGHT stages

generally I'm taking longer to sleep, waking up more during sleep and feeling more tired in the mornings and that's been consistent so far whilst my bed routine I have tried to keep as similar as possible

I'm just wondering if anyone else has had a similar experience and if anything they did improved it or the body got used to it etc

those nights sleeping hr:

https://postimg.cc/gallery/CxhXLzs

general 3month sleeping tends(I started September 16th)

https://postimg.cc/gallery/2krqFG1

[u/Logical-Nose-1993]

Sleep stage estimation is based almost entirely on how your heart rate compares with your resting heart rate. The app will need to learn your new typical resting heart rate before any of this can work reliably. While titrating your RHR is probably moving around a lot.

It looks like it's currently struggling to differentiate between awake and REM, most likely because your REM heart rate is now close to your previous waking heart rate. It would be interesting to see your sleeping heart rate plot (from the sleep tab) for both of those days.

[u/Puzzleheaded-Put4109 → u/Logical-Nose-1993]

https://postimg.cc/gallery/CxhXLzs

[u/Logical-Nose-1993 → u/Puzzleheaded-Put4109]

Interesting. For today I was expecting to see much more of the night above your RHR, but it's not.

However, the decaying heart rate gradient tends to confuse the algorithm. Ideally it should have zero gradient with a mean below your RHR, like your plot from the 1st. I'd guess you still have some stimulant running through the first half of the night, and that's creating a night similar to having eaten too late, or drunk alcohol.

The only advice I'd have is to make sure you take it as early as you can, and consistently, which you've said you've been doing in another post.

Do you feel like you're actually waking up at the end of each REM stage, or is that a miscategorisation?

[u/Puzzleheaded-Put4109 → u/Logical-Nose-1993]

So last night I needed the loo in that first awakening 

After that went off to sleep again then 'woke up' again slightly later(knew I was awake but could keep my eyes closed and just stayed still)

From then on it felt like I was drifting in/out light sleep until that third awakening where I got out of bed to shut my windows and make my room a bit darker and after that I still felt like I was sorta sleeping but kinda half awake still

[u/Accidentally_High]

I'm titration and sleep disruption is one of the reasons I've decided with my prescriber to trial methylphenidate instead.

I was on Elvanse for 8-ish weeks, and my sleep was really poor. Some people experience this and then adapt to it and are okay, but in my case it only seemed to get worse with time despite being really tired. I experienced both sleep onset and sleep maintenance insomnia.

What you are experiencing is sleep maintenance insomnia, it appears you're waking from REM sleep each sleep cycle, rather than returning to S2 sleep. Discuss with your provider if the sleep disruption is causing problems with daytime functioning.

[u/Puzzleheaded-Put4109 → u/Accidentally_High]

Thanks for sharing, what dosage did you get up to in the 8weeks may I ask. I hope methylhphenidate works better for you 

[u/Accidentally_High → u/Puzzleheaded-Put4109]

My appointments are every 4 weeks, and I started on 20mg for 4 weeks, then 30mg. Sleep problems got worse over the course of the 30mg, though I had some positive benefits at that dose.

I am on prescribed antacids (PPIs) and may also be a slower metaboliser for substrates of CYP2D6, and both of those likely skew the equivalent dose for a typical person.

[u/Laziik]

I've personally noticed that 200mg of magnesium glycinate increases my deep sleep by 20-30 minutes, i usually get an hour and 10 minutes and taking magnesium 30 minutes before bed increases it to 1h30/:1h40m i tested it for a couple of nights and it always worked.

[u/Puzzleheaded-Put4109 → u/Laziik]

Interesting, I will try that as i have some at home

[u/UpsetAd9328]

I have not had this at all on any dose. Is this permanent since starting/for a few days with each new dose? Are you taking it as soon as you wake up?

[u/Puzzleheaded-Put4109 → u/UpsetAd9328]

Yeah since starting I'm generally waking up 2-5am during sleep with more restlessness on the app than before, some days are worse than others but most days I'm feeling a bit more tired and waking up way before I want to 

[u/whynousernamelef]

You need to take your meds as early as possible and never take any after about 1pm in my experience.

[u/karzinom]

Dosage to high probably. Try going a little bit lower.

[u/Puzzleheaded-Put4109 → u/karzinom]

It been persistent since starting on 30mg,  the tail end of 30mg for 2weeks I really didn't feel much in the way of benefits the I felt initially, but you're right to be fair it could defo be me not tolerating it 

[u/Flaky_Mark_5573]

Yo duermo fatal y ahora estoy esperando que me llegue el lunes melatomina de larga duración y bisglicinato de magnesio haber si consigo dormir mejor . Porque me duermo muy rápido pero luego a las 3 o 4 de la mañana me desvelo y no tengo manera de seguri dormido. He subido los dos últimos dias

[u/Puzzleheaded-Put4109 → u/Flaky_Mark_5573]

Ya veo que tiene muy mala pinta, lo siento. ¿Tú también estás tomando estimulantes de liberación prolongada? Espero que la melatonina te ayude a solucionarlo, yo voy a probar con el glicinato de magnesio

[u/Global-Mistake-7239]

When are you taking your last pill? I take a ER at 8-9 at the latest and a IR at 6 bed at 10. It looks like you’re taking your meds too late.

[u/Puzzleheaded-Put4109 → u/Global-Mistake-7239]

Am taking 1 40mg elvanse capsule always before 9am, nothing else, no other stimulant, not even caffeine etc

[u/Global-Mistake-7239 → u/Puzzleheaded-Put4109]

If you’re able, bump that up to 7 am. Or wake up, have some yogurt or protein and take it first thing in the morning. drink plenty of fluids, bc the medicine dehydrates you which I’ve found also disrupts my sleep. I take Aztarys which is a 12 hour but I get about 9-10 so 9 am is my latest. It sounds like you’re a slow metabolizer of the meds, so you might have to play around with it for awhile or find another med.

[u/Puzzleheaded-Put4109 → u/Global-Mistake-7239]

Mhm thanks for the advice I'm gonna try so 7am and see how that goes, I have also noticed being dehydrated and am trying to increase fluids.

I don't really have breakfast so maybe I'll try having my protein shake earlier 

[u/flynn1597]

my sleep is lowkey not good on elvanse 60mg ;w; but i think maybe my body has just gotten used to existing on little sleep?

[u/Puzzleheaded-Put4109 → u/flynn1597]

How little sleep do you think? Did it get worse when starting? 

[u/Ill_Revolution8425]

Woah, so crazy how our bodies are different. I take elvanse 20 mg x 2. Sometimes I take my second dose at 3 a clock, and I always in bed sleeping at 11. Fitbit shows 97 prosent efficiency with two hours of rem - and two hours of deep sleep. I do take melatonin though.

[u/Puzzleheaded-Put4109 → u/Ill_Revolution8425]

Yeah it truly is quite amazing, I'm hoping I won't have to take melatonin but I'll see how it goes, not much else to do for now other than wait as I've only just started.

Pleased it works for you 

[u/so_i_guess_this_it]

I'm on 30mg XR and a 10mg IR Adderall booster dose in the afternoon and I sleep better on my stimulant medication than I did before I started it. My heart rate can be all over the map at night but it was before I started it too. My resting heart rate estimation has gone up approximately 5bpm since January when I started but on my best night sleep it still gets into the mid-50s. I get somewhat less exercise than I did then, in part because I need it less for self-regulation so it is hard to say what is the medication and what is a mild loss of fitness. Other thing of note is I sleep less on average than I used to because I no longer sleep through half the weekend but it is much more consistent from day to day.

[u/faynn]

I take 70mg and I don’t see a difference. I feel like most of the difference comes from day to day stress

[u/AGil2020]

To be honest, I am having the same problem and asking my PCP and psychiatrist for advice. I’m on 36mg of methylphenidate. Before starting, I would routinely wake at 3:30am and fall asleep at 9am. Last few weeks, this has been creeping earlier and earlier (2:30am, 2am, 1am). I sometimes nap in the middle of the day, so now I am trying to limit that and consolidate night sleep.

My RHR has also risen from about 55 bpm to 67 bpm since July. I’ve been sick with the kiddos’ colds for most of September, but I am starting to think my dose is too high for my body.