Concerta sleep issues

[Purplebubba]

Hi everyone! My son is turning seven next week and has been medicated for his adhd since September 2022. We have tried a few courses of treatment and found that the most effective for him is Concerta 18mg Long acting, but when he takes this he is awake until anywhere from midnight to four in the morning. 😔

Has anyone else experienced this with their children? I am at a bit of a loss at what to do. We tried guanefacine 1mg at night instead so that he can sleep, but he still is awake until around 10-11 on that and his behavior becomes out of control. We are trying the “liquid concerta” now at 10ml per day, but when that wears off around 3:00 he becomes enraged and defiant for the next few hours through bedtime. I am a behavior analyst and work with kids on the autism spectrum, so I definitely have all of the visuals and reminders and reinforcement systems in place. Sometimes it just doesn’t seem to help when his mind can’t slow down.

I was just curious if anyone else has dealt with similar issues/concerns. He does SO well on the concerta and I can see my son as his best self when he is on it. He definitely still has his personality and is hyper, but his ability to hear what we are saying is present when he is on the medication and that makes all the difference. I have tried melatonin which sometimes works, but not always when he’s on that med. He is super calm all night long and doesn’t seem to be bothered by not falling asleep, he just says he has lots of questions and can’t get to sleep.

If anyone has any advice or feedback I would so appreciate it!!!

[Onthemove1971]

Thanks for the message. It sounds really stressful.

I am a little confused.. but want to help.

If he takes 1 dose of ER in the am he doesn't sleep at night?

Our son takes an ER ( extended Release) and short acting to get through the school day, then for afternoon and tutoring and sports he takes a short acting. of a lesser dose, same medication. This combination helps a lot and he doesn't have any issues sleeping.

Has he always had sleeping issues since being on the medication?

It is also unclear from your message if he is seeing a child psychiatrist? They really are the best specialist to help with managing medication especially as children grow and their needs change.

Really hope you can find what works and get things to work for him.

[Pmommyof5]

my daughter was on Concerta for two years. She has the same issues with staying awake at night while on it and also her mood with the anger and quick change in mood once it starts to wear down. It was difficult but at the time I decided to just continue because she was able to do her best while still being her. She outgrew the medication as she’s gotten older now she’s 12 so we had to change medication. Basically my daughter would describe her mind at night as if she’s still focusing on everything thoughts kept popping up which wouldn’t allow her to unwind and go to sleep.

[Rosem123]

can you try the immediate release? My 8 yo son had the same issue on the extended release. We switched to 2 doses of the IR and he was able to get to sleep by 9p. Though I do have to lay down with him most nights to help him relax.

[Elijah1]

Our son took clonidine at bedtime. It helped him fall asleep (he had no problems staying asleep) and made him a bit calmer around bedtime.

[ADHD_DAD]

We had this issue when we first started Concerta (more than 10 years ago). First, it got much better on its own. Second, we found that if he took it first thing in the morning, it wore off. We find the long acting works about 7 hours. My wife would actually wake him up about 20 minutes before his wake up time to give him the Concerta (and he'd fall back to sleep). This served a dual purpose of making the morning routine MUCH more manageable and assisting with sleep.

[amewhit]

I would maybe try clonidine?

[mom2boy]

I had to take my son off of Concerta. He was waking in the night and I would find him asleep in the morning on the couch. He would also get quickly agitated and and emotions would be all over the place between 4 and 6. We switched to Focalin and ge is so much better. He takes the Intuniv 1mg at night as well. It's a much better combo. My advice: stop the Concerta NOW!