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Intuniv (guanfacine) and insomnia - help?

Hi everyone,

I feel like I post so much, but here it goes again!

We started my 8yr old son on Intuniv about 6 weeks ago, after trying many other things (stimulants, Straterra) that just increased his anxiety and made things worse.

The Intuniv seems to be working for the ADHD, and my little boy is anxiety free and like his old self.

HOWEVER - He is having horrible sleep problems. He often wakes multiple times a night, and now never sleeps past 5:30am. He just started back at school yesterday and he is exhausted. I have no idea what to do. Right now he takes 1mg (we didn't want to go higher for fear of side effects) in the morning.

Is the waking up to do the drug wearing off? Anyone have experience splitting doses and taking them morning and night? Any tips/advice would be appreciated. It has been such a long road finding a med that works for him and doesn't cause horrible anxiety side effects. I want to cry at the thought of taking him off something that seems to be working because he can't sleep. :-(

My 12 yr old son also has trouble sleeping. We unplug him from all electronics at least an hour before bedtime and he takes 10 MG of liquid melatonin. We tried the pills, but the liquid works so much better.
Hope you find a good solution!
Hang in there.

WOW-

We are having the same issue. We started 1 mg Tenex (1/2 a pill in AM and 1/2 a pill at bedtime) about 3 weeks ago. I was acutally thnking of switching him to Intuniv so he would only have to take it once a day.

Since starting, my 6 yo son has been waking up anytime between 1-3 am. He goes to bed around 715/730 pm and prior to starting the Tenex he would normally wake up at 6 am; sleeping all the way through.

He was complaining of wild dreams of which I thought was a starting side effect (hallucinations) during the first week. I thought once he acclimated to the medicine this would stop? Not sure now.

He has responded really well to the medicine as we notice a change in his body control and impulsivity. His OT, Speech and Social therapists have given us positive feedback almost right away. So, I am hesitant to take him off.

I am so curious as to what others suggest or have expreience with.

You're not alone!

We are getting a great response from the Intuniv as well! That's why we are sticking with it through all this sleeplessness.

Just to let you know, it took about a month before a few of the minor side effects wore off. The only thing we are dealing with now is the early wake times. This morning it was 4:45am. But he wakes up happy However, we do have to put him to bed by 7:30pm, which is really hard for an 8 yr old whose friends are still out playing at that time.

I guess it is more of a problem for me than for him. We also have a teenage er who just started university. She got home last night at 2:45am, and my son woke up 2 hours later for the day. I am not sure how I will continue to function while burning the candle at both ends. I was hoping that someone would have some advice.

We do give him melatonin at night, and that seems to help, but doesn't fix the early waking.

MAMAC said:

WOW-

We are having the same issue. We started 1 mg Tenex (1/2 a pill in AM and 1/2 a pill at bedtime) about 3 weeks ago. I was acutally thnking of switching him to Intuniv so he would only have to take it once a day.

Since starting, my 6 yo son has been waking up anytime between 1-3 am. He goes to bed around 715/730 pm and prior to starting the Tenex he would normally wake up at 6 am; sleeping all the way through.

He was complaining of wild dreams of which I thought was a starting side effect (hallucinations) during the first week. I thought once he acclimated to the medicine this would stop? Not sure now.

He has responded really well to the medicine as we notice a change in his body control and impulsivity. His OT, Speech and Social therapists have given us positive feedback almost right away. So, I am hesitant to take him off.

I am so curious as to what others suggest or have expreience with.

You're not alone!

My 6 year old daughter wakes several times at night and has nightmares almost every night. She Is On Guanfacine And Strattera And Liquid Melatonin At night. She always has awoke at night. Are the nightmares from the meds or from their brain function? She was just diagnosed last year and I’m new to all of this. The meds seem to be working. She still has emotional meltdowns. I just read too that there are like 7 different types of afhd.

I’m do happy to find others because I feel like I’m on a lonely road. My husband is still in denile. Last year was hell but her teacher and I and her school team got her an IEP end of last year. I’m praying for a better year. She had a horrible meltdown this am.

We don't see any wild dreams with Intuniv. And it is AMAZING at stabilizing his moods. He was always such an anxious, hesitant kid, but that seems to be almost gone.

We are still not sure what effects it is having at school, since this is only the second week. I am hopeful it will help him be more attentive. Unfortunately he is starting to seem very tired from lack of sleep, and that alone makes the ADHD worse.

I don't know how much longer he can function when he is waking up so early every day.

Has anyone has luck with changing the timing of the Intuniv? Right now we are doing 1mg in the morning and 1mg at night. I was hoping the night time dose would help him sleep later, but it doesn't seem to be doing anything. Now I am considering giving him the 2mg together in one dose in the morning, or at night. This all seems like such a guessing game.

We give er at bedtime

To clarify. I give her Guanfacine xray at 7 pm every nigh and strattera at same time. I give liquid melatonin a half hour before bedtime.

Extended release. Sorry auto correct on phone

My son takes his Intuniv at noon, so I don’t know if the split dose is what is doing it. TENEX is the same drug just fast acting… maybe that is an option for evenings?

Hi Suzanne,

The Guanfacine should help with the meltdowns. We tried Strattera over the summer, and that is what caused the meltdowns in my son. I have heard Strattera works wonders for some kids, but there is a small subset of kids (especially those with a family history of bipolar disorder) that don't do well on the Strattera.

When we took my son off of Strattera and put him only on Intuniv (guanfacine) his meltdowns almost completely disappeared. He is so much happier now, and seems to be doing well in school too.

It has been a constant juggling game with medication for us for the last year. Sometimes it take a while to work out what is best for your child, since they all react differently to the same meds.

Don't give up, and don't be afraid to question your doctor and discuss all side effects. Also don't be afraid to make decisions for your child. You know them best.



Suzanne said:

My 6 year old daughter wakes several times at night and has nightmares almost every night. She Is On Guanfacine And Strattera And Liquid Melatonin At night. She always has awoke at night. Are the nightmares from the meds or from their brain function? She was just diagnosed last year and I'm new to all of this. The meds seem to be working. She still has emotional meltdowns. I just read too that there are like 7 different types of afhd.

My nine-year-old daughter has just been recently diagnosed with high of functioning autism and ADHD. She started ritalin 5 mg twice a day about two weeks ago for the ADHD. Last Friday she started guanfacine. The pharmacist recommend taking at night as it could cause sleepiness. It has had the opposiye effect. She has been going to bed late waking up in the middle of the night and getting up early. I have also increased her melatonin to 3 mg. I was wondering if anyone has had success in giving Guanfacine in the morning only.

Hi! We’re having the same issue with my son taking guanfacine. It’s really disrupted his sleep. He takes the 2mg time release in the morning. We’re tried the morning and afternoon 1 mg but I think it make the sleep issues worse.
Do you have any updates on your son? Has his sleep gotten any better?

Hi Maineiacmom!

We do Guanfacine in the morning and STILL have troubles with sleeping. But it’s been so effective at helping at school. So, it’s hard to decide what to do next, try another drug or look into other options. Any advice or update would be great.

Amy

We moved back to giving the Intuniv (3mg) and night, as late as possible before bed. It doesn’t work as well as giving it in the morning for his focus at school, but his sleep has settled in to a regular pattern. He is still an early riser, and that is something we have just had to work with. He is 10 years old and goes to bed at 8pm, wakes everyday around 5:45-6:15, like clockwork. But I would never consider taking him off of the Intuniv. We had a horrible time finding a medication that worked for him (went through about 7 before this) and he has had awful side effects (anxiety, panic attacks) when on stimulants.

The only time it gets difficult is when there is something for him to stay up late for…a party, or family gathering. No matter what time he goes to bed (it wouldn’t even matter if it was midnight!) he will still get around 6am.

I hope that helps! Play with the timing of the doses. It’s a lot of trial an error, but I do believe that there is a “wear off” effect that causes them to wake up. You just need to figure out how that works with your child.

Hi my 6 year old just started guanfacine 1mg at night about 3 days ago to go along with the Ritalin 10mg he already takes in the morning. His teacher saw an immediate change in behavior. He has been waking up more frequently at night as he has never been a good sleeper and takes 3mg or melatonin before bed. We started to take him to the park to run around after dinner and always in bed by 8pm. This routine has worked a lot better but he still wakes up at least 2 times at night.

I noticed several people in this thread are using melatonin as a sleep aide. Please be aware melatonin is meant to reset the body’s internal clock — for example, it’s appropriate to use the supplement to counter the effects of jet lag, or help someone sleep if they have an unusual work schedule or suffer from a circadian rhythm disorder. It should NOT be used for general insomnia, and, people taking the drugs fall asleep only 7 minutes faster and sleep 8 minutes longer on average, according to a 2013 analysis in the journal PLoS One.

Generally melatonin has no clinic proof that it works as a sleep aide. And it’s not all that cheap, so, you might be better off looking at other sleep aids that have actual clinical trials to support their claims.

I am not a pharmacist (although I’ve worked in a pharmacy for 15+ years) and I am not a doctor! But I do suggest speaking to your doctor about using something like OTC benadryl to assist with sleeping if it’s really a problem overall. There are also mild prescription sleep aides available, although I believe your child really should be 10+ years old before those are considered.

Interrupted sleep or restless sleep is part of ADHD in general, it might work better to figure out the natural schedule your child is on and try to work with that. As an example, my friend’s daughter has ADHD, started meds at the age of three it was so terrible. Since she was a newborn she would sleep a max of 6 hours a day. No matter when she got up, no matter what she was doing, when she went to bed it was for six hours (do not pass go, do not collect $200!). She’s now 20 years old and still sleeps 6 hours. No more, no less. Rather than fight it, my friend started basing her daughter’s bedtime around that fact. At six years old her bedtime was 1:00am, that way her eyes popped open at 7am and she was ready to get ready for school. Insane for the parents? Yes! But it worked for the daughter struggling with ADHD.

azurelle