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Comment by adastra22 | Hacker News Reader

> a non-negligible portion of people on an otherwise perfectly working Vyvanse dosage seem to need a mild-moderate sleep aid towards the end of the day. & where you may think that just indicates a lowering of the dosage, that is mostly wrong & ruins the “otherwise perfectly working” aspect.

I’m in this category. But thankfully 0.5mg melatonin is all it takes to get a good night sleep, and that seems safe enough even as a habit.

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Saying this genuinely - thank for this post/info

I have been pondering for a very long time what the best options may be. I feel as if low dose benzos are a great option, but also that unless you’re somewhat affluent, finding a doc willing to prescribe & help you through amphetamines & benzos would be hard. Likely something like 0.5mg klonopin, small dose temazepam, or same for lorazepam. Likely not alprazolam.

0.3mg melatonin used to help my insomnia before I was ever prescribed amphetamines, but somewhere between when I was not prescribed them, started a low dosage of Amitriptyline for nerve pain, & now - 0.3mg-0.5mg melatonin started to make me wake up extremely agitated & have nightmares no matter what (like clockwork) - & the higher dosage gummies, like 3mg to 10mg, gave me a great variety of extremely realistic dreams.

Also spiked my heartrate by roughly 30bpm (aka a lot)

I’m glad that melatonin works for you because it’s quite convenient (well, I think having to take any pills is inconvenient, but I digress) - & also glad you can agree with the perfect dosage aspect/idea.

I have ran into middle of their career-ish psychiatrists who simply say it’s an absolute bullshit, but then mostly the entire generation of younger psychs, younger PharmD’s, a & large amount of internet psych anecdata agreeing. Conveniently, those middle aged psychs didn’t start their career when Vyvanse was even a thing, & all of the younger I mention have always known of it…

I just don’t understand why some docs outright refuse to believe such benign information/lived experiences from their patients, & presume their patient is lying to their face before they’d ever agree with them.

For those wondering of my excessively long posts… currently not on any amphetamines while dealing with other acute medical issues, but most definitely in a situation in which I have great need to distract myself. Long posts help with that, though maybe I should resign to saving them in my notes instead of hitting “reply” :P

One thing I love about Vyvanse is that it really does have an all-day effect. I'm wired, active, and focused from the moment I take it in the morning, until 11pm or so at night. Unfortunately this also means that it takes a lot of self-discipline to keep a good sleep schedule, which isn't something us ADHDers are very good at, especially as the medication wears off. On just Vyvanse alone, I have a hard time falling asleep and sleeping well.

I got the idea to augment with melatonin from a Slate Star Codex post. Since the author is a board certified psychiatrist, I decided to trust this info. Google should get you the original article, but here's my memory of it: melatonin is safe, little to no side effects, and should be taken by anyone as a first line attempt to fix sleep issues.

Melatonin is ridiculously safe. It basically has no detrimental effects in large doses. As a result, nutrition companies are in a war to make ever bigger over-the-counter doses because those sell better. But unfortunately while 5mg isn't toxic, it also makes me sleep 10 hrs and wake up groggy. As a result it's hard to find over the counter melatonin that is in the real dosage I want, 0.3 - 0.5 mg. However I found that Costco sells kids melatonin gummies with a 1 mg dosage, which is the smallest you can find on the market without paying extra. I just cut/bite the gummies in half to take approx 0.5mg a night. It's perfect, and I'm sorry it didn't work for you :(

The one thing that doesn't replicate for me from the SSC post is that he suggested taking melatonin 7(!) hours before sleep. I find I get tired upon taking melatonin immediately, and to take it early just screws ups my circadian rhythm.

Regarding the dream thing... Here's the weird thing: I have aphantasia when awake, and typically don't dream. But when I take melatonin I not only sleep better, but have vivid dreams that I remember upon waking. I guess I'm fortunate these don't turn into nightmares, generally. I guess I'm saying I can confirm your experience that melatonin leads to active dreaming, but maybe the nightmares are caused by something else? That is to say the melatonin is working to get you quality REM sleep, but some other interaction or issue is agitating you to make those dreams unbearable. Maybe worth talking to a doc about what can fix persistent nightmares.

> One thing I love about Vyvanse is that it really does have an all-day effect. I'm wired, active, and focused from the moment I take it in the morning, until 11pm or so at night. Unfortunately this also means that it takes a lot of self-discipline to keep a good sleep schedule, which isn't something us ADHDers are very good at, especially as the medication wears off. On just Vyvanse alone, I have a hard time falling asleep and sleeping well.

Interestingly, adderall not having an all day effect is something I like about it. I take an XR in the morning and have a smaller IR in the afternoon. It gives me the flexibility to not take one or the other if I'm not feeling up for it.

> Melatonin is ridiculously safe. It basically has no detrimental effects in large doses. As a result, nutrition companies are in a war to make ever bigger over-the-counter doses because those sell better. But unfortunately while 5mg isn't toxic, it also makes me sleep 10 hrs and wake up groggy. As a result it's hard to find over the counter melatonin that is in the real dosage I want, 0.3 - 0.5 mg.

My sleep doc has advised ~0.5mg a couple hours before going to sleep. As I've come to understand it, taking it too soon before sleep is what causes the grogginess.

> However I found that Costco sells kids melatonin gummies with a 1 mg dosage, which is the smallest you can find on the market without paying extra. I just cut/bite the gummies in half to take approx 0.5mg a night. It's perfect, and I'm sorry it didn't work for you :(

I found some 1mg flavored chewable tablets that're easy to split in half. I've found the same brand at my grocery store and on amazon

I buy these ones here on Amazon: https://www.amazon.com/Melatonin-Capsules-Supports-Relaxatio.... They were linked from either the Slate Star article or gwern's one, I can't remember which.

I buy the 1mg, then break it into quarters. Melatonin can make me very irritable the following day.

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