Contrary to hypnotics and sedatives, stimulants are substances that affect the body and the central nervous system by increasing our level of alertness and making it hard to fall asleep. That is why stimulants are usually connected with wakefulness, but they can also improve your mood and lower stress on a daily basis. When given in certain doses, stimulants can actually be used to improve sleep.
A stimulant is basically any substance that impacts the body by increasing its nervous or psychological activity. Most often they affect the nervous system to reduce sleepiness and increase mental alertness. One widely available and probably the most common stimulant is caffeine, which many people use on their own to handle excessive daytime sleepiness.
For more severe cases, such as sleep apnea or narcolepsy, a more profound approach is needed, so some legal stimulants such as Modafinil (Nuvigil), Amphetamines (Adderall), Armodafinil (Nuvigil) or Methylphenidate (Ritalin), may be the best option.
Before treating the condition, the underlying cause of sleepiness should be examined to see if it is possible to solve it naturally by adjusting the sleep schedule or routine, reducing stress or creating a more sleep-friendly environment. For example, shift workers that have irregular sleep schedule due to their job, often feel excessive sleepiness and fatigue while they are working. For them, changing something in their sleep pattern is not an option, so they have to reach for medications and stimulants to stay awake and complete their obligations.
The US Food and Drug Administration (FDA) has approved the use of Adderall in only one case, to treat the disorder of attention deficit hyperactivity. But, regardless of that fact, Adderall is most commonly used off the label as a stimulant that keeps us awake and in focus. Many college students use it as a study aid, as well as people who work under high pressure. Adderall improves abilities of certain neurotransmitters such as dopamine, a brain chemical which boosts our alertness and energy. Besides that, Adderall will increase the heart rate, decrease the blood flow and open up breathing passages, as a result of it, this drug causes a feeling of invigoration and energy, something similar to what cocaine does too. Also, it creates that rewarding feeling of euphoria which is why it has become so popular as one of the recreational drugs.
Some short-term adverse effects can include dry mouth, restlessness, suppression of appetite and weight loss, cardiac issues, heart palpitations, etc.
Even in the countries where Adderall is available through prescription, it is still recognized as a drug with high potential for abuse, so its supplies are often limited, and in some countries, like Japan, it is completely banned.
Long-term consequences of Adderall abuse are paranoia, erratic behavior, psychological disorders, increased risk of heart attack, extremely high blood pressure, vitamin deficiency, etc.
Addiction to Adderall might be either physical or psychological.
- Physical dependence occurs when a user is so used to the presence of Adderall in its brain that if he stops using it, it will cause some of the withdrawal symptoms.
- Psychological addiction happens when someone uses Adderall compulsively, and their addiction and urge became so strong that they are willing to put their well-being at risk in order to attain and use the drug.
When it comes to withdrawal treatments, there are yet no medications that can assist users during the process of withdrawal, although there is some evidence that antidepressants might manage some of its psychological aspects such as include depression, anxiety, and fatigue.
Besides Adderall, Ritalin is the second most popular stimulative study drug, taken to keep people awake and enhance their memory and focus. The most common side effect of taking this drug is sleep issues, which many are willing to ignore. Since 1950s doctors use Ritalin to treat different conditions such as depression, narcolepsy, and fatigue. The FDA also approves Ritalin as a drug for ADHD, but it has also been proven that it helps patients with brain injuries, but it does not restore their memory. A study from 2001. reported that small doses of Ritalin actually improved cognitive performance and working memory among healthy volunteer, while higher doses impaired their focus and performance.
Ritalin improves the action of a brain neurotransmitter called catecholamines, and it achieves that by blocking dopamine and noradrenaline reabsorption by neurons.
Because Ritalin is a stimulant similar to cocaine because they have a very similar chemical structure, it has the potential for abuse and may cause some undesirable changes in the brain. Since it is a legal prescription drug, it is easy to abuse since many neglect its potential side effects. Studies of long-term use were performed on animals and have shown that extended use may cause anxiety, sleeping issues, psychosis, nervousness, nausea, reduced appetite, brain plasticity, and weakened memory.
Nuvigil belongs to a group of stimulants called eugeroics which all promote mental arousal and wakefulness. It is often prescribed to patients dealing with obstructive sleep apnea, excessive daytime sleepiness, narcolepsy or shift work sleep disorders.
Some reported side effects include nausea, headache, insomnia, dry mouth, and dizziness. Using a higher dosage than it is prescribed can lead to overdose, symptoms of it are disorientation, mania, hallucinations, chest pain, increased blood pressure, etc.
The exact way of how Nuvigil works is still unknown since it does not bind or inhibit any of the receptors in charge of regulation of the sleep-wake cycle.
How Caffeine Acts as a Stimulant
Caffeine is the mostly used stimulant that keeps millions of people awake each day, and many even develop caffeine addiction as they cannot function without it. Most of us rely on a cup of coffee in the morning or/and later in the afternoon to push us through the next few hours. It has been estimated that around 80% of adult Americans take caffeine in some form each day.
Apart from using caffeine to stay awake, this substance can affect your body in other ways too. Although caffeine temporarily and almost immediately eliminates the symptoms of fatigue and drowsiness, too much caffeine can cause headaches, heartburn, vomiting, and nausea, and also raise your blood pressure. On the other hand, some other benefits besides keeping us awake and alert are decreased risk of oral and throat cancer, lower risk of Alzheimer and dementia, and according to one study, even 45% lower risk of suicide since caffeine has mood-enhancing abilities. These benefits are only related to high-octane coffee, not to decaf.
Although we mostly connect caffeine to coffee, it can be found in some medications, or even in food, since it does not have any taste and nutritional values on its own we can hardly know if it is present. A safe amount of caffeine for adults per day is anything below 400 milligrams, which is around four cups of coffee, but the amount of caffeine in coffee varies among different types of it. One standard coffee cup has eight ounces, a mug or a cup at certain coffee shops can contain even up to 16 ounces or more.
If we consume approximately the same amount of caffeine every day, our body will develop a sort of tolerance to it. Our age and other personal preferences determine our caffeine tolerance. Sudden decrease or increase of caffeine is not recommended, so if you are thinking about withdrawal, you might do it by slowly reducing the amount you consume each day. Caffeine withdrawal can be harsh, and some symptoms include headaches, irritability, drowsiness, and anxiety.
Caffeine stimulates our central nervous system, once it reaches to the brain, the most noticeable effect is alertness, the feeling of tiredness will be erased, and that is why caffeine is a common ingredient in many medications that are meant for drowsiness, migraines, and headaches.
It is possible to overdose with caffeine, but it is extremely rare, some signs of it are hallucinations, vomiting, and confusion, and sometimes convulsions can lead to death. Overdosing is a result of large consumption of caffeine, usually in pills or energy drinks, or if you drink more than 400 milligrams of it.
Can Stimulants Improve Sleep For People With ADHD?
ADHD stands for attention-deficit/hyperactivity disorder, and it is one of the most common mental disorders that affect children. Their brains develop differently, affecting their attention, self-control, focus, ability to sit still, and so on. Many children and adults who suffer from it usually develop some sleep disorder over time. Studies have shown that people with ADHD have troubles with falling and staying asleep because when they are tired, their ADHD symptoms get worse, which prevents them from falling asleep. Around 67% with ADHD reported this problem, while approximately 50% of children with ADHD has signs of some sleep-related breathing disorders.
Common sleep disorders among adults with ADHD include disorders of the circadian rhythm, sleep apnea, restless leg syndrome, and periodic limb movement syndrome. There are some differences in behavior among sleep-deprived children and adults with ADHD. When adults are tired they slow down, but children tend to accelerate and overcompensate, they can also often be very moody, aggressive or emotionally explosive as a result of sleepiness.
A study from 2018. gathered 34 adults who were ADHD diagnosed in childhood, and showed that methylphenidate, which is a central nervous system stimulant, can improve sleep among adults with this disorder. The polysomnographic sleep study showed that stimulant reduced not only the sleep latency, a period between going to bed and falling asleep but also the number of nocturnal awakenings and sleep quality. This study also confirmed that ADHD symptoms developed during childhood continue into adulthood.
Side Effects of Stimulant Use
As with any other substances, downsides are always an option, and here are some things that you should take into consideration before you decide to use stimulants as a form of sleep-aid. Side effects depend on the type of drug, dosage, duration of usage, and individual characteristics. Since all of them promote wakefulness, sleep-related problems or disorders can be certainly expected. It is very easy to start abusing these drugs and get addicted to the feeling that these stimulants can provide. The best way of making stimulants work for you is to combine them with other behavioral changes and habits, and to not take it on your own.
Most common side effects include insomnia, hypertension, headache, back pain, dizziness, irritability, nausea, diarrhea, anxiety, etc. while some long-term effects can be more severe and potentially dangerous for our life.