How do clinicians handle ADHD when someone has chronic insomnia?

Sleep is often addressed first because poor sleep worsens ADHD symptoms and medication side effects. Clinicians may adjust timing, choose shorter acting options, or start at very low doses. Non stimulant options or behavioral sleep strategies are sometimes used alongside or before stimulants. The goal is balancing symptom control without worsening sleep. Treatment is usually gradual and closely monitored.