> Most amusingly insomnia is a known risk of atomoxetine.
Given that atomoxetine is an sNRI, and norepinephrine modulates both alertness and muscle tone, I would bet dollars to doughnuts that what this treatment is doing is mostly helping people who have inadequate muscle tone in their pharynx at night due to inadequate NE levels, restore that muscle tone, and thereby keep their airways unblocked. These people aren't going to get insomnia from having their NE levels increased — because insomnia in sNRI use is a symptom of excess NE, while in these people, NE is just being brought up to a neurotypical level.
(In other words, the same logic that explains why [correctly dosed] dopaminergic stimulants don't make people with ADHD manic — but applied to NE dysfunction rather than DA dysfunction.)
Given that atomoxetine is an sNRI, and norepinephrine modulates both alertness and muscle tone, I would bet dollars to doughnuts that what this treatment is doing is mostly helping people who have inadequate muscle tone in their pharynx at night due to inadequate NE levels, restore that muscle tone, and thereby keep their airways unblocked. These people aren't going to get insomnia from having their NE levels increased — because insomnia in sNRI use is a symptom of excess NE, while in these people, NE is just being brought up to a neurotypical level.
(In other words, the same logic that explains why [correctly dosed] dopaminergic stimulants don't make people with ADHD manic — but applied to NE dysfunction rather than DA dysfunction.)