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It will get better, because you are doing what you need to do to make sure it gets better. I think your step by step approach is just right: deal with the sleep, then see how it affects the ADHD-like daytime behavior.

In your post on the SN forum, his need to control your behavior around his bottle being "perfect" did jump out at me, perhaps because I am on another adoption listserve where we have been talking about the intense need for control that many of our kids have. Once you feel like some of his neuro issues are better understood and any biological barriers to sleep are being addressed, it might be time to look a bit at that issue as well. I know that our daughter often tries to make us jump to her will and whim in order to try to have a sense of internal control that she struggles with. We have to be really firm, limit her choices, and even verbally remind her that "I'm sorry, but you aren't in charge of my behavior. I know that's frustrating, but I'm not going to get you a new banana because the one you have has a nick on the corner of it. You can eat that one or not." Just something to watch for down the road when you get out of emergency mode.

At any rate, I wish you well in these next steps. In the meantime, any chance you could leave the house for a couple of nights to get some sleep? As someone who has had chronic insomnia off and on, I know how it feels to consistently (like for years!) lack adequate sleep. It's a serious health issue; I hope you can find a way to take care of your need for sleep a bit at least, while you are trying to find a solution for him.
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