Friday, February 16, 2007

Insomnia

Caleb has horrific insomnia. Childhood insomnia is defined the same as adult insomnia (can't go to sleep, can't stay asleep, etc), but the time limit is if your kid doesn't fall asleep in 40 minutes, it's insomnia. It takes Caleb from 2-4 hours to fall asleep each night. I finally gave up and stopped sitting with him. (That actually helps because he has nobody to talk to and gets bored and sleepy faster).

So I did some research on insomnia in kids and found a lot of websites blame it strictly on the parents. They couch it in "you can solve this problem" terms, but the general gist of it is "It's your fault." Some help. It's NOT my fault. The worst are the websites that sell homeopathic or herbal remedies--I guess guilt sells product. EVERYONE agrees that if a kid can't sleep, you have to fix their "sleep hygiene" first, which means institute a bedtime routine and bedtime and stick to them.

We have a bedtime routine. Our bedtime is flexible, unfortunately, based on my judgment of how long it will take me to get the kids to bed based on their behaviour throughout the evening. If I try to put them to bed too soon, I discovered, I just sit there doing nothing and being angry for literally HOURS until they actually are ready to sleep. That said, we're fairly consistent with bedtime, although it shifts with the seasons. (This "seasons" connection, I think, may be the key to the problem).

So, having ascertained that I do everything the "sleep hygiene people" say to do except bathe the children before bed (are you nuts? That takes at least an hour and makes it so I can't sleep because it hurts too bad when I bathe kids--fibromyalgia.....), I did more research and discovered, surprise surprise, that it's actually a miracle that the OTHER kids don't have sleep-onset insomnia like Caleb does. Apparently, childhood insomnia is common in children whose parents have (guessed yet?) ADD/ADHD or Fibromyalgia because it is likely the child has the same problem as the parent--and both problems cause sleep issues.

Oddly, the fibromyalgia sites I read said that fibro is finally being diagnosed in children, but that in 75% of the cases it goes away. I think someone forgot to check back--I suspect the childhood fibro (often called "growing pains") just cycles more slowly in children, so it appears to disappear for years at a time but does, eventually, recur. I had growing pains, trouble sleeping, fidgetiness while sitting, hand and arm pain, etc throughout childhood--but would go years without. (On a side note, I wonder how many cases of childhood fibro are diagnosed ADD because of the fidgetiness and trouble paying attention issues--the inability to sit still because of pain, not brain focus trouble).

If we look at Caleb's problem that way, it is just like mine when I was a kid. I was the "night owl" in the family--I would go to my room and close the door and work on projects or read for one or two HOURS after everyone went to bed. Mom finally said, "Just don't keep the other kids awake." Fibro causes sleep prblems in its own right, including shifted schedules, but also as a result of "ignored" pain. Caleb would be the "night owl" in our family if you define it as a person who needs to stay awake for hours after the rest of the world has gone to sleep. He just stays awake until dawn because our "world" sleeps weird.

ADHD kids with insomnia often report that they are tired, but they can't sleep because their brains won't turn off. They just lay there and think and think and think for hours. Unfortunately, the lack of sleep exacerbates the ADD symptoms (to the point that doctors are suspecting that up to half of kids diagnosed with ADD actually have a sleep disorder that manifests itself during waking hours with ADD symptoms). The ADD/ADHD symptoms, exacerbated, make it harder for the kid to sleep, which just gets them into one of those nasty self-feeding cycles. This is definitely what happens with Caleb. Every five minutes or so after he's been put to bed, he asks me another fascinating question ("Why did the people at the time of the Jaredites try to build a tower to heaven?" "Is it going to be winter forever?" "Can Winnie the Pooh speak Spanish, too?").

Tim has told me that he didn't learn how to fall asleep and stay asleep until he was in high school and learned relaxation techniques in band. He had more of the symptoms of insomnia than Caleb does because he was forced to wake up to go to school--and his family has joked for years that Tim could (and did) fall asleep at the drop of a hat. They have pics of him sleeping in the bathroom when he was supposed to be brushing his teeth, and draped across the table "doing homework", etc. Classic signs of childhood insomnia.

So Caleb is just like BOTH of his parents. No wonder he can't sleep. Neither of us could, either.

And the cures? There are none. The only advice is treat the kid for ADD/ADHD and teach them techniques to go to sleep. In fact, until Caleb lost his bottle, he slept just fine, possibly because the baba was his "cue" to stop thinking and fall asleep, and he needs a new "cue". Some people advise reading your kids to sleep. Other, more practical people, advise creating a tape or CD of you reading something interesting but not so much so that it keeps you awake (like the Book of Mormon, for a five year old) so that Mom can go to bed but kid can be read to sleep anyway. LOTS of doctors say do what Mom did--say, "Do what you want but don't keep anyone else awake". (Interestingly, scientific studies noted that mothers of children with insomnia are less affectionate until the insomnia is cured.....)

We did notice that in the summer, it's not a problem. Probably because Caleb spends hours outside absorbing sunlight in the summer, and the melanin (melatonin? I forget which) regulates sleep. That's probably also why we all have a worse sleep schedule in the winter--not enough sunlight hitting our skin, even if we do go outside. The only scientifically studied sleep aids for kids that worked in most studies was to give them melatonin, but the side effects were mostly not noted except that it can cause epileptic siezures in some kids. Apparently this also adjusts the bedtime problems in everyone getting to bed too late because melatonin is the thing that resets the internal clock. No wonder vampires stay awake all night and are pale--they're allergic to sunlight, and that's what regulates sleep cycles. Maybe instead of using supplements, we need different lights, like the kind they use to treat jet lag.

We're just grateful that we homeschool. Caleb, unlike most kids with insomnia, is not required to wake up anyway, so he's not sleep deprived and we miss most of the worst problems arising from insomnia. We noticed early on (when we were trying someone's advice to just wake them at the same time every day and the bedtime will adjust itself) that if we deprive him of sleep, it doesn't get him to bed. It just makes him (and us) absolutely miserable.

I suppose if we moved to a sunny place, the insomnia would be cured because the kids wouldn't have a winter to deal with. They'd get plenty of sun. And I would have plenty of asthma. The next source of research in our house, then, is on melatonin suppplements--how safe are they, what are proper doses, etc. Also research on L-tyrosine for kids.....I'm so slow in getting to that.

At some point, we may have to go to a doctor. I just hesitate because my experience as a "welfare" patient has been miserable--everyone assumes I'm dumb and can't parent. Everyone is belittling and very few people actually listen. Their method of "teaching" is actually blaming everything on my behavior and making me feel guilty for it (like Daniel's eczema was somehow my fault?). Since insomnia isn't life-threatening, I'm going to try everything I can before we resort to doctors.

I'll keep you posted, since so many of you have fibro or ADD, too, and your kids might have insomnia at some point, too.

1 comment:

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