adolescent insomnia?

[topaz]

So, my eldest boy has trouble falling asleep.  No big deal.  He gets it from me.  I don't deal well with enforced bedtimes -- I go to sleep when I'm tired and not before.  As a child I would often turn my lights on after bedtime and read myself to sleep, a process which could take a couple of hours.  I read to Morgan at bedtime, and it usually takes at least 45 minutes for him to relax enough to fall asleep.

Last Saturday, while staying over at his grandparents' house, he stayed awake all night.  After everyone else had gone to sleep, and he was still awake, Morgan turned on a light to read.  When his grandmother woke up at 5am, Morgan told her he'd been up reading and asked her to make him some breakfast.  He finally conked out at about 4:30pm Sunday afternoon and slept straight through until 7am Monday.

Until now I haven't worried much about this -- like I said, I've been there -- but as I don't think it was ever quite this bad for me, this incident made me sit up and take notice.

So, anyone have any experience with pre-adolescent insomnia?  Suggestions for ways to help a kid learn deliberate relaxation or how to fall asleep?  I'm thinking that making a CD or an MP3 playlist of soothing music (or audiobooks) might help, but I'm especially interested in skills he can learn to help himself get to sleep when music or other external aids aren't available.

Comments

[keyne.livejournal.com]

I teach relaxation, you know. :) I've taught Morgan a few techniques over the years; if you think they'll help here we can review them with him.

[innerdoggie.livejournal.com]

What did you do to cope with your own insomnia? Would that work for Morgan?

[ghislaine.livejournal.com]

I know nothing about adolescent insomnia, but I'll share my experience with childhood difficulty with sleeping.

When I was 5yo my cousins pulled a nasty prank on my and scared the shit out of me. I had nightmares every night. Every night. I couldn't fall asleep eventually. I'm sure my parents were at their whit's end.

My mom started to do hypnosis with me. I realize this is a type of relaxation, of course, but she would go through the relaxation exercise and at the end she would suggest that I would go to sleep when the clock reached 1 (and she counted down from 12 verrrry slowly).

And it worked. Every time.

She had to do this with me *every* night for weeks, maybe months. When she didn't... nightmares. Eventually she taught me how to do this for myself. Of course, it was SO route by this point that it didn't take much teaching. It was just the difference of using her voice vs mine in my head. She would also touch me on my forehead soothingly, stroking with the cadence of her voice.

I realize the source of insomnia is different, but I guess I'd support Keyne's idea of teaching relaxation - only possibly to the more intense level of hypnosis. You're already sitting there for 45 minutes. I think the whole process my mom did with me was maybe 15-20.

Oh, and I still use this now. Both for relaxation and for those rare nights I can't get to sleep. Still works every time. :)

[kimcob.livejournal.com]

I do a mediation/relaxation exercises with Gabe. He would love them every night- for me to do it that is. It seems a touch beyond his skill set to do it himself. I would imagine it would take weeks or months of every night with me and then setting a transition week or two and then you are on your own kind of thing, like Ghislaine mentioned. I know there are hypnosis cd's and relaxation geared toward kids. Obviously Keyne is skilled at this as she mentioned:)Best of luck.

[awfief.livejournal.com]

I guess the question is what's keeping him awake? Unlike the woman who had nightmares, it just sounds like his brain isn't ready to turn off. If he's tired and not sleeping, that's bad. If he's not tired and not sleeping, it's not bad -- consider it like kids and food. Most kids don't emotionally eat like adults do, and your doctor will say "don't worry about the food, they'll eat when they're hungry" (to a certain age of course, and if you're really concerned or it's a really long time, then they'll test for things.)

Sleep is the same, likely, especially since you're familiar with it.

It sounds like his brain won't turn off. when you read to him for 45 minutes, you're directing his attention to the book, to you. I'm not his parent (nor any other kid's parent) but I think he'd distract himself from a CD or MP3 of music or an audiobook.

Something that uses more of his senses, like a calming tv show (or even something like a Baby Einstein video) playing on a TV that's set to automatically shut off after 30 minutes or whatever might have better results. I guess the question is "when you say it takes him 45 minutes to 'relax', exactly what is that relaxation?" ie, is it more of a 'forced to sit in one place, thinking of one thing only,'? Why didn't he sleep at his grandmother's -- because he was focusing on the book?

Also, you'll win a lot of points if you ask him what he thinks about it. Ask him if grandma was surprised or angry (hopefully the former and not the latter, so you're reinforcing that it's not a "bad" thing, just a thing that's different), ask why he thinks she felt that way (probably something like "because people sleep at night") and then ask him if he thinks it's a problem, why he thinks it takes so long to fall asleep, etc.

He will likely surprise you with something like "I'm tired but my brain keeps thinking at me". Hopefully it won't be something like "sometimes I have bad dreams". And he knows what works for him, he might actually even know why. Reading all night can definitely be a distraction to sleeping. Maybe some sensory deprivation (not in a bad way, there are lots of ways for kids to have managed sensory deprivation that's good for them....my nephew has some issues that are mostly resolved by chewing gum (instead of his shirt collar/sleeves), having an active sitting disk, etc).

To answer your original question -- I'd recommend looking into meditation for kids. The "clear your mind of thoughts" kind, because it sounds to me like his brain is like mine -- it just keeps going on and on. (then again, mine's ADD, but I developed coping mechanisms when I was young, things like writing things down so my brain wasn't worried I'd forget them, etc. I was diagnosed at 25, so I definitely was high functioning).

The two that work for me

[dancingwolfgrrl.livejournal.com]

Progressive muscle relaxation and counting breaths down from 100

[harimad.livejournal.com]

I get "my brain won't quiet down" insomnia. What works for me is something I can concentrate on a little but not too much. My personal best solution is no-advertisement talk radio; white noise is usually worse than nothing.

Have you worked through the usual recommendations?
- create a set of "time to go to sleep" triggers, such as hot milk or hot cocoa, going to bed (and only sleep in bed - read somewhere else), etc.;
- no caffeine or sugar after ___ pm (you get to figure out the appropriate time); this can be expanded to include refined flour and other white carbs, possible exception for hot cocoa;
- as mentioned already, bed is only for sleep;
- go to bed at the same time each night;
- if he can't sleep and wants to read, institute a rule that for every 45 min he reads, out of bed, of course, he then goes back to bed and tries to relax for 15 min (so he doesn't get caught up in a book and thus stay awake longer)
- is his room an appropriate temperature?
- too much or too little to eat/drink close to bedtime?
- how long does he wait before deciding he can't fall asleep? up to half an hour is reasonable for adults, by the same token waking up at night for as long as 20 min is normal for adults (usually we forget about it by morning).

Forgot some

[harimad.livejournal.com]

- didn't they recently move rooms/beds/something? and big changes coming up, is worried/excited/concerned?;
- relaxing tapes of the "you are floating along a quiet, broad river" variety;
- starting with his feet, tense each muscle group for a count of 10, then relax, and work his way up his body;
- is his brother a distraction?

[moominmolly.livejournal.com]

As a kid, I had to do something very intricate and boring with my brain in order to turn it (slowly) off. The one that my mother hit on that worked for me: going through all the phone numbers I knew, in my head, in order. Reading was WAY too exciting...

[muckefuck.livejournal.com]

I agree with awfief and harimad in everything and have only one thing to add: My sister has some similar problems with her eldest, who has been diagnosed as "on the autism continuum". (Probably Asperger's in his case.) His greatest challenge is regulating sensory input, so to aid him he has a "sense box". Feeling a squeezable by prickly ball, for instance, helps him achieve a state of calm attention (such as you need for traditional classroom instruction).

I'm not suggesting that M has the same issues exactly, but perhaps there is some kind of sensory input--cuddling a stuffed animal? washing his face with a warm cloth? feeling a breeze from a soft fan?--that would help him relax when purely mental techniques fail.

[maebeth.livejournal.com]

I have notes from my mom writing to her sisters about how she worried about me. I just thought that bed was where you laid awake.

sensory overload and inability to turn off the brain were prime. So I'd be busy reading all the book titles on the shelf, listing everything I did all day, re-living bad situations. Ideas like relaxing each muscle were too interesting... I'd carefully do each one in order than wonder if there were separate muscles for each toe.. and could I do them separately? and hey, can you do toes and ankles at the same time....
And thus, not asleep.

As a kid, prayer is what worked. Not imposing here, but essentially the idea that it was completely safe, tht God would cover me over the night.
At the same time, all the healthy sleep rules. Its ok to read, sitting up in a chair, but not in bed. Get up after 20 minutes of waiting and go do something else. And for certain, being in a room that is dark, cool, and quiet, with sufficient covers for weight to feel secure and heat control to feel warm.
(I use a heating pad now to preheat the space where my feet will be.)

Re: The two that work for me

[beah.livejournal.com]

I second progressive muscle relaxation.

[tamidon.livejournal.com]

I actually have huge amounts of experience with this,diagnosed at 8 with insomnia,night terrors, and somnambulism(yes,either not sleeping,walking around while sleeping,or screaming my head off in my sleep from a panic disorder) It's why I'm such a hard ass about bedtimes and am a firm believer in sleep hygiene. You have to train your body to go to bed,never read or eat in bed,no tv in bed,not varie bed times,stuff like that.

Also,there is a difference between not being sleepy and insomnia,insomnia happening when you're tired but you can't sleep because your mind is cycling.

Re: The two that work for me

[numignost.livejournal.com]

I count breaths down from 10, then 40, then 100, then (sometimes) 400, then (very rarely) 1000.

Re: The two that work for me

[dancingwolfgrrl.livejournal.com]

For me, I make myself go back to 100 when I notice that I got distracted :) The only time I ever got all the way down to 0 in this way was on a plane trip!

Re: Forgot some

[keyne.livejournal.com]

The kids have not moved beds, though they will when we move in with Tim's parents. They're still on mats on the floor of our room.

[keyne.livejournal.com]

Morgan has ADHD, and insomnia is a common side effect of the medication.

[keyne.livejournal.com]

There's no doubt he's tired -- it's impossible to get him up in the morning.

It's really hard to set different patterns for the boys than for ourselves -- we have wildly varying bedtimes ourselves (though we try very hard to get them to bed by 9 or 9:30) and read mostly in bed -- especially while they're still in our room. I suspect this problem will be easier to solve once the boys are in bunks in a separate room, this summer.

[keyne.livejournal.com]

Oh, also: Morgan has sleep terrors as well. Early in the marathon Sunday sleep session, I had to steer him away from sleepwalking down the stairs to the laundry room, get him to the bathroom, wake him up with ice down his back (his rarely resolve on their own; we have to interrupt them), and get him back to bed. :/

[chukspace.livejournal.com]

I've seen some recent news reports of studies that indicate that adolescents are often sleep-deprived. It seems to be because they produce melatonin later at night so their natural circadian rhythm becomes "stay up late and sleep late". You might try giving him melatonin an hour or 90 minutes before he should sleep. I'm not a doctor though, so talk to yours about that.

[kcatalyst.livejournal.com]

Having recently learned a bunch about Mass General, I can report that they have what is reputed to be an extremely good Sleep Disorders clinic.

That said, I'd be loathe to declare him insomniac or anything until he's been on a pattern of good sleep hygiene for a while. Stupidly enough, many of the symptoms of chronic sleep deprivation, I've heard, can look a lot like insomnia. I know you've all had a lot of trouble keeping to a set sleep schedule, maybe Morgan would have more success if it was declared a family project and the adults could role model for him, both the efforts and the difficulty, which can sometimes be useful to see.

Do your folks have stable sleep patterns? Maybe the time with them could be a "new leaf" for everyone wrt sleep.

[creidylad.livejournal.com]

I know it seems cruel, but one of the things all the experts agree on is no TV before bedtime.

We have had huge sleep issues with poor Gwen up until recently. I'm not sure what Morgan's particular issues are (unless it's just a Really Good Book), but somethings that have helped: body-brushing (with a brush about the texture of a potato or carrot-brush. I can go into details), a weighted blanket (they usually have adjustable weights and are very safe), light-blocking shades, and white noise generator. Also, a bath right before bedtime.

These things helped, and turned an endless process into 1.5 hours-long one.

What really kicked it into gear is melatonin. She just takes one ml a half hour before bedtime. Turns out that is what our bodies produce to help us sleep and some kids (particularly ones like Gwen with sensory issues, but this can be a VERY wide spectrum of kids) have trouble producing enough of it to help them get to sleep or to signal the body that it is time.

I would only do it under the advice of a pediatrician, though.

[creidylad.livejournal.com]

Sleep terrors can sometimes (usually in conjunction with other things) be a sign of something physiological (I can't remember what -- something GI Tract related?) going on. My very vague memory is not being very helpful, sorry! But it is certainly something worth talking over with a pediatrician if they are serious or frequent.

[creidylad.livejournal.com]

We have the same problems with chaotic bedtimes. Our neurologist STRONGLY recommended moving Gwen's entire schedule an hour earlier to 'shock' her system a bit -- an hour earlier to wake up, and a strongly structured going-to-bed ritual help a lot for most kids.

[creidylad.livejournal.com]

To build a bit on the distinction I think tamidon was making (I am Ms. Posting today), there is a distinction between 'kid is sleepy and desperate to sleep but can't' which would be insomnia vs. 'kid is sleepy cause he didn't sleep much last night but come bedtime wants to do anything but sleep'. You could also have 'kid is sleepy but not admitting this to himself or anyone else' -- which isn't quite insomnia, by my (limited) understanding, but obviously still needs to be addressed.

[keyne.livejournal.com]

I know it seems cruel, but one of the things all the experts agree on is no TV before bedtime.

Fortunately, none of us watch TV, so that's not an issue :)

[creidylad.livejournal.com]

Gah, I meant no reading!

No tv before bedtime wouldn't be especially cruel.

Like you could have reading time -- but it ends at bed-time, hard stop.

[keyne.livejournal.com]

That's really odd; do you know why?

I suffer from nightmares when I'm especially tired. The only way for me to fight them off — and I've learned this through thirty-odd years of hard trial and error — is to fall asleep reading, as it allows me to segue into the dreaming process much more gently. I'd hate to take that possibility away from Morgan. :/

[creidylad.livejournal.com]

Oy, sorry to hear about your nightmares!

I do think your idea of teaching him relaxation techniques is probably the way to go, but to me that implies a 'lights out is coming and time to sleep is coming so now it is time to do this exercise, after I've put my book away' ritual, anyway.

After poking about at the various health pages that talk about sleep issues, I kind of liked this one the best as most thorough:

http://www.helpguide.org/life/sleep_tips.htm

But I think the real way to go is talk to the pediatrician.

(I do know the latest 'reading is not good before sleep for people having trouble' study was very very recent, not sure if it's hit these 'guides' yet, in general. Obviously, what works for you works for you, but from qrrty's description it sounded like maybe Morgan just doesn't know when to put the book down.)

[harimad.livejournal.com]

KCat brings up another point. All the books & techniques I reviewed to help our infant/toddler sleep agreed that sleep begets sleep, and our experience is the same. Before you start something new, what can you do to get him well-rested?

I bet the parental modeling is also an issue. If it's too disruptive for you guys to be good role models, maybe wait to institute regular habits till the boys are in their own room, and don't see you doing something different.

[innerdoggie.livejournal.com]

This is silly, but does the dog help?

When I had a dog, if I sat next to her on the couch and she fell asleep, I'd go to sleep pretty fast myself. There were powerful sleeping vibes from that little body!