Monday, October 5, 2009

Sleep: WHY is it such an issue?!

OK - so my question to all of you is.... WHY do so MANY children (and adults too, for that matter) with autism spectrum disorders have SUCH a difficult time falling and staying asleep???
Over and/or under stimulation? This is probably the biggest problem right there. Too much outside noise or not enough. Too much outside light or not enough. Being overfull from dinner, or maybe even HUNGRY. Too much "screen time" before bed. Not enough time for relaxation before sleep. Not enough deep pressure/stimulation or maybe even too much.
--I've yet to actually figure out if anything I do with regards to this helps Ashton sleep or not sleep. It seems like whenever I get him figured out, that he changes it up on me, just to spite me! Ok, so I know it's not really to spite me, but sometimes it feels like it! I don't think our children are inherently trying to cause us strife; I don't think they master the tools of manipulation, but hey, maybe I'm wrong! :) I am tired after all! Insomnia? If insomnia is already a problem, then not sleeping is already putting you/them at a disadvantage. It perpetuates the entire cycle and makes things worse, and worse.... and even worse.
--This definitely happens in my house. It seems like the more tired he is, that the more he fights going to sleep. The evidence of this is when he's wide-awake and bushy-tailed at 2 o'clock in the freaking morning sitting in the bathroom flapping and clapping and filling up the bathtub with water. He doesn't even look REMOTELY tired at all, and you have to wonder WHY is he trying to take a bath in the middle of the night? (we asked ... we didn't get a reply, just a blank stare). I post this example because it happened last night. Luckily my husband woke up and heard it before the tub overflowed (I don't think Ashton would have known what to do at that point and I can't say that he would have come to wake us up).
Medications? I know there are some medications that make it very hard for some to fall asleep. Stimulants such as Ritalin, Adderall, Focalin, etc are all stimulants that are often used in the treatment of ADHD, which many children/adults with autism have symptoms of. Unfortunately, those medications can cause problems with sleep; both falling to sleep and staying asleep. ---- Now of course, there ARE medications that are traditionally used to help one go to (or stay) sleep. Melatonin is an over the counter herbal supplement that our body produces anyways, but many people just do not make enough. People that often have erratic sleep schedules due to work, school or travel, will take melatonin to help regulate sleep. There are many other medications that are used "off-label" for sleep issues.
--Some of the ones that *we've* tried are: Trazodone, Clonidine, Imipramine, Seroquel and even the good ol' standby, Benadryl. We've tried multiple combinations of all of the above medications (in conjunction with and without melatonin too!) and while we always find something that works, it's usually very temporary. Sometimes we'll get lucky and it'll work for a few months but most combinations only work for a few short WEEKS!
I strongly believe that if my son can fall asleep at 8:15pm and have to be WOKEN UP BY ME at 6:40am, than he really NEEDS that much sleep. I can even handle him not falling asleep until 9-9:30pm and getting up at 6:40am. It's the fighting sleep and not going to sleep ALL FREAKING NIGHT (twice now he's literally stayed up for nearly 24hours straight ... once he went to sleep around 6am; last night/early this morning he FINALLY fell asleep around 4:20am....). Even when he doesn't pull that number he will fight sleep and not go to sleep until 11pm or midnight. He has to be up at the latest by 6:40am to get ready for school and be on the bus by 7:05am.
So ... any suggestions, or words of wisdom? Commiseration? Want to laugh at my misfortune? (go ahead, it's good for the soul sometimes! ;))
I went and bought a BABY MONITOR today .... for a TEN YEAR OLD! I didn't tell Ashton what it was, nor did I tell him what it was for. I made sure he had his "cocktail" of sleep medicines tonight and then let him soak in a warm bath with some lavender scented epsom salts. I turned the light off in the bathroom and made him whisper and told him *NO CLAPPING*. He was very calm and very relaxed. Got him cleaned up and then dressed for bed and put the radio on and let him lay down on the couch. He went upstairs to bed at 8:30pm (same time I took Holden upstairs for a shower) and I haven't heard a peep from him yet. This technically means we're in the clear as far as him GOING to sleep. We'll see if he stays asleep ALL night like he's supposed to. Anyways .... I KNOW someone, somewhere out there, can completely commiserate and is just as desperate for sleep as we are. So ... here's some sand from the sandman and wishing you all a good night's sleep!