Child up all night

amother

Tue, Sep 13 2022, 7:46 am

My middle school son is often, if not almost always, up most (if not almost all) of the night.

He does have ADHD. His morning medication is long out of his system by bedtime, so it’s not that. He also takes clonodine ER in the afternoon and clonodine immediate release as well as long acting melatonin before bedtime.

He generally fakes his sleep until we’re asleep (he’d be busy with something or other, but look asleep when we’d check), and somehow keeps finding stuff to busy himself with. Then he gets out after my husband and I are asleep, and stays up most of the night doing stuff. He doesn’t “eventually fall asleep when he’s tired”, as people always say.

This obviously isn’t helpful at school, on top of his already difficult time with his adhd.

I’m looking for anyone who’s been there and found a good way to go about it. We have a great pediatrician and a great psychiatrist, and yet we’re still at a loss.

It’s not anxiety, and likely not a sleep issue. It’s most certainly his adhd constantly keeping his mind occupied with stimulation.

Chickensoupprof

Tue, Sep 13 2022, 7:52 am

Look for DSPD/circadian rhythm disorder it's quite common with ADHD. DH has both and a neurologist and psychiatrist are helping him with the right amount of melatonine and a sleep therapist was there. He had to go under chronotherapy but they didn't advice it because I'm pregnant nad it take a long while that your body is used to a sleep system so it won't be practical with a baby.

amother

Tue, Sep 13 2022, 7:55 am

Chickensoupprof wrote:

Would you explain what this is?

amother

Cornsilk

Tue, Sep 13 2022, 8:32 am

amother OP wrote:

Melatonin never worked for my adhd kid, it had the opposite effect. He was on clonidine for a few years, but then it slowly stopped working. Once we took him off, he started sleeping (or at least longer than he had been before.) He still has some nights when he’s up, or when he wakes up in the middle of the night, but for the most part he is sleeping.

amother

Tuberose

Tue, Sep 13 2022, 8:34 am

It actually might still be the stimulants. For many people, the desired effects wear off well before the side effects. When my ds was on stimulants, he couldn't sleep either. Without them, melatonin could get him to sleep. With them, clonidine didn't even help. And many adhd kids can't handle being bored. So as soon as he's frustrated enough by that, he's moving around and killing his body's tendency to eventually put him to sleep.

What stimulant does he take? Is it possible to switch him off an ER onto something he takes twice a day and see what happens? How well are they working? You can also talk to your doctor about adding or replacing with Intuniv. It's not as good with focus, but helps with sleep and is ER for the emotional regulation piece.

amother

NeonPurple

Tue, Sep 13 2022, 9:25 am

amother OP wrote:

Adhd keeping his mind busy is a sleep issue. Healthy brains settle down at a certain point, calming beta waves kick in, excitatory neurotransmitters settle down, melatonin goes up, and fatigue and sleep sets in. Being constantly wired is a brain thing. It could very well be his medication, it could be his adhd, but either way it’s neurological.

I second the poster who recommended the book finally focused. It has some great information. Diet is also a very important piece. Cortisol and adrenals make a huge difference in the sleep wake cycle. Histamine is a big player too. Magnesium throughout the day would help. Gaba and l theanine can be super helpful for such kids too.

amother

Fuchsia

Tue, Sep 13 2022, 9:31 am

My son's adhd doctor advised us to give a small dose of ritalin before bedtime TO HELP HIM FALL ASLEEP He says that there are a percentage of adhd kids whose brains whizz so fast that they can only fall asleep with the ritalin in their system.
It's working for us.
He takes concerta in the morning and short acting ritalin (a low dose) in the evening.

From what you're describing, this might work for you.

Chickensoupprof

Tue, Sep 13 2022, 10:18 am

amother OP wrote:

Would you explain what this is?

Circadian rythm disorder means that the biological clock has a problem. It's most of the time intrinsic there are a few disorders from which DSPD is one. Delayed sleep phase disorder (DSPD) is the most common circadian rhythm sleeping disorder, involving an abnormal alignment of the sleep-wake cycle causing the affected individuals to feel sleepiness and wake up later than what is considered normal.

For instance DH can be wide awake at 03:30 AM but can sleep in till 11:00, it starts in childhood/puberty. It's a disorder which is common with ADHD and treatable but you really need to work hard on it. We tried to but it's not managable if you will have a baby. DH lives with a chronic feeling of being jetlagged but BH he is better then before thanks to help with a neurologist and a psychiaterist. The neurologist will give you cotton wool where u need to suck on, that will measure the melatonine DH had to do it every hour for 25 hours, they are going measure it and it happens that DH doesn't make melatonine despite of a peek around 12 at midnight he has melatonine but that doesn't really help so they wanted to start chronotherapy. Which is that you are basicially going to restard your biological clock, in a few weeks you have to wake and sleep at certain hours and wake up at certain hours till u falll natuarlly asleep at a convient time and then u need to do that for at least a few months. With a baby this will disturb the treatment. The psychiaterist is carefully dosing the ritalin so it wears off before the evening.

amother

Tue, Sep 13 2022, 2:58 pm

amother Tuberose wrote:

He takes Adderall in the morning, like 7’ish. It’s long gone by bedtime. We can technically switch to two short acting doses, but I don’t trust that he’ll end up taking his second dose on school. So I can’t rely on him having to take medication at school.

We tried getting Intuniv, but insurance wouldn’t cover it. And so far the Adderall is working well.