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Saturday, August 2, 2008

Desperately Seeking Slumber

This year has been rough. So far, I think it has been the worst year of my life. Maybe I'm being melodramatic. Still, that's allowed every now and again. I think it's cathartic to feel sorry for myself every now and again.

Anyway, the girls have had a tougher time than usual falling asleep this year. Generally we have sleep cycles that last 3-6 months; one cycle will be good and the next will be not-so-good. A good sleep cycle (remember, "good" is a relative term) entails getting roughly 6-8 hours of sleep, most of them occuring after midnight, for at least five or six nights a week.

A bad sleep cycle, on the other hand, is anywhere from 2-6 hours of sleep. Sleep can start anywhere from 10 pm until 5 am, and can possibly be interrupted multiple times throughout the night.

Bad sleep cycles affect all other facets of life: oversleeping and missing the school bus, gigantic messes being made while I am sleeping, grouchy moods, and other things of a generally bad nature.

This current bad sleep cycle is the worst we've experienced since the girls were infants. Earlier this year, when they weren't sleeping, but I was, the girls pursued all sorts of delightful activities. Let's see, there was the ever popular "rip the childlock off the fridge and destroy all of the food in the messiest possible fashion" game. Also, the "poop on the carpet and make a nasty mess of it" game. The most popular of all was the "plug the kitchen sink drain, turn on the water, then go pass out somewhere while the downstairs floors accumulate an inch or more of water game".

Generally, while these household Olympics are going on I am somewhere (generally the floor or my bed) in deep, deep REM sleep. I'm quite the heavy sleeper,which doesn't help matters any.

In our quest, or I should probably just say "my" quest for slumber, I've tried many actions. I'm not all that keen on using medication, but after just two months of this fun I threw in the towel and decided to try something.

We'd already used "natural" products to help induce sleep and relaxation, and they didn't work. We tried transdermal melatonin, GABA, inositol, valerian root, and other herbs and minerals with calming properties. My kids weren't falling for it.

Then we went the prescription route. First was Neurontin, generally used for those with Epilepsy. I thought it worked the first night, but it also could have been due to the fact that the girls had been up all day, since about 4 am, after only four hours of sleep. The next two weeks I saw no noticeable effect from the medication.

Then came Depakote, which is generally given to treat mania, Epilepsy, and migraines. It worked for the first week or so, then seemed to begin losing effectiveness. We upped the dose more, and again it worked for a week or so then seemed to not work. It also made the girls eat non-stop. They put on weight and retained water. Also, we had to have blood work done to see if it was overtaxing the liver. Yay!

Then came Clonidine, which is generally used to lower blood pressure. We used this for about a month and saw no noticeable results.

And finally came Ambien, which is meant for those who have trouble sleeping. We started with half a tablet: nothing. One tablet: nothing. One and a half tablets: some drowsy looking faces and the ever-present urge to fight off sleep. Two tablets: drunken behavior (staggering around, bizarre sayings, etc.) and sleep.

Even with an adult dose, the girls can fight off the urge to sleep for two to four hours. Once they get to sleep it isn't a guarantee that they'll stay asleep for more than 4-6 hours, but they generally will go to sleep earlier overall. I don't really enjoy giving them a sleep medication, but it has cut down on some of their late night shenanigans.

Unfortunately, when I went to refill our prescription I had a surprise: our insurance only covers 30 pills a month per child. So, this means that I'll have to fork over $120 or so a month if I want the full dose. And, it seems, the prescription was only written for 45 pills a month, which will still leave us 15 pills short, per child.

I desperately wish that I could give them my sleepiness. If I pawned my exhaustion off on them I'd be able to stay up about 18-22 hours a day and get all sorts of work done. Or goof off and play video games. Either way, it'd be a good deal. For now however I'll just have to keep (day) dreaming...

2 comments:

Julie Fletcher said...

With my daughter I began a serious sleep routine when she was 3. It takes time, sometimes a LOT of it and infinite patience, but it will eventually work. Why? Because autistic kids thrive on routine.

1.-Tire them out. Get up early, 5 to 6 am. No naps.

2.-Around two hours before bed take a long walk or let the kids do some sort of excercise that will tire out their muscles. Make sure it ends at least an hour before you want them to get into bed.

3.-A warm relaxing bath, then massage. Our massage is a deep pressure method Ambi's PT teacher told us about. Push down on both shoulders with a little pressure. Then grip the arms in your hands and squeeze, work your way down the arm in increments. Do the same to the legs. Ambi looks very content when we do this.

4.-Use a heavy blanket/quilt/whatever. This was the key to getting Ambi to sleep all night. You don't have to spend a ton of money on weighted blankets, improvise. After using the heavy stuff at night, Ambi slept like a log all night and has ever since, even without the blankets today.

I hope some of this helps!

Autism Mom said...

I've tried the compression and deep pressure on my girls, but they aren't big fans of it. :(
It seems like anything that makes them aware of how tired they are makes them anxious to fight it off.
We usually do showers before bedtime because (for who knows what reason) baths either scare them or get them really excited and wound up.

We have a bedtime routine that seems to be helping now, but we are also still on Ambien. I think that puberty kicking in is throwing them for a loop. They've been really moody lately, and I can see that sometimes it is confusing to them. They'll be happy/sad/mad/etc., then switch to the opposite mood then right back again. Then, sometimes, I see a look on their faces that says, "What in the heck am I doing and why do I feel like this?". Still, you can't logically control hormones...

Thanks for your tips! I hope that you and your daughter are doing well.