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Child Behavior (Expert Forum)
ADHD Sleep Disorder - Irrational Night Fears
Answered by
Kevin Kennedy, Ph.D. - Child and Adolescent Psychotherapy, Family Therapy, Crisis Intervention
Harvard Vanguard Medical Associates
This forum is for questions and support regarding child behavior issues such: Child Discipline (behavior management), Normal Child Development, Parent-Child Communications, Social Development
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ADHD Sleep Disorder - Irrational Night Fears
by helpformatt, Aug 31, 2004 12:00AM
My son was diagnosed with ADHD, is in counseling 2x per month, is being tutored 2x per week and is taking 15 mg of Adderall XR daily. He is getting all the help and support we can possibly provide to him, but it doesn't seem to be enough. His most serious issue is his night fears/inability to sleep through the night. He sleeps with the hall light on, a nightlight and a radio on low all night long. His bedroom is sandwiched between his parents' bedroom and his younger sister's bedroom (we have a one-story ranch), so he is not isolated from his family. We bought him a dog in hopes it would make him feel relaxed and safe, and in extreme cases we will give him Benedryl to try to make him sleepy (upon recommendation from his pediatrician). My son will fall asleep with relative ease, but keeping him asleep through the night is impossible. The only way he will go back to sleep if he wakes in the wee hours of the night is if we allow him to crawl into our bed and sleep with us (but he is 7 years old!). We have tried everything: re-tucking him in his own bed and sitting on the edge of his bed for a long while to ease his fears; using positive reinforcement and even punishment; boosting his self-confidence and assuring him he is loved and safe in his home (there has never been any type of incident that would justify his fear/behavior, and he had these night fears prior to being put on the Adderall XR); limiting caffeine intake; increasing daily activity, reading bedtime stories together, and he even has a consistent bedtime of 9:30 p.m. He has woken as early as 2:30 to 4:30 a.m., can wake up several times throughout the night and sometimes won't go back to sleep at all. I'm afraid his lack of sleep will only add to the difficulties he already has in school and it certainly doesn't help his emotional state or ability to deal with day to day issues (he is overly emotional and sensitive). The night fears overwhelm him and often we will end up in a crying, hysterical shouting match. My husband and I are so frustrated and have run out of patience with the situation (we are often going on a few hours of broken sleep because of this). We are starting to feel absolutely helpless. I have talked to my son's counselor, but she has no definitive way to handle this problem. Is there a non habit-forming prescription or over-the-counter sleep aid (in a liquid form since my 7 year old son cannot take pills)? Is there something we can do to help him stay asleep and make his irrational fear of being alone at night go away? Is it possible he can outgrow this? (It has been going on for 2 years.) Please help. We are out of answers and the situation is getting out of control!
Doctor's Answer
by Kevin Kennedy, Ph.D., Aug 31, 2004 12:00AM
, Aug 31, 2004 12:00AM
There really is no way to predict what the course will be over time. Short-term use of Benadryl to help a child fall asleep is appropriate, but regular use (which I know you are not doing) is not good. You are doing then sensible things, even though it can be hard on you to disallow his joining you in bed. I do have two ideas which might be worth considering. First (while I don't recommend this with most youngsters), you might place a cot either in your room or outside the room, and this is the place your son could go if he wakes up during the night. This may help you get through the night without him bothering you. Second, either Tenex (guanfacine) or Clonidine (catapres) can be useful re: sleep onset and maintainig sleep. These are both antihypertensive medications that are employed with children in small doses to assist with sleep and with some behavioral symptoms. In your son's case, the medication would be administered a while before bedtime (this would also allow him to get to be at an earlier time). The pills are quite small and often children take only one-half or even one-quarter of a pill. You might ask the doctor about this.
The Adderall helped my daughter to relax and stay asleep all night. I think the dose was much more than only 15 mg though. We are now on the non-stimulate medication called STRATTERA(sp?) which has been good. It really helped with the severe weight loss. She sleeps good now. After 5-6 years of having a child with sleep issues, it is nice to get good sleep again. She is 10.
I would try to hang on and get the correct dose of the medication and give it a chance. You could try Strattera and see if that medication is better.