ADHD Sleep Disorder - Irrational Night Fears

[helpformatt]

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 (adderrall) 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 (adderrall) 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!

[Kevin Kennedy, Ph.D.]

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.

[justme§thedog]

Are his fears totally irrational? Since he's going to sleep and you seem to be handling the beviour management well, I wonder if his doctor has ever assessed him for sleep disorders? (most especially sleep apnea in kids).  Kids who are affected often appear/are diagnosed with ADHD and with treatment many no longer experience the ADHD symptoms.  Sleep deprivation in kids and adults can cause horrific 'hallucinations' (half-dreams, basically) as well.  There are a number of studies on these effects and they know so much more, but it's important to have the screening done; you can't tell just by watching them sleep. There's also alot more information online (sleepnet is a good place to start) with links to a few studies.  Effective treatment can make all the difference for these kids, your son may be one.  At the very least, a sleep/breathing problem would be excluded and you can focus solely on the behaviour management.

[Mugwump]

My 8 year old grandson Just started adderol. Went to bed screaming & crying :This medicine isn't working!", woke up displaying strange behavior about 2 am. He was wearing his  13 year old brother's clothes, had Comet and a rag & was scrubbing the stairs. Also took everything out from under the bathroom sink & lined the containers up in rows on the edge of the bath tub. This can't be good. Stop it now or give it time?

[redavaw1]

My child was on Adderall (adderrall) for ADHD and it actually helped with her sleep issues.  She was a sleepwalker who woke up to 15 times a night.  She was actually sleepwalking and we thought she was awake the entire time!  Kids do crazy things in their sleep. I was a sleepwalker and actually went outside in the middle of the night. It can be hereditary.  
The Adderall (adderrall) 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.

[tericross]

My daughter was on Ritalin LA for a few years and took clonodine for sleeping.  I don't know how I would have ever lived without it!!  Once she takes it, she is normally asleep within 45 minutes and sleeps good through the night.  ALTHOUGH, we just took her off the ritalin as I believed it was causing alot of her anxiety problems.  She has severe separation anxiety - still sleeping with me at night (she's 11!), not wanting to stay the night anywhere but home, not wanting to leave me to go to school, etc.  Since taking her off the ritalin la 3 weeks ago - it's been CRAZY.  I can hardly stand it, and she is getting yelled at to "calm down" or "quit interupting" most all of the time.  We saw yet another doctor this week, who prescribed effexor xr for the anxiety - and said it would help also with the adhd - primarily the hyperactivity.  I'm just skeptical about it...does anyone have any feedback they can provide on this?  Thanks!!!  And seriously...ask your doctor for the clonodine.  It's not a controlled substance, and it works wonders!!