insomnia in 7 year old daughter

[letig]

Hi,

My daughter had a complicated early history with severe reflux for her first 3 years (requiring medication).  Typically, she would feel extremely uncomfortable when she would lay down for bed and then violently vomit after some time. As a very young child, sleep onset was delayed because of this for hours at times.

Despite the fact that the medical issue has been completely resolved, she still has a lot of trouble falling asleep. It can take her 1.5 to 3 hours to fall asleep.  Last night she fell asleep after midnight although usually it is more like 10 PM.  We have a sleep routine that involves bath, stories, soothing and then she reads books to herself in bed.  She does not leave her room or bed (so it is not behavioural), but just tosses and turns for hours.  She reports that she does not like to sleep, but denies feeling anxious or scared.  I do think she is an anxious child though as she is shy sometimes and bites her nails, often at bedtime.

I have tried relaxation tapes with her and have encouraged her to breathe slowly.  We leave the hall light on for her.  I do not lay down with her and always tell her to relax, close her eyes and clear her mind.  None of this has changed this longstanding pattern.

When she does fall asleep, she stays asleep.  She will sometimes sleep in quite late if she can, but this is not frequent as she has to go to school.  Her lack of rest is making her irritable.  Do you have any suggestions? I would rather not try medication although I have heard that Melatonin can help (I am worried about the long term developmental consequences of melatonin in children).

[Encephalomalcia]

Does she have a nightlight?  If so, can she sleep without the nightlight in total darkness?  It is best to sleep in total darkness.  Another thing is how much exercise and activity is she getting during the daytime and after school?  Is she really tired and ready to go to sleep?  I find that when we take the kids to the park to run, they sleep very well that night.  Kids have a ton of energy and they need to use it during the day.  School doesn't allow for enough activity, so after school there should be plenty.  Our kids rollerblade, play basketball, badmitten, volleyball, ride bike, run around the house playing tag games, get on the scooter, run and play hard at the park after school each night.  Increase her activity level after school and get rid of the nightlight if you can.  I think you will see a difference.  

[supermomma531]

It sounds like that your daughter has developed a sleep pattern from probably birth. These patterns can be very hard to break especially if she's remembering these terrible times of bedtime. It sounds like anxiety to me. It will take a long time to break this cycle. In the mean time, she probably does need more exercise to tire herself out. Ask her what she thinks her problems is and then try to reassure her that things will be and are okay for her to fall asleep. It will probably take a long time to succeed. I've never heard of melatonin but if you have reached the end of your rope, ask your doctor about different ways of curing this problem. Most doctors don't want to have to prescribe medications to children unless it is absolutely necessary. It doesn't hurt to ask for help. Good luck.

[letig]

Thanks for your comments - they are really helpful.

I agree about the exercise - she probably could do more afterschool.  She is naturally less inclined to excercise than her twin brother and when she is extremely active, she does drop off more readily. One of the issues is that they are in lots of afterschool programming which does cut into our time to do these things.  But I will try to increase the activity level.

I also agree that it is a longstanding pattern which will likely take a long time to clear up.  I do feel that she likely feels anxious about bedtime because of her horrible early experiences.  However, because she was so young, she really can't remember them or articulate them.

I think I am going to keep working on helping her feel more relaxed about bedtime, talk about her feelings and increase the activity level.  I have also made an appointment with her pediatrician to see if she has any more suggestions.