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Night and Day

  • Posted on September 30, 2013 at 10:00 AM

Sleep is a peculiar thing. You’d think it would come naturally. I’m sure, for some people, it does. But not for me and not for many of the people I know.

A circadian rhythm refers to a natural, biological process attuned to the 24-hour day/night cycle of the earth. In theory, human beings sleep according to a circadian rhythm that attunes them to the day/night cycle. We sleep best at night and are most alert during the day. The night shift, of course, changed that for some. Others, myself included, faced life challenges that disrupted their circadian rhythms.

Though the boys have gotten much better at sleeping at night, not to mention sleeping long enough to get a good rest, I have found restoring my circadian rhythms much more difficult. My body tends to slide through the week.

For example, last week I was so far behind on my work and coursework, I shorted myself on sleep and tried to be awake during the nights so I could have a longer period of uninterrupted work. I was firmly entrenched in this cycle by the end of Wednesday, which had repercussions I’ll discuss in my next post. I spent the week working at odd hours, sleeping at odd hours, and my sleep was definitely not cyclic in nature.

This week I’ve committed myself to a day schedule. I spent my day of rest (Sunday), resting up from my wee-hour work day on Saturday, eschewing caffeine, and going to bed early (for me) on Sunday night. I woke refreshed this morning and ready for a full day—at least, I hope so! Yet, despite the best of intentions, I suspect I’ll slide back into an irregular schedule by the end of the week.

What’s decidedly worse is that I tend to rely on external chemicals in order to get to sleep regardless of when I do it. I take between 6 – 10 mg. of melatonin and a full-strength OTC sleeping pill (the equivalent of two Tylenol PM pills, without the acetaminophen). And that’s when I’m already quite tired and feeling “ready to sleep.” When that is insufficient, I usually add a third melatonin to push me over the edge of consciousness into sleep. Most of the time, it works. But sometimes it doesn’t. Usually, I’m up and alert after 5 – 7 hours of sleep. Only when I am unwell can I get the 8 or 9 hours people tend to claim we need.

Mark, on the other hand, will take a full-strength OTC sleeping pill on the nights he can’t sleep and sleep for 12 hours straight—and he’ll sleep hard! I find myself facilitating from envy to resentment, wondering how he can manage to stay asleep so long. Seeing that neither envy nor resentment are good qualities/emotions, I try to put off such feelings and instead embrace with gratitude his willingness to cope with my sleeping peculiarities, so that (most of the time) I can sleep when I need to regardless of the time of day.

The (Missing) Sleep Factor

  • Posted on May 22, 2013 at 10:00 AM

My kids have trouble sleeping. In fact, my whole family has trouble sleeping, me included. A long, long time ago I resisted the idea of using melatonin to help alleviate that problem. I got over it. Now, Alex happily takes his melatonin in gummy form. Ben still has to take crushed up pills, but we have a system that makes it less of a battle. Unfortunately, I seem to be the only one who can implement the system.

Willy’s prescription medication helps him sleep, though it doesn’t make him sleepy per se, just more regulated. Mark’s prescription medication helps him sleep by making him sleepy, but only in combination with a formerly-prescribed-now-over-the-counter medication that isn’t supposed to have any sleepy-time effects at all. If he takes each pill separately, there’s no sleepy-time effect. If he takes them together, there is. If he runs out of his prescribed medication before it can be refilled, then he can’t sleep at all. Even with melatonin and/or Tylenol PM.

I take melatonin and Tylenol PM to help me sleep now and it just barely works. When it doesn’t, I get a headache instead of much needed Zzzzs.

I know that people who are on the autism spectrum seem to have more trouble sleeping. I don’t know whether this is a statistically proven fact, however. But I have to wonder if there’s another factor, because it all seems to be getting worse.

I tried an experiment where I rubbed lavender oil, as per usual, on the boys after letting them stay up later than usual, but I didn’t give them their melatonin. It took them longer to get to sleep, but they stayed asleep longer. Then, the next day, I went back to using the melatonin. That brief respite seems to have improved the effects of the melatonin.

When I’ve tried something like that with myself, however, my sleep just doesn’t come. That’s a problem, because I’m not longer able to pull a 48-hour shift or even a 36-hour shift. Can’t do it. Just can’t function.

I have to take 6mg of melatonin and two Tylenol PMs just to get 6 hours of sleep. And then I’m done. I may be able to take a nap a few hours later, but after waking up with 6 hours of sleep, I can’t just go back to sleep, even with more medication. My body is getting used to it, but I still feel like I need more sleep.

I wonder if there might be an environmental factor. Maybe we’re just feeding off of each other. I don’t know. Shouldn’t sleep come more naturally than this?

How to…Get Some Sleep

  • Posted on March 28, 2012 at 8:06 AM

When my boys were younger, they had a lot of trouble sleeping.  Our current problems with sleep seem insignificant in comparison.  I remember getting three hours of sleep a night.  It went something like this: Willy would be wildly awake until he fell into a brief, exhausted sleep that lasted maybe five hours.  I fell down and slept as soon as I could.  A few hours later—three or four usually—Alex would wake up, eager for morning.  By the time Willy’s sleep schedule normalized (more or less), Alex was where Willy had been (difficulty falling asleep) and Ben was where Alex had been (waking up very early).  Now, both Alex and Ben are (more or less) in sync. 

It might seem ill-advised for me to do a how-to on this topic, since it’s something we still struggle with, but it’s that “still” that has modified our techniques for more effective solutions.

Personally, I advise against medicating children unless absolutely necessary.  But, sleep is necessary, and there are more natural solutions than the kind of sleeping pills adults so often rely on.  Here’s what’s worked for us:

1) Melatonin

Melatonin is a hormone produced by the body to control your sleep/wake cycle.  “Normally, melatonin levels begin to rise in the mid- to late evening, remain high for most of the night, and then drop in the early morning hours,” according to WebMD.  But sometimes this natural production doesn’t work so well.  Luckily, it can be supplemented without druggy side effects.  There are both pills (which are safe to be ground up) and liquid forms of melatonin you can dose your children with to stimulate sleep.

2) Lavender

Lavender is a flower (as well as a color and a scent) that can be reduced to its essential oils.  Natural lavender (the flower or the essential oils) can trigger relaxation, which can translate to sleepiness without the druggy side effects.  Just be aware that you don’t just want a mass produced lavender scent (candles and other smelly products).  You want something with real lavender oils in it.  Natural food stores often carry the essential oil products, and a few drops in the bath, rubbed over the chest, or sprinkled under a pillow can make a world of difference for a good night’s sleep for those who are so revved up they can’t calm down, even when tired.

3) Staggering

Anything you use can be overused.  The body can get used to it, requiring higher doses to the point that it gets dangerous—even homeopathic oils and natural supplements, like melatonin and lavender, can become dangerous with high doses.  Instead of upping the dose, take a break from the product.  The break should be long enough for the body to adjust; a few days are usually enough.  Then start again.  Start by using one product (melatonin, for example) for a while.  Then, start up with the other product (lavender, for example).  Overlap for a night or two.  Then, stop using the first product for a several days (maybe as long as a week).  Use only the second product.  Then, switch again, following the same pattern.  This should help you and your child(ren) get some much needed sleep, without overusing or overdosing.

And don’t be afraid to dose yourself.  Your body gets used to the rhythms of your children, so you might need the extra help getting a good night’s sleep even after you’re sure your children are getting the rest they need.

Some other natural products you might want to try include:

  • Chamomile
  • Valerian
  • Relaxation techniques (think yoga, and there are yoga programs for kids)
  • Light therapy (for those who are responsive to the change in seasons)

Summer’s Here

  • Posted on March 23, 2012 at 8:00 AM

It’s March, and yet it feels like the beginning of summer.  Maybe it’ll last, maybe it won’t.  But it’s wreaking havoc on my children’s delicate systems.

Spring equinox is always hard.  Is it the pressure systems bearing down on us while they blow through?  Is it our changing proximity to the sun?  Or is it the daylight savings nightmare?  I don’t know, but the boys struggle—especially with sleep.

For a while now, we’ve been doing the melatonin thing.  For the most part, it helps.  A lot.  Until it doesn’t.  Then, it doesn’t help at all.

We’re there now.  I tried upping the dose.  They’re regularly at three milligrams, which seems like a lot, since we started at 1 milligram.  I tried bumping it up to 4.5 milligrams, or a pill and a half.  But it didn’t work.  It’d only take them an hour or two to go to sleep (after lights out).  But they’d wake up a few hours later, revving for daylight.

So, we took a break from the melatonin.  It took them two + hours to get to sleep, but they slept through the night and woke up kind of tired.  We’ll see how long this lasts.

The Elusiveness of Sleep

  • Posted on August 15, 2011 at 3:19 PM

As the mother of three children with autism, each of whom have had sleep issues of their own over the years, I find that one of the unintentional—or perhaps involuntary—sacrifices I have made on behalf of my children is the benefit of a regular sleep cycle. Though it’s rarely an issue now (admittedly, we had some echoing of it early this summer), once upon a time I regularly got between three to five hours of sleep, and that’s it. (When I included that in a fiction story, my professor circled it as a potential “factual error.”) At that time, five hours was the most Willy would sleep at a time (and if he napped, his brothers were almost always awake, so I still couldn’t sleep). At that time, my husband was working, and he was depressed, so he could rarely help me get more sleep. In fact, those crazy-making months were one of the major reasons I started building a better support network.

One of the strangest things about this is that my body learned (my mind happens to disagree, but that’s another matter entirely) that it could function on three to five hours of sleep. When the need arises (as it occasionally does, even now) my body will revert back to that time-frame, over my mind’s strenuous objections.

You see, as I said, my mind disagrees with how much sleep is required. For mind to function—which, btw, is necessary for a professional writer, go figure—I need at least six (preferably seven) hours of sleep. So those times when my body kicks into sleep-dep mode, my mind is deprived of sufficient rest to do its tasks, even while my body can keep up (more or less) with the boys and the chores.

Another detrimental effect of all of this is the lack of a regular sleep pattern. I cycle between day and night, sleeping when I can and working when I can’t. I’ve tried melatonin, sleeping pills, and herbal remedies, but I can’t seem to regulate my sleep cycle for more than a week at a time.

This makes scheduling certain things rather difficult. I can’t really plan ahead and know I’ll be awake and ready to go. BUT that’s also where the 3 to 5 hours of sleep and the sleep cycle irregularities kick in. If I have something scheduled and need to be up, even if I have not succeeded on getting myself on a schedule that makes it seem right, I can usually make the temporary switch.

Predictably is the key, however, to getting certain things done, and it’s the key I lack. For instance, when I first wrote this post I slept Friday night to Saturday morning like a “normal” person. I got a good amount of sleep and was asleep at night and awake during the day. Then, I pushed myself a little late to spend some quality time with my mom, and Mark had a sleepless night, and so I went to bed at 1 a.m. Sunday morning, slept for two hours, and woke up and stayed up, because I couldn’t get back to sleep. I didn’t make it a full day. When Mark was ready to be up, I went back to sleep, and got back on the “night shift.” ***I, unintentionally sabotaged my mom’s sleep Friday night, so I wouldn’t blame her in the least for the “oops” in my sleep. Besides, it was my choice.***

The funny thing is, after my two hour nap, I was productive. I got some household work done, some writing work done, some miscellaneous work done, and I was okay. I was effective. So, basically, my body and brain are semi-erratic and rather unpredictable. But it works! Sounds kind of like my life raising children with autism.

Melatonin Update

  • Posted on August 9, 2011 at 5:37 PM

After weeks of forging a routine that involves dosing Alex and Ben with melatonin to help regulate their sleep, we’ve finally gotten to the point where the boys are wholly cooperative in taking their doses. Now they go to bed (and to sleep) with relative ease (most of the time), and sleep through the night (most of the time). We’re now working to get them into bed earlier, so that they’re back on a school schedule by the time school starts. The melatonin is helping with that, too.

The biggest downside is that if there is sufficient cause (exciting happenings in the environment), the boys are able to fight off the effects of the melatonin. Thus, melatonin is not the only important element. Some things, like what’s going on in our house, can be controlled. Unfortunately, things outside our house (like fireworks) cannot. So, our nighttime routine is still a work in progress.

Now if I could only get my own sleep cycle under control…

Back to Bed

  • Posted on June 6, 2011 at 10:25 PM

As I’ve said before, my boys have sleep issues. And, of course, they get worse in the summer. Like, say, now. On the upside, Ben is no longer wandering into Alex’s room and scratching up his face. Instead, Ben wanders into the upstairs bathroom and tries to flush miscellaneous items down the toilet. Since the toilet up there has been blocked for the past two weeks—probably another milk cap—and nobody has had time to pull up the toilet and fix it, Ben satisfies his urge by stuffing clean washcloths down as far as he can get them. We discourage this. We try to prevent it. And, so, instead of putting him to bed and hoping for the best, I’ve been sitting outside his room, doing what little work I can from that location, and stewing in my own idleness—oh, and telling him to go back to bed every few minutes until he finally falls asleep.

Overall, it’s a bad system. It doesn’t actually help the boys get a good night sleep and it does horrible things to my stress levels. Me + idle = badness.

In the past, we’ve tried melatonin (to be ingested) and we’ve tried lavender oil (like perfume). Both worked, for a time, but the effects wear off and I’m not comfortable just upping the dosage. So, I haven’t used either in quite a while. But now, with the summer (and their sleeplessness) revving up, I’m going to try again, starting with the melatonin.

Last night, Alex took his melatonin very well, and he went to sleep very nicely. Ben, on the other hand, fought with everything he had. He wouldn’t drink down the crushed pill in Dr. Pepper, which he used to do. So, I tried to give him the pill by mouth. About ¼ of the pill dissolved in his mouth. The rest ended up smeared on his face, on me, and on the surrounding bedding. Then, he made himself throw up, on purpose, as a protest. Tonight was a bit better. Alex was a bit more reluctant, but cooperative with just a tiny bit of coaching. Ben struggled, but he didn’t throw up, and he ended the whole battle by giving me kisses—after I let him go. Then, Ben fell asleep within half an hour, but Alex is still up, still bouncing. So, you win some, you lose some, and as long as I win with one of the boys each night, I’m good to go!

The thing of it is, when the boys take their melatonin (assuming the effectiveness hasn’t been reduced due to frequency of use), the boys sleep better and have better days. Once the boys gets used to taking the melatonin, they’re happier and more functional and they like that—go figure. It’s just a matter of getting them used to it again, and helping Ben remember that sleep is actually good for him.

 

Melatonin Update

  • Posted on September 2, 2010 at 9:04 AM

So, we’ve had the liquid form melatonin for just about a week—long enough for the boys to have gotten used to it.  The delivery arrived just in time to get them on the sleep schedule they need to be ready to start school.

I am very impressed with the results.  The boys are calming down and sleeping much better at night.  Not only that, but—after only a few days of taking melatonin—they are ready for bed at an appropriate time.  I give them each a dose of melatonin, and by the time I’m ready to put them to bed—about twenty to thirty minutes later—they are going upstairs nicely and climbing eagerly into bed.  This is a fabulous change, since I used to have to herd the boys up the stairs—sometimes carrying one or both of the little ones—and then wrestle them into bed.  And still they wouldn’t stay there, so I’d camp out between their rooms for an hour or three until they finally fell asleep.  Melatonin has changed that!  Last night Ben was even curled up and drowsing on one of the downstairs couches before it was even time for bed—though I think that might be because he’s fighting off his first cold of the season.

Melatonin has been a great relief.  Not only does it work once the boys are actually dosed, the dosing is much easier than I expected.  The liquid form can be diluted in a small bit of milk or other beverage—Ben prefers Dr. Pepper over milk, silly guy that he is—and they drink it with little resistance, though it does require monitoring.  Willy is actually excited to take it and wants to make sure he gets to help with the dropper!

The only downside is that it doesn’t seem to carry over in the sense that it creates a sleep habit.  At least, it doesn’t help me to create a sleep habit.  I took melatonin two days in a row and was on a regular sleep schedule—going to bed at night and waking up in the morning.  Then, I didn’t take it two nights in a row and just kept going and going like I usually do.  Luckily, when I took melatonin last night, it helped me sleep and I woke up fine in the morning.  So, it works—it just doesn’t create a sleep habit that allows me to maintain a schedule without it.  At least not after two days of use.  So, I have to be sure we have a steady supply of melatonin for each week.

Overall, I’m impressed.  I appreciate the benefits to my family and hopes it keeps working this well over the long haul.  I’m glad I tried it.  I still retain my skepticism regarding the popularity of experimenting on children using various over-the-counter remedies.  But I also think that when a problem gets severe enough, trying remedies used by a large network of trustworthy individuals is an appropriate step.  The bottom-line, for me, is to remember that all these drugs on the market are, above all else, powerful and incompletely understood.  It’s not something to play around with “just in case it works.”  But taking a cautious, rational approach can allow us skeptics to make use of these drugs, while still preserving the long-term welfare of our children.