I'm at my wit's end. Please help me troubleshoot this.

[spooko]

DS is 7.5. ADHD, began Ritalin a month ago. Even before medication, he's always gone through periods of insomnia in the middle of the night. We've done what we can to minimize this by taking the lights out of his room so he can't easily play in the night and giving him a set time that he needs to be in bed until (6AM). With some reminders on occasional nights, this was previously working. 

NOW: He hasn't slept through the night in several weeks. I know the medication doesn't help this, but we've asked that he still stay in his room until 6AM. We did have to take the clock out because he was fooling around with it in the night, but when he does venture downstairs, he can see other clocks and I also often wake up to send him back. When this hasn't helped, I told him I would open his door at 6 so he knows when he can come out easily. We've given him the option of earning the clock back by following the rules and we've had 0 success. 

We have the Xbox set up in the living room and he comes down and tries to play with it in the night. This is despite the fact that he's both 1)supposed to have prior permission to touch it, and 2)grounded from it ATM. 

Every night I hear/see the light when he gets up and usher him back to bed. Sometimes I catch him right away, sometimes he gets into the Xbox. Either way, back to bed, with additional consequences for breaking the house rules. He ends up getting defiant and I have to stay up until morning to keep putting him back because he just sits by his door and waits until I go to my room in order to sneak back out. He's taken to waking his sister up to play with in the night, either so that he can take her iPod (also grounded from) or so that he has someone to play with since everything is gone.

I've run out of consequences and nothing is even making a dent in this. I'm exhausted, having not been able to sleep myself as a result, and my patience is waning. Heck, it's outright gone. I have no more patience for this bullshit and even if I take away something huge like the opportunity for him to go to a wrestling tournament or something, I know that it isn't going to actually click for him to make a change. It never does. 

So barring locking him in his room (DH's brilliant plan when I finally tried to get him up in the night to deal with one of these times), WWYD? I'm very torn between being super pissed at his outright and blatant disrespect of my rules and being slightly sympathetic because insomnia sucks. I don't think 6AM is too much to ask and I don't think having him stay in his room is out of line, though. I don't expect him to sleep on demand, but I don't want to give him a preferred activity as an option because he won't ever sleep then. He will literally stay up for the majority of the time for days on end, all while his behavior tanks, and then he will crash in some random place at an inconvenient time. 

[hopecounts]

Ugh that sucks for all of you.
My first thought is can he trial a different ADHD med? It may be Ritalin is a bad fit and exacerbating his insomnia and another option will be less problematic.
Second thought if he is grounded from the Xbox remove it from the living room for now and put it in your room.
Third I might even try the babyproofing door knob covers and an audio baby monitor if he isn't going to make mature choices you have to keep him safe.
4th reasonable compromise what about audiobooks he can listen to if/when he wakes up? DD loves listening to them and we use them for quiet time. She isn't asleep but she will lay quietly and listen.
He may fall back asleep easier if his mind is distracted, let him go with you to the library to pick them out (or pick them out via overdrive and download them to iTunes and burn them to CDs) and see if he'll buy into it.

[funchicken]

Have you talked to the doc about the insomnia? I would definitely put a call in. Maybe his dose is too high. Maybe he needs something else for a while to help him wind down.

In the meantime I would put the Xbox away somewhere, so he doesn't have access in the middle of the night. Waking his sister up? Ugh, sorry I don't know. Maybe bubba has some advice she can share. I know her DD doesn't need much sleep.

Hugs! Sleep issues totally suck, and it makes it that much harder to have patience with the daytime behavior.

[spooko]

I would move the Xbox, but I've been hesitant to as that's the only TV and it's actually DH's. I have a hard time with "punishing" DH because DS doesn't follow the rules.

I think the Ritalin is a good fit during the day, and he doesn't have trouble going to sleep. It's the staying asleep that typically causes issues. I've thought about putting a white noise machine in, but like the clock issue, I'm concerned with him playing with it and then us having problems with going to sleep, too.

We have an appointment with the doctor for Monday morning, so I'll talk with him about it then.

I know the dose is supposed to be about 4 hours, but does it actually wear off after that long? Is him waking up 6-8 hours after it should be worn off actually connected? Theoretically, the dose should typically be worn off by 8PM if his last dose is at 4PM. He wakes up between 2-4AM, generally. I just don't know if this is actually a medicine thing or the same shit we have dealt with before.

[princesslily]

Aw, I'm so sorry your not getting any sleep


Our NintendoDS and tablet charges by DHs bedside, so unless we give permission he won't touch/play them. Can you put all electronics in your room and or in a locked cabinet until you say okay? Does an XBox have parental privacy controls?

[funchicken]

I don't have any experience with ADHD meds, but 4pm seems pretty late in the day for a dose. DD1 (6.5, ADHD) doesn't take ADHD meds, but I find that if I have to give her any OTC meds like cold medicine or Benadryl that affect sleep, they seem to screw up her sleep cycle even though they initially make her drowsy. It's so hard to know how these things affect them.

As far as your DH is concerned. He's not being punished. He's being a partner in parenting. If he's not going to deal with the middle of the night wake ups, the least he can do is make it easier for you to deal with them.

[hopecounts]

It may be that coming of the Ritalin is affecting his ability to get into a good sleep pattern so he wakes easily later in the night.
4 is pretty late for a Ritalin dose IME for most kids.
And your DH may have to take one for the team in this situation. Sometimes parenting means not strong to do this you want to because it's best for the kid.

[funchicken]

Jan 24, 2015 9:19:56 GMT -5 hopecounts said:

It may be that coming of the Ritalin is affecting his ability to get into a good sleep pattern so he wakes easily later in the night.
4 is pretty late for a Ritalin dose IME for most kids.
And your DH may have to take one for the team in this situation. Sometimes parenting means not strong to do this you want to because it's best for the kid.

Jinx We seem to be on the same page this morning.

[spooko]

Thanks. I know 3-4pm is when a lot of kids go off Ritalin and the parents just end up trying to deal, but I couldn't. He was 100x more difficult to handle and I think Mrs B had succinctly summarized for me: it was like he was saving everything bad he would have done and it all came flooding out. We really do need something to bridge the afternoon with daily homework and sports half the week. Plus, I just couldn't really manage him and he was way too jazzed to fall asleep and when he has the dose in his body at bedtime, he is still calm enough to lay still and fall asleep.

I think you're on to something about the sleep schedule being disrupted. I wish I knew how to fix it, though.

I asked DH about the controls and he said everything should have been locked up. We're not sure how DS was able to get into the system. He did say we can just move the controllers into our room, but I do think it will be time to unplug if that doesn't stop it. Thanks for the reassurances that it's not out of line to do that. I feel so frustrated with DS that he's way too old to be doing this stuff. He knows better. It's exhausting to have these same fights over and over again.

[hopecounts]

Remember ADHD reduces his executive function skills.
He likely knows better but may not have the self control to do better in the moment yet.

[akafred]

I know you feel you need the evening dose of Ritalin to get through homework and extracurriculars but that is 3 doses a day, and clearly exacerbating the insomnia. He probably needs to drop the third dose, reduce the strength of the third dose, or trial a different med.

For insomnia in general, a couple of ounces of tart cherry juice an hour before bed helps sleep later and wake up less frequently. Melatonin also helps, but should be short term if possible. Chiropractic may also help. Lavender and chamomile essential oils are very calming and soothing (don't use lavender on boys' bodies, but in a diffuser is fine).

[akafred]

Locking him in his room isn't the answer, but if you need to know when he gets out of bed right away, you can get an alarm for his door. They make them where they are wireless and the part that makes the noise (usually a ding dong like a store door chime) plugs in anywhere. You can plug it into your room and it will tell you when his door opens. That way at least he can't sneak around and play the games.

[spooko]

@akafred, he's on the lowest dose possible for the 3rd one. I don't see him successfully functioning if we don't give it because he is off the rails. Yes he stays sleeping slightly more (but not completely) but it's because he's causing trouble for 4 hours past bedtime instead of in the middle of the night. I don't really think doing 3 short doses versus one long dose is a huge difference.

I hadn't heard about the juice. I'll see if I can find it. What is the issue with lavender for boys? Thanks!

[spooko]

Jan 24, 2015 9:53:15 GMT -5 hopecounts said:

Remember ADHD reduces his executive function skills.
He likely knows better but may not have the self control to do better in the moment yet.

I do know this. And I actively try to remind myself if it. But it's so tiring and frustrating and I struggle to find a balance between cutting him the necessary slack and keeping the bar high so that he keeps progressing.

[akafred]

Remember meds aren't like switches where they turn right on and off. They slowly metabolize in and out; of course some formulations metabolize more slowly on purpose, but even the fast acting ones don't just turn off. It's sort of like alcohol in how it leaves the system. So it may be that the 4 hour med is more slowly metabolizing or is kind of building up with the earlier doses and is disturbing his sleep. It's possible that a slower acting med would end at theoretically 7pm but would have enough potency to get through to bedtime but not disturb his sleep. Or maybe the three doses are enough but he needs a stronger dose in morning and a very low dose for 2 and 3 rather than just the third. Definitely talk to the dr though because something isn't working. It's great that his behavior is so much better during the day, but he needs sleep and so do you! Hopefully just a small tweak will help.

[akafred]

Lavender may be a hormone disruptor causing boys to produce estrogen and possibly grow breasts. The study that cited it wasn't a very good study but it's probably better safe than sorry. Certainly don't overuse it.

[mrsbuttinski]

A couple of random thoughts-

1. Are you sure he's fully dxd? Even a kid with ADHD (Impulsive Type) should be able to understand and mostly follow the house rules most of the time. Given the frequency with which this is happening, in spite of the consequences, I'd be looking to figure out why he's not responding to a behavior mod most ADHDers would.

2. The behavior you describe sounds almost like it comes from a place of anxiety or defiance. This can be hard to tease out. Defiance would generally be more of an ODD- "screw you, lady, you're not the boss of me" attitude which does not seem like your kid's MO. You'd expect him to be fighting teachers, peers, siblings and potentially being aggressive and mean at times.

3. To my ear, filtered by my own experience, anxiety sounds more likely. TBH, I know a lot of kids who have trouble with gaming as a kind of addiction. This is really common in kids with HFA, but some I've met kids with "just ADHD" who are as bad. Anxiety around being able to get their next "hit"- it can make them edgy, suck up the bandwidth needed for other activities and result in dreadful behavior. The best approach to this sort of situation is a draconian removal of the object that is driving your son to demonstrate such poor character. You want to set him up to be successful. If you boxed the set up where he can't get at it for a time, he'd learn to be OK with not having access and would be able to stand down his anxiety created by planning to sneak around to get his fix and ou may find in time, he can exhibit self regulation around this once he's learned he can function without it.

4. As for "punishing" your DH. He's an adult and a father, he may need to take a hit for family harmony. I really don't like that he's not fully on-board with supporting you in managing this. A united front will solve this problem a lot more effectively than crating your son overnight so he doesn't disturb others. You should both get up and redirect. Either together every time or switch off nights. TBH, there are certain boys who respond better to masculine discipline- your kid might be one of them.

5. Good luck with you upcoming appointment. I do hope they can come up with some strategies to help your DS make better choices and bring calm to the house. I hesitate to punish around sleep- poor sleep is often a manifesation of a condition. Ramping up the anxiety over falling/staying asleep tends to make sleep worse. And of course, kids with ADHD tend to be really off the chain when they aren't getting optimum rest. I wonder if giving your DS something quiet and soothing to do if he wakes up might be best- like a book and a low wattage reading lamp.

6. You are probably already doing this, but in case anyone else is reading, limiting his exposure to "blue light" from screens after dinner would help. Computers, tablets, TVs all emit a blue light that interferes with sleep ad should be turned off at least 1 hour before bedtime.

[akafred]

I agree with Auntie about anxiety. This is the sort of thing that would give Char anxiety. When she was "napping age" at preschool, she acted up every single Thursday, which happened to be the day they had ballet in the afternoon. Then she would act up in ballet and have to go back to the classroom. Soon her teacher decided that if she didn't nap on Thursdays, she couldn't go to ballet. It would be used as a "reminder" when she started acting up, which Char interpreted as a threat, and then she couldn't sleep because of anxiety and it became a regular thing. Once I intervened and established that 1) I wasn't paying for ballet she wasn't allowed to go to, and B) they were making the issue worse, they stopped making it a given that she couldn't go to ballet if she didn't nap and would at least get a chance in ballet, she started napping again on Thursdays. She still does this kind of anxiety sabotage, and interprets even reminders of consequences as threats and punishment, when they aren't meant that way.

There seem to be 2 ways to deal with that kind of anxiety. If you have read, "Parenting the Hurt Child," you'll know that food hoarding is a common problem with foster kids and kids with RAD. Some caregivers 100% remove the food, get a lock for the fridge, etc. Others do the opposite and open up all the cabinets to show that food will always be available. Both tactics seem to work for different kids and families.

[spooko]

I'm intrigued by the anxiety idea. I was an anxious kid but it never manifested this way. It does seem to make sense, though. I can see trying some of each. I can't allow unfettered access to the xbox, but I guess I can back off some in the sleep issue. I mean, he isn't sleeping anyways, so he may as well read or something.

I appreciate everyone's insight.

[bubbalicious]

When did the insomnia start? When is the last dose of medication? Are you using melatonin?

We have done everything in the books to help with sleep. Most didn't work.

I have used Melatonin in the middle of the night.
We see difficulty going to sleep as opposed to waking at night. The night wakings happen all the time. She just crawls in bed with us. It isn't a great solution but she is safe and I need to sleep way more than her.

Modify the environment first. Suggestions for modifying. Put the Xbox away for awhile until the insomnia is worked on. We have locked dd in her room. She eventually figured out how to get out. Gate at the top of the steps (DD was pretty good at defeating barriers if motivated...have a hunch your little is the same).

Use one of those alarm clocks with the stop light...shows green when they can leave. Add positive and visual reward to this.

What worked best for us besides Melatonin, was having something that was special to her bedtime. We have a kindle to play with at bedtime. There are nights I have to take it and other nights that she goes to sleep without. There is a lot of talk about screen time and what it does to the brain...really you need the kid in one place if they are to sleep. You could use a small electronic in his room for a reward. Start small. Something that can be managed through parental controls.

For a long time, I didn't use it as a tool in behavior but more as a something to keep her in her room and laying in bed. Now I use it for behaviors too.

[jmski]

Would he do better sleeping in a little tent, in a sleeping bag, using a weighted blanket? My son puts himself inside his pillow case at night because he likes the tightness. It's strange, but it is his habit.
Is there an issue with him having to go to the bathroom? Even if he doesn't wake up and go use the restroom is he needing to go (BM), but too anxious to go when someone else knows he is up? My son has had anxiety about the restroom.

[megara4]

My son (12) had a hard time going to sleep when he was taking Concerta for his ADHD. He still does now, but not as bad as when he was taking the medication. He took the extended release. He said he had a hard time sleeping b/c he had a hard time turning his mind off. It helped a lot when we'd have him go lie down in bed and read for an hour before bedtime. I just asked him and he also said white noise from a fan or listening to the ticking of his clock also help him to fall asleep easier.

Have you seen these? It may help with him learning when it's okay to come out of his room.

www.amazon.com/Trainer-Children-Seller-Quality-Shipping/dp/B00DY7LQH2/ref=sr_1_1?ie=UTF8&qid=1422132450&sr=8-1&keywords=gro-clock+sleep+trainer&pebp=1422132450746&peasin=B00DY7LQH2

[numbbears]

Jan 24, 2015 15:49:51 GMT -5 megara4 said:

My son (12) had a hard time going to sleep when he was taking Concerta for his ADHD. He still does now, but not as bad as when he was taking the medication. He took the extended release. He said he had a hard time sleeping b/c he had a hard time turning his mind off. It helped a lot when we'd have him go lie down in bed and read for an hour before bedtime. I just asked him and he also said white noise from a fan or listening to the ticking of his clock also help him to fall asleep easier.

Have you seen these? It may help with him learning when it's okay to come out of his room.

www.amazon.com/Trainer-Children-Seller-Quality-Shipping/dp/B00DY7LQH2/ref=sr_1_1?ie=UTF8&qid=1422132450&sr=8-1&keywords=gro-clock+sleep+trainer&pebp=1422132450746&peasin=B00DY7LQH2

Reading and white noise helped me sleep as a kid, also. It still does.

I hope you find something that helps, spooko

[akafred]

Just to clarify, I wasn't suggesting you give him 100% unfettered access to the Xbox, just that taking it away from him as a punishment may be causing anxiety that then makes sleeping more challenging and also behaviors. Putting it out of sight, out of mind is a solution (just make sure you don't hold it over his head to try to get him to "earn" it back or anything like that). Another option is to assure him he can use it for a half hour a day on a basic schedule (right after school, right before dinner, etc) or can use it an hour a day on weekends, etc etc etc. There are lots of options.

[spooko]

@akafred, I know you didn't mean that. I just was comparing the extremes in my head/aloud. This is a tough predicament for me because we rarely have anything he's interested in and my first instinct is to then use it for consequences/rewards. I keep running into this roadblock where it isn't working that way, though. Sure, he'll snap back in line a time or two if I threaten to take it, but as soon as he actually loses it, he kind of goes well, F-it and spirals out of control to the point that he'd be earning it back forever. He gets himself in this vicious cycle.

And the hardest part is that I can see him consistently do that, but I don't have any other discipline tools that are any more effective. I do set him up to succeed as much as I can but that isn't foolproof. It's exhausting and no one else really can/will do it to the level I do so he still fails elsewhere. And he can't just get away with everything because he responds poorly to consequences, or conversely, doesn't care. I know it's kind of a separate issue, but it's kind of woven in, and is something I really, really struggle with.

[mrsbuttinski]

See that's why I'd make the X-Box go away. Take it off the table. If there's no option for accessing it, a lot of the anxiety will go away.

[akafred]

Jan 24, 2015 20:12:03 GMT -5 spooko said:

@akafred, I know you didn't mean that. I just was comparing the extremes in my head/aloud. This is a tough predicament for me because we rarely have anything he's interested in and my first instinct is to then use it for consequences/rewards. I keep running into this roadblock where it isn't working that way, though. Sure, he'll snap back in line a time or two if I threaten to take it, but as soon as he actually loses it, he kind of goes well, F-it and spirals out of control to the point that he'd be earning it back forever. He gets himself in this vicious cycle.

And the hardest part is that I can see him consistently do that, but I don't have any other discipline tools that are any more effective. I do set him up to succeed as much as I can but that isn't foolproof. It's exhausting and no one else really can/will do it to the level I do so he still fails elsewhere. And he can't just get away with everything because he responds poorly to consequences, or conversely, doesn't care. I know it's kind of a separate issue, but it's kind of woven in, and is something I really, really struggle with.

Right. Char is exactly this way, and punishments and rewards don't work with her. They aren't my style anyway but when I have tried them, they backfire exactly this way. There are some great tools in the Positive Discipline toolbox that really do help when I remember when and how to use them, but ultimately it's this kind of thing that makes parenting our kids so challenging. This conversation is really making me remember things and renew some vows .

[spooko]

@akafred, is there something specific or a few specific things that would help? A lot of what I remember from when I was looking into the positive discipline stuff (and it was brief and a few years ago) was centered around the prep work and the preparation for success. I don't remember anything about after the damage is done, really.

[akafred]

blog.positivediscipline.com/2011/12/52-positive-discipline-parenting-tools.html?m=1

[spooko]

Re: the positive discipline, because I know there's a few here the do it... Do you feel like it sets your child in a position of being more of a peer or a higher level role in the social hierarchy than other systems? I seem to remember kind of feeling that way before, but IDK if I'm remembering accurately.

For someone with a child who already doesn't really respect authority and really struggles in the school system as a result, I wonder if I'd be setting him up for more failure by implementing things that made him feel like he has more say/control/rights/etc. than he realistically will in school.

akafred
KC thepouchh8r (you do the positive discipline, too, right?)