Figuring out how to get my ADHD child to sleep

Lexie has always had a problem falling asleep. I am jealous of those parents who report that their children are in bed and asleep by 7 p.m. Heck, I am even jealous of the ones who get them asleep by 8 p.m.or even 9 p.m.

Lexie, on the other hand, is usually up until 10 p.m. or later even though her bedtime is 9 p.m. My husband originally dismissed it as her taking after him. He has always had trouble falling asleep. But now we know he is right. Her sleep problem is related to her ADHD (which my husband was recently diagnosed with too so it is something she inherited from him.) The problem is that she can’t stop her racing mind long enough to fall asleep.

Actually, the diagnosis of ADHD for both Lexie and my husband explained a lot. And while medication helps both of them in the daytime to focus and be productive, that medicine has run out by bedtime.

Originally, we thought her medication might be keeping her awake, and even her doctor suggested giving it to earlier to make sure it has worn off by bedtime. But even the best extended release medicine is not going to last the 14 to 16 hours of a typical waking day, and I can typically see when her medication is worn off. She becomes hungrier and just a little wild. Since the meds have worn off, she has no way to calm down to go to sleep. (Once asleep, she is out so no worries about that at least.)

While doing some research online, I found several medical sites that said many adult ADHD patients take an additional dose of their medication so that they can quiet their mind enough to sleep. Of course, that sounds odd as ADHD medication is a stimulant which you would think would have the opposite effect and keep them awake rather than going to sleep.

A good night’s sleep is vital to your child’s mood and brain function. Not getting enough sleep can worsen the symptoms of ADHD. With the recommendation of 9 to 11 hours of sleep at night for a nine-year-old,  I definitely want Lexie to get more sleep.

But rather than dose Lexie with more medication, we have decided to try some of the other suggestions for getting her to sleep.

Here are some suggestions gathered from the internet:

• Use a white-noise machine, ear plugs, or play soothing music to distract from any other night time sounds
• Cut down screen time before bed (in other words, no TV, computer or iPads for the 30 minutes or an hour before bed)
• Ensure she gets one hour of exercise a day
• Sticking to a schedule is very important for someone with ADHD so establish a clear bedtime routine
• Make the hour before bed calm, low lights
• If light sensitive, use blackout curtains, turn bed away from door or use a sleep mask
• Avoid large meals or snacks before bed
• Try aroma therapy with lavender, chamomile, sandalwood or vanilla.
• Use a weighted blanket
• Practice relaxation techniques – focus on breathing or visualize yourself in a calm place
• Taking melatonin (available OTC) or other prescription medication for sleep

Now, I will admit when I first saw this list of suggestions I didn’t feel confident that they are going to do anything. But I was tired of the nightly battle. We decided to try cutting the before-bed screen time last week. We had them go to their rooms 20 minutes before bedtime and not use any electronics.

OMG! It worked! They were asleep before 10! The next night was the same. Eureka! We have found the cure! Well, it didn’t work on two nights but we were not consistent with the timing of getting them into bed. Lexie still gets up a few times in her procrastinating manner but we have seen a drastic change in how quickly she falls asleep when we stopped the screen time and had them read or draw instead.

Adjusting my daughter’s ADHD meds – at her request

In June of 2015 we started our daughter Lexie on medication for ADHD. At the time, we weren’t even sure she had a problem. Her teacher had shown concern that she couldn’t sit still in class and was having trouble concentrating. The test from her pediatrician had proved inconclusive but she suggested trying medication to see if it would help – and it would give us the answer to the question whether Lexie had ADHD or not.

Jumping to medication may seem like a jump when you don’t have a definite diagnosis but no amount of redirection seemed to help Lexie. We worried about the side effects of the medication and that we would be creating some kind of zombie who shuffled through the day. But we also didn’t want her to continue struggle in school.

We started her on the lowest dose possible but saw little in the way of change. But the next highest dose seemed just about right but we waited until she started the school year to finalize the amount of medication she took. We wanted to see how she did in a school setting verses just being at home in the summer. At our first parent-teacher conference, her teacher said she was doing great. Lexie’s reading had already jumped several levels and she seemed to have no problem paying attention.

Everything progressed well through the school year. The dose seemed the right amount to give Lexie the focus she needed without diminishing her bubbly nature.

Then she started third grade. From the beginning, she began complaining about not being able to focus. She would tell us when her teacher had to redirect her or when she would get in trouble. Comments from the teacher came home echoing the same thing – Lexie wasn’t paying attention in class.

Lexie has never been a fan of taking the medication. She doesn’t like that it sometimes makes her not hungry. She worries that she isn’t her same fun self on the meds. But she also finally has realized the benefits. She too knew that last school year she had less problems.

When I asked her if she thought the medication wasn’t working properly, she said yes. We talked about how much she has grown in the past year and how medications must change as you get bigger. She suggested that might mean she needed a higher dose. She then thought about it for awhile and even talked about it with her teacher who of course wouldn’t tell her what to do but did ask her questions to help her fully explore her options.

When we went to see the pediatrician, my eight-year-old calmly explained to her rationale for going to a higher dose. The doctor agreed it was a good thing to try so we went up one more level in her medication.

And so far it has been helping. Both Lexie and her teacher say she is more focused in class. So barring a drastic change in her weight at her one-month follow up appointment, it looks like Lexie was correct in asking for an increase in her medication.

Changing my daughter’s ADHD medicine due to insurance

Last June, my daughter began taking a generic version of Focalin to help her focus in school after she was diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). By July, we had increased the strength. We thought her behavior was much improved. Even the doctor noticed a difference at a follow-up appointment. We decided to wait for school to start to see if it was the correct dosage to help her with her classroom learning.

When we met with Lexie’s teacher for a parent-teacher conference in November, we learned that she was doing great in school and that even her reading scores had risen from last year. Her teacher said her dosage was perfect.

That was all well and fine until we received a letter that the Lexie’s medical insurance plan was being discontinued, and we would need to select a new one. When we looked at the plans out there, we were left with two choices – either select an insurance that had her pediatrician on the plan and NOT her specialists (ophthalmologist and allergist) or pick one that had the specialists but would cause us to lose the doctor she has had since birth.

If you have been following my blog, you will know that Lexie has had a variety of medical issues (situs inverses, eczema, allergies, polysplenia). Things have been going well, and I was eager to keep the pediatricians we knew and who knew her.

Before choosing our new health insurance, I made sure Lexie’s meds were on their approved list. She takes two antihistamines as well as the ADHD medication. I checked, and they were on the list. Yeah!

January hit and when I went to fill Lexie’s ADHD medication, the pharmacy said that the insurance wouldn’t cover that drug. They wanted her switched to Adderall.

It seems I had missed something very important when looking up coverage of her drug. Her medication had an “ER” at the end of it. That is for Extended Release.

Her new insurance would cover the generic Focalin but not the Extended Release version. They requested we switch her to Adderall Extended Release. Her pediatrician petitioned them to allow her to stay on the Focalin, but the insurance denied the request. While waiting for the decision, we had no choice but to put her on Adderall.

I warned her teacher about the change, so she could watch for any side effects and to let us know if the medicine wasn’t working as well as the previous one. Her awesome teacher sent me an email every day for the first couple of days. She noticed no side effects, and it seemed to be working fine.

That is good news and bad news. Good that she is responding to the new medicine but bad that we will no longer go back to the medication her doctor prefers. I guess all that really matters is that the medicine is working, and Lexie is able to focus during school.

 

Learning to have patience with my ADHD child

No one ever said parenting was easy. It helps to have a fair amount of patience with kids. But patience is not my strong suit.

Luckily for me, our first born, Jase, was a good baby and toddler. He was eager to help out, thrived on praise and generally a good boy. He lulled us into believing this is what our next child would be like.

Now while Jase is our rule follower, I like to call Lexie our rule tester. If you give her a rule, she will see how far she can go.
Originally, I attributed it to just her personality. While Jase was quiet and reserved, she was loud and crazy. Then in April of last year, Lexie was diagnosed with Attention Deficit Hyperactivity Disorder. People with ADHD can have trouble paying attention, controlling impulsive behaviors or be overly active. Their brains simply work in a different way.

To manage Lexie’s ADHD, we put her on some medication. It still amazes me to see the difference in her behavior on and off the medicine.  And while that calms her down and allows her to focus while at school, the medication has worn off by the time she comes home.

Lexie’s diagnosis of ADHD makes perfect sense now. It also explains a lot of her behaviors that try my patience. Often I would have to remind her dozens of times to finish a task such as cleaning her room or continually prompt her to stay focused on the book she was reading aloud. Now I understand that she wasn’t doing these things to annoy me. She simply can’t control herself.

Now I don’t want to excuse every behavior she has by blaming it on ADHD, but as I read up on it, I realize that many of the things that other parents, grandparents and well-meaning friends may think can be conquered with the proper parenting or discipline, just can’t. Her brain simply works in a different way than Jase’s or mine.

I am not saying that she can’t learn what is acceptable. Of course, she can. But her internal regulation is more prone to impulsive behavior.  Her mind goes a hundred different ways at one time. This made sitting in school nearly impossible. But with medication she can focus on her learning.

Lately, I have been losing my patience with her. Maybe it is because she was on winter break and home for two weeks. But suddenly, I feel like I am always annoyed with her, and I am sure it shows.

I need to learn to breathe deeply when she interrupts. I should be gently reminding her not to do that rather than being exasperated that she has done it again and snapping at her or using that tone which clearly shows my annoyance with her.

I need to learn to let go of my frustrations with her. I need to base my expectation on her attention deficit-influenced behavior. I should expect that I will need to remind her often to do something. And that likely she will stray from her task if not reminded.

Just the other day, my husband asked her to pick up her toys in the hall. She made two trips to her room with toys before she got distracted by some other toy in her room. Time for a deep breath and a reminder to finish the job. But often we end up raising our voice and wondering why she didn’t do as we asked.

One tip I have seen often – whether your kid has ADHD or not – is to pick your battles carefully. Children with ADHD often have messy rooms. While I am not going to allow her room to become overrun with toys and laundry, I am not going to waste my time trying to get her to have everything in its place. I have decided it is enough that you can walk to her bed without stepping on a Lego or some other small item. I would rather concentrate on her academics rather than stress over her leaving her shoes in the middle of the floor (again).

I am hoping that realizing Lexie IS different and cannot control these behaviors will allow me to regain some of my patience with her. Re-framing my thinking to what she can and cannot do should lessen my frustration. So from now on, I will take time to breathe, relax and collect my thoughts before responding to Lexie’s behavior.

Top Parenting Posts from 2015

As the new year begins, I wanted to take this time to highlight some of my parenting posts from 2015. If you missed out on these and want to read more, simply click the link to see the complete post.

Making family time a priority

It is easy throughout the year, and even more so during the busy holiday season, to be preoccupied with getting your list of chores and tasks done that you forget to take the time to stop and really just enjoy your family. (To read more…)

The necessity of Date Nights (or spending time together) for parents

Marriages take work. No one tells you that when you get married. There are compromises and fights along with the good times. And one thing that a couple needs to do – whether they have kids or not – is to continue dating. (To read more…)

Dealing with childhood anxiety

Our rule-follower, Jase, is also our worrier. When we announced this summer’s vacation would be a cruise, he worried the ship would sink. When we went to a friend’s informal wedding reception, he worried about whether kids his age would be there. I knew our friend’s son would be there but that news didn’t reassure Jase, and he seemed uncomfortable with the gathering as we knew very few people there. (To read more…)

Discussing strangers, drugs and fire safety with the kids

Drugs, stranger danger, bullying, inappropriate behavior, sex, what to do in case of a fire (or other disasters) – there are a multitude of topics parents should discuss with their kids. (To continue reading…)

Personality trait or attention disorder?

Lexie has always been full of energy. Because of her horrible eczema when she was little we often indulged her – allowing her to be a little more rambunctious than her brother. She was so uncomfortable all the time but always a happy girl. But getting her to listen and follow directions has always been somewhat of a chore. (To continue reading…)

Starting ADD medication

I wrote back in March that Lexie’s teacher was concerned that she might have an attention or focus problem. I brought it up to Lexie’s pediatrician at her 7-year-old checkup in April. After a few basic questions, she gave us the paperwork to have her assessed for ADD or ADHD. (To continue reading…)

Dealing with Road Rage

There are many things that I don’t understand in life and one of them is Road Rage. Oh, I am not saying I have never been annoyed by another driver or waved my hand at them as I mutter a bad word or two over their stupidity. I am talking about the serious Road Rage that leads to someone beating another person or shooting at them. (To read more…)

Why doesn’t the tooth fairy and Santa bring equal gifts for all?

“Madison gets a toy from the tooth fairy. I hope I get one too,” Lexie says as we tuck the miniature yellow tooth chest under her pillow.

“I don’t think so,” I reply. “Our tooth fairy brings you money. Madison’s tooth fairy can bring her toys if she chooses.”

“Mom, there is only one tooth fairy.”

It is a predicament that every parent faces. Kids talk. They talk about what the tooth fairy brings them. They talk about what Santa brings them. And often there is a discrepancy between what my kid gets and the other kid. (To read more…)

Leaving the kids home alone

Last week, I wrote about letting my son (age 9) walk home by himself and how so many people seemed astonished by that. So I guess, I shouldn’t mention to those same folks that I have let him stay at the house without adult supervision. (To continue reading…)

Two indoor “snow” activities for the kids

We don’t get much snow here in San Antonio. It might snow every three or four years, and even then it is never enough for the serious childhood snow play that I remember from my youth.

So whether you live in a snow-free climate or you just don’t like going out in the cold, here are two snow activities that you can do from the warmth of your house. (Click here to find out about these two awesome ideas!)

 

And here is to many more wonderful parenting post in 2016!