I have a little girl age 7 whom is severly ADHD and has sleep insomnia.She is on concerta 36 mg and ritalin 10 mg 2 times daily and clonidine 0.3 mg and 50 mg of trazadone for sleep which the pshy doctoe just increased her trazadone to 100 mg.Is it just me or do they have her way to medicaded?She only weighs 43 lbs soak and wet.We have a 350 doctors apt today because she is still not sleeping been up since 2 am like every other day.Dont make any sense.It was brought to my attention that maybe she could have a undx breathing problems,could this be so?Please give ur input if u can,thanks so much.I will let you all know what the doctor says today.


Sandra

The only breathing problem I've heard of is Sleep Apnea.

A person with it usually goes to sleep fine....then ends up having trouble breathing during the night and are completely unaware of it. They wake up in a state of distress because it actually causes a certain amount of shock to your body.
In that state it's hard to get back to sleep.

in addition to looking into this you might want to make your daughters room hypo allergenic. I think that's the term.

She could actually be allergic to something in her room that is causing the distressed condition.

To find out more read: Allergies and the Hyperactive child.
It could be something as simple as dust mites in the carpet or something she eats......to as complicated as a combination of food items and external exposure to things.

Some things you can do right away without reading anything is go out and buy her a new set of sheets and a hypo allergenic pillow.

Wash the sheets in perfume and dye FREE detergent and don't use any fabric softener or drier sheets or anything else. Let her sleep on JUST that and remove as much from her room as possible. Like stuffed animals and things that can easily hide allergens.

Sleep apnea is what they (is it the doctor who suggested a breathing problem?) are refering. What happens is a person stops breathing during sleep, for various reasons, and ends up gasping for breath when the body's autonomic processes kick in and force a breath, which pretty much wakes the person up - or almost wakes them. The result is that the person never gets any deep sleep - which you need to function correctly. The symptoms can be like ADHD - lack of focus and concentration....
I could be wrong, but I don't think apnea is common in children.
Does your child have trouble falling asleep or staying asleep - does she wake many times during the night? Speaking in huge generalizations here, but people with apnea find it easy to fall asleep, they just don't stay asleep, and they don't feel rested the next day. My mother has apnea and she thought that she was getting enough sleep, from a time perspective, but in reality she was waking dozens of times a night and not realizing it. It's quite common in people that are older and obese.
Many ADHD people find sleep a problem. Sometimes it's "racing" thoughts that cause the problem - thoughts, worries, or whatever, racing through your mind, that you can't stop. I can tell you from personal experiance that this is a nasty type of insomnia - when this happens to me, there is no way I can sleep without some kind of sleep medication. I have heard of people who find that a small dose of stimulant helps them sleep because it can help with the racing thoughts.
Has your daughter always been a poor sleeper? Has the Concerta/Ritalin made it worse? or better? I gather the problem is that she falls asleep (with the help of the trazadone) but then wakes at 2 am and can't fall back asleep? Has this been her pattern of sleep for most of her life?
It's impossible to say if she is "over-medicated" since it all depends on the person. There is no such thing as a "normal" dose - there may be an average, but it's meaningless because there is so much variation. Some people have metabolisms that "chew" up chemicals in the blood stream very quickly, so they need larger doses. The way to judge is by what the medication is doing to the child at that dosage.

Gregster
Thanks for the wonderful post.I have sleep apnea,im supposed to use a c-papmachine/mask but i do not like it cause i feel trapped.My little girl has always had a sleeping problem but i do notice that it is much worse with the concerta.I just do not know what way to turn.The trazadone makes her fall asleep within like a hour but within a few hours shes back awake tearing down the house.She gets into EVERYTHING.Lastnight it was a bottle of blue wash out hair die she made like 5 of her porclein dolls hair really pretty,lol.She gets into things like comet,soap,stuff like that.Doesnt eat it just plays in it.I do not understand.So needless to say mom sleeps with one eye open at all times.
I just do not know what to do anymore,i may be wrong for this but it seems like most of these doctors just wanna push the medication without study into a person.I mean come on my little girl is 7 weighs 43 lbs soak and wet,and she is on concerta 36 mg and ritalin 10mg 2 times daily and clonidine 0.3 mg and trazadone 50 mg for sleep.


Thanks again!!!


Sandra

Sandra,

Since speaking with you this morning I have been doing a lot of research on sleep. I believe I found some sites that may offer you a lot of practical advice, information and help if not you may kick me in the morning.

The Sleep Site (http://www.thesleepsite.com/) was really helpful and we are doing a lot more reading since Koda has stretches were he will not sleep as well.

Sleep Foundation (http://www.sleepfoundation.org/)

Sleep net (http://www.sleepnet.com/)

Stanford Education (http://www.stanford.edu/~dement/)

Most the sites have sleep journals available and tell you how to go about starting one to better arm yourself for your daughter's next doctor appt.

Good luck and keep us posted.
Cherity

Thanks so much Cherity,i have a pt in the am with her doc as well and i will let you all know what they say.Thanks for everything!!


Sandra

In my opinion, although Im not expert, thats alot of meds for a 7yr old at that weight. 36mg given after 9 am for my son gives him a hard time falling asleep at 9pm. On busy days we give him a booster but no later than 4pm. Otherwise, he will have a very hard time falling asleep. Im sure you have tried lots of different things, but how about an exercise regimen? I find that if my son stays active, and I mean serious activity, like basketball for an hour, he will be more apt to crash early. Also a very strict evening routine might help, with calming activities before bed.

Hope you find your answer