I am at my wits end and seriously need direction re: a non-sleeping 9yo

[Janna]

My dd, 9yo, has been having difficulty sleeping since Christmas. Last night she (and thus, I) didn't get to sleep until nearly 4am. I am absolutely at my wits end. Let me give you a brief background of what the deal has been since Dec.

Sometime in Nov. I took her into the Dr. because she had been having some allergy symptoms for awhile and they weren't getting better. When she was there, it was determined that she actually has the beginnings of asthma. She was given Singulair as well as Nasonex because of swollen nasal membranes and stuffy nose. We had a follow up appt. a few weeks later to see how the medicine was doing. It wasn't making a difference in her breathing so the Dr. added Pulmicort - a preventative inhaler. About 4 weeks later, just after Christmas, she started having trouble going to sleep and/or staying asleep.

At first, we thought it was because she had received a Nancy Drew PC mystery game for Christmas and she was overstimulated with that. She loves Nancy Drew and when not playing the computer games, she's reading the mystery novels or thinking about the games. So we stopped the computer play after a certain time in the day, and we limited her actual playing time to 30 min. That didn't seem to help. So then I thought it had to do with a new baby on the way. She was the one who was so upset when we told her we were going to be having another one. And then when she found out it was a boy, she was nearly devastated. But no matter how much her dad and I talked to her, she kept saying that it wasn't that and she was fine with the idea of a new baby brother now. When her inability to go to sleep until after midnight continued, I thought it must be the medicine.

She had another follow up in January to see how the Pulmicort was going. I mentioned to the Dr. her sleeping problems and asked her if it could be the medications she was on. She said that she wasn't aware of insomnia being a side effect with them and highly doubted it was the medicine. So then I left dd in the room with the Dr. alone to talk, thinking maybe it's something in her mind that she isn't comfortable telling her dad or me. But the Dr. said she genuinely didn't seem to know why she couldn't go to sleep. She just said, as she's told us, that it's hard to "turn her brain off". So the Dr. suggested we give her Benedryl for about a week to kind of force her body to sleep and that would put her back into a regular sleeping schedule. She gave additional suggestions, like reading before bed (which she does anyway, and we let her read as long as she needs to when she can't fall asleep) or before getting into bed, taking some time to write in her journal. She loves to write in her journal, but she doesn't do it at night, so that was an excellent suggestion - get her thoughts out on paper and then go to bed with a free mind.

For the first couple of days, the Benedryl and journal writing seemed to work. We were so relieved. But then after maybe the 4th day or so, she was back to not being able to sleep. We continued giving her the Benedryl to her, past a week, and it continued to not work, so we took her off of it.


I don't know what else to do. We read to her at night, and then let her read as long as she wants. Dh will sing to her, we talk to her, trying to see if there's something going on, but there truly doesn't seem to be. We pray with her, we instruct her to pray and read her Bible. We talk about peaceful thoughts before bed, trying to set a peaceful scene in her mind to concentrate on, we've tried music, changing her temperature in her room, changing what she sleeps in...you name it. When she came in at 3:30 am to tell me she couldn't sleep this morning, I just about had it. This has GOT TO STOP, but I don't know how to make it!

I talked to my mom about it back at the beginning of January and she wondered if it was hereditary. My mom has always had sleep problems - she and my dad haven't gone to bed at the same time since I don't know when. I honestly don't know how they conceived 3 children, LOL. Since I can remember she has stayed up, drinking wine, watching M*A*S*H, doing bills, listening to music until she would fall asleep on the family room floor. She still does this. She said her dad was the same way, but she attributed that to being in WW2 and the trauma of that experience.

DD's next appointment (again a followup, but now on the sleeping) is this Tuesday. I know she's just gonna give her a prescription sleep aid. I don't want that. I want to know what is causing dd to not sleep.

I am so frustrated I could cry (but that's me being tired, too). This not only affects her, but it affects me too. I don't feel like my dh and I can be totally relaxed to have good, private conversations because I know she's up. Even though she's in her room, she still continues to come out for water and then to go to the bathroom and besides, just knowing she's up makes me uneasy.

What else can I do? Please, offer up anything. Just be gentle because I too am exhausted and fairly emotional.

Thanks for reading.

[Cadam]

I would take her off the inhaler. It seems that wether it is a known side effect or not the meds are keeping her up. Other than that Melitonin and telling her she is not allowed out of her room is what I would suggest.

[midwestbelle]

My mom had trouble sleeping at night for years. She went to a homeopathic type doctor and was told that her calcium was low and to take her calcium supplements at night. She said it has made a huge difference. I even started taking mine at night, but I never had trouble sleeping anyway. This may not be your dd's problem, but checking her vitamin regiment could help.

HTH

[Claire]

Even if insomnia is not a common side effect of these drugs, it could be a side effect in your daughter. I would highly suspect one of the drugs, or the combination of drugs, to be causing the insomnia.

I Googled "pulmicort insomnia" and came up with a few websites that mention insomnia as a possible side effect. It's not common, but it has been reported. Following is an excerpt from one website:

The following other adverse events occurred in placebo-controlled clinical trials with similar or lower budesonide doses with PULMICORT TURBUHALER with an incidence of ≥1% in the budesonide group and were more common than in the placebo group:

≥3%: respiratory infection, sinusitis, headache, pain, back pain, fever.

≥1-3%: neck pain, syncope, abdominal pain, dry mouth, vomiting, weight gain, fracture, myalgia, hypertonia, migraine, ecchymosis, insomnia, infection, taste perversion, voice alteration.

I don't know much about asthma, so you may want to ask others who have BTDT. However, since you mentioned your dd has only the beginnings of asthma, I would do some research on the internet to try to figure out if there are other approaches that would be better. I would be leery of using 3 prescription medications to control beginning asthma, but as I said I don't know much about the problem.....

[Adrianne]

If she sleeps late, this would contribute to the insomnia.

I would stop the inhalers as a test just to see.

After reading your post, I did some research on the internet and found a few sites that list insomnia as a side effect of Pulmicort. I believe it is a steroid which can cause insomnia and hyperactivity in some people.

I hope things get better for you Janna!

Adrianne

[Jean in Newcastle]

I'm going to get a reputation for being obsessed about possible food allergies but I would check to see if she has any. Food allergies (and environmental allergies too) can be a cause of asthma. It would be much better to treat the asthma at the source (if you can find it) than just with medication.

[Pajama Mama]

Is it possible that the drugs *together* are causing the problem? Insomnia might not be a side effect for only one but if she is taking Pulmocort, Singulair and Nasonex together it might cause a problem. It might be too much medicine for a 9 yod. When I first was diagnosed with Asthma I used the regular inhaler with Albuterol. I overused it when the asthma became worse and I was very jumpy and unable to sleep. I realize the meds aren't the same but maybe it's the same issue. Maybe 3 meds for a 9 yo girl is too much for her.

[Mx5]

My dd, 9yo, has been having difficulty sleeping since Christmas. Last night she (and thus, I) didn't get to sleep until nearly 4am. I am absolutely at my wits end. Let me give you a brief background of what the deal has been since Dec.

Sometime in Nov. I took her into the Dr. because she had been having some allergy symptoms for awhile and they weren't getting better. When she was there, it was determined that she actually has the beginnings of asthma. She was given Singulair as well as Nasonex because of swollen nasal membranes and stuffy nose. We had a follow up appt. a few weeks later to see how the medicine was doing. It wasn't making a difference in her breathing so the Dr. added Pulmicort - a preventative inhaler. About 4 weeks later, just after Christmas, she started having trouble going to sleep and/or staying asleep.

At first, we thought it was because she had received a Nancy Drew PC mystery game for Christmas and she was overstimulated with that. She loves Nancy Drew and when not playing the computer games, she's reading the mystery novels or thinking about the games. So we stopped the computer play after a certain time in the day, and we limited her actual playing time to 30 min. That didn't seem to help. So then I thought it had to do with a new baby on the way. She was the one who was so upset when we told her we were going to be having another one. And then when she found out it was a boy, she was nearly devastated. But no matter how much her dad and I talked to her, she kept saying that it wasn't that and she was fine with the idea of a new baby brother now. When her inability to go to sleep until after midnight continued, I thought it must be the medicine.

She had another follow up in January to see how the Pulmicort was going. I mentioned to the Dr. her sleeping problems and asked her if it could be the medications she was on. She said that she wasn't aware of insomnia being a side effect with them and highly doubted it was the medicine. So then I left dd in the room with the Dr. alone to talk, thinking maybe it's something in her mind that she isn't comfortable telling her dad or me. But the Dr. said she genuinely didn't seem to know why she couldn't go to sleep. She just said, as she's told us, that it's hard to "turn her brain off". So the Dr. suggested we give her Benedryl for about a week to kind of force her body to sleep and that would put her back into a regular sleeping schedule. She gave additional suggestions, like reading before bed (which she does anyway, and we let her read as long as she needs to when she can't fall asleep) or before getting into bed, taking some time to write in her journal. She loves to write in her journal, but she doesn't do it at night, so that was an excellent suggestion - get her thoughts out on paper and then go to bed with a free mind.

For the first couple of days, the Benedryl and journal writing seemed to work. We were so relieved. But then after maybe the 4th day or so, she was back to not being able to sleep. We continued giving her the Benedryl to her, past a week, and it continued to not work, so we took her off of it.


I don't know what else to do. We read to her at night, and then let her read as long as she wants. Dh will sing to her, we talk to her, trying to see if there's something going on, but there truly doesn't seem to be. We pray with her, we instruct her to pray and read her Bible. We talk about peaceful thoughts before bed, trying to set a peaceful scene in her mind to concentrate on, we've tried music, changing her temperature in her room, changing what she sleeps in...you name it. When she came in at 3:30 am to tell me she couldn't sleep this morning, I just about had it. This has GOT TO STOP, but I don't know how to make it!

I talked to my mom about it back at the beginning of January and she wondered if it was hereditary. My mom has always had sleep problems - she and my dad haven't gone to bed at the same time since I don't know when. I honestly don't know how they conceived 3 children, LOL. Since I can remember she has stayed up, drinking wine, watching M*A*S*H, doing bills, listening to music until she would fall asleep on the family room floor. She still does this. She said her dad was the same way, but she attributed that to being in WW2 and the trauma of that experience.

DD's next appointment (again a followup, but now on the sleeping) is this Tuesday. I know she's just gonna give her a prescription sleep aid. I don't want that. I want to know what is causing dd to not sleep.

I am so frustrated I could cry (but that's me being tired, too). This not only affects her, but it affects me too. I don't feel like my dh and I can be totally relaxed to have good, private conversations because I know she's up. Even though she's in her room, she still continues to come out for water and then to go to the bathroom and besides, just knowing she's up makes me uneasy.

What else can I do? Please, offer up anything. Just be gentle because I too am exhausted and fairly emotional.

Thanks for reading.

I would not stop a preventive medication without consulting the doctor.

Also, since your dd is 9, there's no reason why she has to announce to you that she cannot sleep. Give her acceptable things to do quietly. She shouldn't be allowed to disturb you unless, as is my rule, she's throwing up or bleeding ;)

Try melatonin. There are lots of different dosages per pill, so look closely at what you're getting. Also, there are no long term side effects that I know of for using a bit of Benadryl before bed.

[Karen sn]

Davis' Drug Guide for Nurses states insomnia and restlessness as side effects.
Doctors don't always read the side effects listed in the drug insert....did you keep your insert? The one that comes in the actual Pulmacort box from the drug company - because sometimes the print out from the pharmacy is abbreviated.

[Karen sn]

Jean in Newcastle - I totally agree with you. Diet before medications. The side effects of all the drugs for asthma are sad. Would rather treat the source.

[Unicorn]

My ds was on singular and pulmicort. He has been off the pulmicort for 8 months now. He definitely sleeps better now, however, he was never a sleeper, even as an infant! What time is your dd taking the meds? If she is taking pulmicort once a day- make sure it is in the a.m. If it twice a day, make sure the last dose is early in the evening, like right after supper, not too close to bedtime. You can also move the singulair to a.m. if she is taking that at night.

I also have a 9yo dd who hasn't slept since X-mas. She is not on any meds, but we have caught her watching t.v. at 4:30 in the morning. Maybe it is some kind of hormonal thing! She reads for hours every night before bed as well. I hope things get better for you both soon!

[NicksMama-Zack's Mama Too]

I would watch the clock radio numbers flip (pre digital dino here). Many nights I never slept. My youngest has the same problem. We have had much success with Melatonin. He takes 5 mg. He used to be real grumpy due to lack of sleep - now he's much better. He know it helps his brain turn off, so he takes it without any reminder. I take it too and find I get a really good night sleep. I used to take Excedrin PM to help me sleep - but I'd feel like I had a hangover the next morning (foggy brain). I don't have that side affect with Meletonin.

hth
kd

[JudoMom]

I don't feel like my dh and I can be totally relaxed to have good, private conversations because I know she's up.

First, I can't believe that being as tired and pregnant as you are you're still willing to have good, private conversations with your dh. Unless of course you actually meant talking....I know when dh & I "talk" in our bedroom, there's not much talking going on :p.

But seriously, I'm sorry that y'all are still suffering with this. I would be inclined to take her off the inhaler to see if that would help. If not, I would be tempted to take her off all the meds just to see if that helps. If she tends to have trouble turning her brain off, the meds might just be enough to push her over the edge from "having a bit of trouble" to "being completely unable to turn it off". If it doesn't help you can always start her back on the meds again, and at least you'd have that ruled out.

Not sleeping is not fun, and I'm sorry that this is going on. Do you think that your dd not sleeping could be interfering with your sleep enough and that's why you're so tired?

I hope you find an answer soon. I'll be praying for you guys. (((Janna & dd)))

[unsinkable]

I am so frustrated I could cry (but that's me being tired, too). This not only affects her, but it affects me too. I don't feel like my dh and I can be totally relaxed to have good, private conversations because I know she's up. Even though she's in her room, she still continues to come out for water and then to go to the bathroom and besides, just knowing she's up makes me uneasy.

What else can I do? Please, offer up anything. Just be gentle because I too am exhausted and fairly emotional.

Thanks for reading.

Put a water bottle in her room. Tell her not to disturb you. Let her read, write in her journal, whatever she wants except disturb you.

For you, I'd do anything you need to do so you sleep soundly. Exercise during the day, relaxation techniques at night, ear plugs, white noise machine.

Your reaction to her being awake seems so intense. Maybe she is going to be a person who needs very little sleep.

unsinkable

[Tracey in TX]

Inhalers are stimulants--at least the ones DS and I use. I have a wicked reaction to stimulants; can't sleep for 2 nights w/ certain types.
Discuss the possibility of another med for the RAD/asthma and try to get her off the current meds.
Good luck!

[Janna]

If you all don't mind, I multi-quoted and am going to answer mainly in one message. I appreciate more than you know the help and suggestions you've given. Hopefully, these will be better answers for you. Otherwise, keep the suggestions coming. Oh, and by the way, a number of you suggested meletonin - what is that and where can I find it? Thanks!

If she sleeps late, this would contribute to the insomnia. I hope things get better for you Janna! Adrianne

She doesn't sleep very late at all. But that's probably relative. She's usually up around 8:30. This a.m. it was 9:30, after falling asleep at 4am. Thank you for your well-wishes, Adrianne!

I'm going to get a reputation for being obsessed about possible food allergies but I would check to see if she has any. Food allergies (and environmental allergies too) can be a cause of asthma. It would be much better to treat the asthma at the source (if you can find it) than just with medication.

Diet before medications. The side effects of all the drugs for asthma are sad. Would rather treat the source.

I completely agree with both of you. I hadn't thought of food allergies though. I just really want to find the source of all this - not just treat it. That's what is so frustrating and I know the Dr. is just gonna prescribe a sleep aid which will really bother me. I will keep the food allergy in mind to ask on Tues. at her appt. Thank you both!

It might be too much medicine for a 9 yod. Maybe 3 meds for a 9 yo girl is too much for her.

Yes! I have said this from the beginning to dh! I have told him that how can a child who has never been on anything, has only had 1 ear infection in her life, all of a sudden need 3 different medications? It has made me very nervous from the get-go. But she really noticed a difference in her symptoms. Ugh.

Also, since your dd is 9, there's no reason why she has to announce to you that she cannot sleep. Give her acceptable things to do quietly. She shouldn't be allowed to disturb you unless, as is my rule, she's throwing up or bleeding ;)

Try melatonin. There are lots of different dosages per pill, so look closely at what you're getting. Also, there are no long term side effects that I know of for using a bit of Benadryl before bed.

She has been told what are acceptable things to do and for many weeks she hasn't disturbed us. I think last night, being the latest she's been up (4am) kinda freaked her out which is why she came in. But I did say to her, "what do you want me to do about it? There's nothing else I can do to help you. You know the suggestions we've given you, we've taken you to the Dr. you're on medication. The rest is just up to you." I said it nicely, but she got the point. The Benedryl, we did use, but as I stated in my OP has stopped having an effect on her. It just simply doesn't help anymore.:confused:

Davis' Drug Guide for Nurses states insomnia and restlessness as side effects.
Doctors don't always read the side effects listed in the drug insert....did you keep your insert? The one that comes in the actual Pulmacort box from the drug company - because sometimes the print out from the pharmacy is abbreviated.

Karen, thank you. I did keep the insert. We have read it thoroughly many times and I have seen where it says it's a possible, but rare side effect, which is why I asked the Dr. if that was it. She said she highly doubted it but suggested we go from 2 puffs to 1 puff, and rather than at night, have it be in the am. So we have done that. However, with it being switched to the am, I don't remember to give it to her everyday. So actually, she hasn't had it in over a week. Therefore, I don't think it's the Pulmicort.

What time is your dd taking the meds? If she is taking pulmicort once a day- make sure it is in the a.m. If it twice a day, make sure the last dose is early in the evening, like right after supper, not too close to bedtime. I also have a 9yo dd who hasn't slept since X-mas. She is not on any meds, but we have caught her watching t.v. at 4:30 in the morning. Maybe it is some kind of hormonal thing! She reads for hours every night before bed as well. I hope things get better for you both soon!

See above to Karen - I've switched her to the am and one puff a day, but have been forgetting. That's so weird about your dd too! I hope it gets rectified with her as well. Thanks for your suggestion and well-wishes!

Put a water bottle in her room. Tell her not to disturb you. Let her read, write in her journal, whatever she wants except disturb you.

For you, I'd do anything you need to do so you sleep soundly. Exercise during the day, relaxation techniques at night, ear plugs, white noise machine.

Your reaction to her being awake seems so intense. Maybe she is going to be a person who needs very little sleep.

unsinkable

LOL, she does have a water bottle. She really doesn't disturb us. See above about last night being an exception for coming in to our room. It's just for me, knowing she's still awake. I think she refills her bottle and goes to the bathroom just for something different to do than lie there, kwim? And you could be right, and we've talked about that - about her possibly needing little sleep. I will talk to the Dr. about the hereditary possibility on Tues. Btw, what do you mean my reaction seems so intense? :confused:

Inhalers are stimulants--at least the ones DS and I use. I have a wicked reaction to stimulants; can't sleep for 2 nights w/ certain types.
Discuss the possibility of another med for the RAD/asthma and try to get her off the current meds.
Good luck!

I did talk to the Dr. about the Pulmicort and being a stimulant. She assured me that this was a preventative inhaler, rather than a treat as needed inhaler like albuterol, which are stimulants. This is definitely a steroid, which makes me nervous and I told the Dr. that, but she said this was one of the lower dosed steroids.

[Janna]

First, I can't believe that being as tired and pregnant as you are you're still willing to have good, private conversations with your dh. Unless of course you actually meant talking....I know when dh & I "talk" in our bedroom, there's not much talking going on :p.

Do you think that your dd not sleeping could be interfering with your sleep enough and that's why you're so tired?

I hope you find an answer soon. I'll be praying for you guys. (((Janna & dd)))


Actually, I really did mean talking because as you said, as tired and pregnant as I am...ahem...yeah that "desire" is completely vanished, LOL.

In regards to dd having anything to do with my being tired, no I don't think so. She knows to stay in her room and she knows all the suggestions we've given her as well as the Dr., and there's nothing we can do for her. Sometimes we'll hear her crying in her room because she wants to badly to sleep. On those days, dh will go in with her and sing to her or talk to her so I can go to bed. Last night though, she came in which was unusual. I think she was freaked out about it being 4am.

Thanks for the prayers. I covet them more than you know. Hey did you get my response to your retentive vs unorganized question? And how did co-op go?

[mooooom]

She's not on any meds though - which really sounds like it might be an issue with your dd. When I mentionned dd's sleeping issues with my ped - he said, "Her sleeping issues are only an issue if she is keeping YOU from sleeping." Great point, Doc. With this backing from my ped, I immediately issued a "Do what you like, but stay in your room and under no circumstances wake your parents rule?. Took awhile to get started, but now it works. She is up sometimes in the middle of the night, but she just reads until she manages to go back to sleep. I bought her one of those clocks that makes background noises - she uses this. She stuffs a blanket under the crack in her door, to keep other peoples' noises from waking her. She is 12 and has learned how to cope.

I do seriously wonder how she will ever make it in a college dorm though.

[LisaTheresa]

It can take a while for medications to build up in your system, so that's why it may not have affected her immediately. My niece takes ritalin and she was fine for the first few weeks on it and then she began to suffer from insomnia. Fortunately, her neurologist recommended using melatonin to get her to sleep and that has resolved the situation for her.

Anyway, I would talk to the doctor, but I would definitely want to do a trial period without the Pulmicort to see if that resolves things.

Hope it works out. I feel sorry for you and your daughter. It is a terrible thing when you cannot sleep.

Lisa

[cin]

Just one other thought. Is dd getting physical exercise each day?

[strider]

The meds might have started the problem, and now it's kind of a habit her body and mind are in. Also it takes a while for the meds to truly wear out of the body.

I would stop the pulmicort and then also treat her as if she has an insomnia problem to retrain her body out of the habit it has formed. You can google this or research. There are options such as putting her on a strict sleep/wake schedule--especially wake her up at the same time *no matter what* and not allowing her to sleep during the day *no matter what*--and other options like doing the same, soothing ritual each. and. every. time. she goes to sleep (something like warm shower, music, sleep).

[kalanamak]

(filler for too short a message)

[Cindyg]

It has been a miracle around here. My son has taken it every night for 4 years. It's the difference between no sleep with everyone miserable and a totally normally bedtime with a good night's sleep for everyone.

You get this at the healthfood store. Try a sublingual (under the tongue) because you can take a really low dose. My 4th grader takes .5 mg per night.

I've asked 4 doctors about this, and none had any concern.

Melatonin doesn't work for everyone, and it gives some people nightmares. My son reported nightmares one evening when he accidentally took a quadruple doze. But at a small dose, it is perfect for him.

Please try this before trying a Rx.

[Laura Corin]

Is she getting any exercise? With the asthma this may be difficult, but long (slow) walks might help. My 11yo and I both get very sleepless if we don't get enough exercise. Both my boys are sleeping like logs at the moment, having received in-line skates for Christmas.

Laura

[JudoMom]

Actually, I really did mean talking because as you said, as tired and pregnant as I am...ahem...yeah that "desire" is completely vanished, LOL.

In regards to dd having anything to do with my being tired, no I don't think so. She knows to stay in her room and she knows all the suggestions we've given her as well as the Dr., and there's nothing we can do for her. Sometimes we'll hear her crying in her room because she wants to badly to sleep. On those days, dh will go in with her and sing to her or talk to her so I can go to bed. Last night though, she came in which was unusual. I think she was freaked out about it being 4am.

Thanks for the prayers. I covet them more than you know. Hey did you get my response to your retentive vs unorganized question? And how did co-op go?

I did see your answer to my question, and actually laughed out loud before we left this morning. What do you think drove me to not restrain myself about your conversations with your dh ;)?

Have these meds kept the other issue at bay like you'd hoped?

[Christy B]

We are HUGE fans of Calms Forte for Children (and adults).

My 9 yo dd has always been a bit of an insomniac (like her mommy!) She, too, has trouble "turning off her brain". We have found the Calms Forte for Children (available at Walgreens and probably a lot of other drug stores) to be tremendously helpful. No brain fog in the morning.

Even if you eliminate medication, allergies, etc, as one poster mentioned -- the body can get into a "habit" of not sleeping, and that can be problematic.

Best wishes, I understand how disruptive it is to have a little one burning the midnight oil!