Sleep Issues, Again

Charlie (yes) walking on a warm spring day  Be careful what you wish for, the saying goes.

Charlie woke up just before 5am yesterday and as I heard him clomping into the shower I thought, well that's later than 3am.

For the past couple of years, one of my recurring complaints has been the difficulty of rousing Charlie in the morning and getting him out of bed in time for the school bus. Charlie being able to wake up earlier and get himself ready for school: How great that would be, I thought. 

For a time Charlie had been falling asleep around midnight. Melatonin and strict adherence to a structured bedtime routine seemed to solve the bedtime problem for a time, though we suspected the former played a role in rendering Charlie very groggy in the morning. A new problem became getting him out of bed and much energy was expended in devising ways to get him out of bed on his own. While carrying and gentle tugs had helped to get Charlie out of bed, these became not only ineffective, but really annoyed Charlie for reasons that seemed obvious enough to us: Who wants to be prodded and pulled at, especially while you're just coming to consciousness?

We tried alarm clocks, music (CDs and the radio), turning on the lights and opening all the blinds. These all provided occasional and middling success and too often the day began in yowling and tears as Charlie was rushed to the bus. It certainly didn't help that the year Charlie started middle school (and much earlier than he'd ever had to–school started at 7.45am) was the year he had the most unsympathetic bus driver ever (I know everyone has their problems and issues, but still). 

And now Charlie's sleep issues seems to be of the opposite sort now. School starts later and he no longer has to catch a bus as we're driving him; for a time, when he started at the Big Autism Center, he was going to bed around 9 or 10pm and waking around 7am. That was a pretty perfect schedule, I realize. But there were a few days with 4.51am and the like wake-ups. Sometimes before or during Spring Break he started going to sleep much later (11pm) or much earlier (7pm) most days and, as recently noted, waking at very early times (2, 3, 4 am) and ready to hop in the car and go to school. The switch to daylight's saving time might have something to do with it; Charlie's always had trouble adjusting to moving clock's numbers around. 

Usually, though, Charlie's been able to get back to a more regular schedule after a few days, and his disrupted sleep hasn't dragged on for days as it has been. There's plenty to speculate about why this new pattern: A growth spurt and the general physiological changes of adolescence? Difficulties in regulatingenergy levels, so somedays Charlie is exercise exercise exercise and other days, he crashes? 

The sun was starting to shine when Charlie put on his shoes at 5.30am and he and I went out for a walk. It was quite cool; Charlie still refusing to wear even a sweatshirt, I brought along a hooded one, just in case. He moved slowly and when I draped the sweatshirt over him, he didn't object. At home, he was happy to sit on the beat-up blue couch and listen to Disney songs on the laptop, and to eat the pack of sushi I had put into his lunchbox. (Resulting in me having to make him something else for lunch really, really fast.) 

He went swimming at school in the afternoon, dumping his swim bag into the trunk when Jim and I picked him up. We then had a different sort of afternoon (good thing, after so many have seemed to all be the same of late—personally, I was starting to feel that most blog entries were "we went for a walk and a ride and then another walk and then the computer and then a walk….."). 

We had first to drive in a westwardly direction to get some errands done and then Jim made haste to drive into Jersey City, as he needed to be in Manhattan to speak at a 6pm event. We were driving against commute traffic and got there quickly, dropping Jim off near Journal Square. Charlie asked for his longtime favorite—Vietnamese summer rolls—and I picked some up. He ate them in the car as we drove back over the Route 1 & 9 truck bridge (amid a lot of container trucks) and then—as the rain came down and we saw a lightning bolt—sat, sometimes talking ("Versha!" "Tara, Blake, Julie…": names of former therapists and other old friends) and other times just listening to the jazz on the radio, in bumper to bumper traffic. At home, after hearing some more music (more Disney—I'm starting to hear "Can You Feel the Love Tonight" and "Something There" buzzing in and out of my thoughts), Charlie asked for bed. He was asleep by 7pm.

Boding another 4am wake-up, at the latest. 

Not that I'm going to start wishing Charlie might having more "normal" hours. I'm going to be a little careful what I wish for this time around.

Charlie having gone to sleep so early Wednesday night, I found myself sitting down to dinner and reading the news, and—talk about 'timely'—found this New York Times post on Sleeping (or not) by the Wrong Clock. Particularly interesting is a description of taking a "minute dose" (much, much smaller than Charlie has been taking) of "sustained release" melatonin about five hours before bedtime:

The mini-dose does not act like a sleeping pill, so you spend the evening awake and alert. Rather, it communicates with the circadian clock in the same way as morning light exposure, shifting internal night earlier.

I've thought that melatonin does not seem to be helping Charlie to sleep as it once did. I'm always leery of just giving larger and larger amounts of anything in the hope of increasing its effects. But there's something to, um, sleep on here.

11 Responses to “Sleep Issues, Again”
  1. Shannon says:

    I was wondering about today’s 5:30 AM EST communication from you. Hope things regulate soon, because a dependable sleep cycle, that is a precious thing.

  2. Jennifer says:

    I know this sounds strange, but I’m just going to put it out there.
    Does Charlie take a regular old multivitamin? For some reason, I have horrible insomnia when I don’t take one, so even though I know it’s better to get your nutrition from fruits and veggies, I still do.

  3. Regina says:

    “(good thing, after so many have seemed to all be the same of late—personally, I was starting to feel that most blog entries were “we went for a walk and a ride and then another walk and then the computer and then a walk…..”). ”
    And if it did? After all, it’s life, not a short story or novel. I imagine that our daily diary would be pretty boring…we got up, did our teaching thing, took a walk, went to the store, made dinner, watched TV, went to bed. I kind of cherish the boringness which indicates a routine and predictability.
    Are you keeping a sleep diary, and kind of an IS/DOES description? Are there any patterns that you can see?
    Hope that things settle down into a pattern that works for all of you.

  4. emma says:

    Interesting about the mini dose melatonin and light therapy. Have you ever seen a sleep specialist?
    Hm, over-the-counter melatonin is a supplement, no? Therefore not controlled as “drugs” are, I have heard from others of varying qualities and effects according to brand. Don’t know if this is true or not, but may be that plays a role for Charlie?
    I like reading about your travels and adventures, and the feel of Jersey as you describe it.

  5. autismvox says:

    Up right now…….. Charlie has been taking a multivitamin.
    Trying to think of patterns; I suspect some of the medications Charlie is on may have something to do with the changes in his sleep.

  6. MATeacher says:

    Some food for thought (or sleep)
    One of my students is having similar sleep issues to Charlie, and they think it is caused by a recurrence of his Sleep Apnea. Might be worthwhile to get Charlie tested.

  7. autismvox says:

    Thanks for noting that, will mention it to the pediatrician!
    I was able to get him to go back to bed by 2.30 and then he was asleep (fully) about an hour later. Woke up by 8 and made it to school in time for a 9.45am field trip.

  8. Niksmom says:

    Wishing you (and our family) some sleep. Luxurious, refreshing, fall-asleep-and-wake-at-near-“normal”-times sleep!

  9. autismvox says:

    Glad you like reading about our ‘adventures’ in Jersey; it’s my favorite sort of post when I write about them. Have been giving Charlie the same brand of melatonin and the same dosage for awhile; I’d prefer not to up it, if possible–so many things already to give him.

  10. Louise says:

    This is going to sound like a weird question, but have you ever considered brain entrainment recordings, the ones that use binaural beat patterns to induce specifc brain wave patterns? They are usually played along with soothing music or environmental sounds. Even ambient noise is used. You can get recordings to induce delta waves, which are those found during sleep.
    I can email you you an mP3 if you are interested. They work very well for me.

  11. Hi Kristina,
    You’ve probably already been down this road, but — Clonidine? This has always helped Nat sleep regularly and it has no side effects. Melanonin was inconsistent for us, too.

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