Somnolence

[miles2go]

difficult child is supposed to be BiPolar (BP) but this pattern is more or less throughout the year, intensifying during the allergy season, which around here, pharmacists say, is year-round.
He's is manic when he's up at 5am until about 9am then starts getting more tired and by noon he's can barely stand up straight and is very irritable. Fell asleep at school the other day. Yells at staff. Refuses to do work at school and at home, and falls asleep by 6 pm. Won't do the catch-up work in the morning either, "but it's boring, dad!"

To me this all is so related to his fatigue -- I used to just think that his brain runs so fast for the first few hours of the day that it just tires him out, but -- has anyone see anything like this?

psychiatrist says that if this were from Abilify then it would not happen before he gets his pill after dinner.

difficult child -- 9 y.o. boy, BiPolar (BP), Abilfy 15mg, Intuniv 4mg
Me - single dad, about 50
+ assorted easy child kids and cats

 

[Wiped Out]

My difficult child is somewhat similar (especially the last couple of months). Once up in the morning he is extremely manic-like until about 10:00 in the morning. He often is falling asleep at school around that time for about 45 minutes. However, he makes it through his afternoon somewhat less manic. He is getting plenty of sleep at night (thanks to his medications because otherwise the boy would not sleep). He also refuses to do much of the work. What little work he does bring home, most of the time he doesn't do. Still, I believe much of this is due to his bipolar but, in my difficult child's case, I think some of his fatigue is due to the medications.

 

[Shari]

Wee was a lot like that last winter. he slept almost every day at school. however, this year, his teacher is doing a lot more to engage him and modify his work to be multi-sensory and he's only fallen asleep twice this whole year. i now think he was just not engaged well last year.

 

[TerryJ2]

Miles2go, does your psychiatrist specialize in children with-bipolar? Because he may be looking for a horse instead of a zebra. I don't like it when doctors make assumptions based on general statistics. FWIW, you could try a different medication, or try giving it to difficult child at a diff time of day. Use a Saturday, for ex., and give it to him in the a.m. and see what happens. It's your kid.

 

[miles2go]

Terry, I d be a lot more dubious about the BiPolar (BP) diagnosis if mania, rage etc wasn't more obvious in his unmedicated mom, and in her lineage with family violence, rage, alcoholism, suicide. psychiatrist questioned me about what time difficult child gets his Abilify, and since it's arounf 5-6pm, and fatigue starts earlier, he ruled out a side effect. We also had his tonsils/adenoids removed, trying to help quality of sleep; snoring's gone and that's about it.
If difficult child's weight continues to push up, psychiatrist will switch him to geodone and we'll see what we'll see.

 

[tiredmommy]

Is he treated for allergies? Does he have asthma? Does he ever have a dry little cough after a cold has cleared up? His pattern sounds a lot like Duckie.

 

[miles2go]

Reducing Intuniv from 4mg to 3mg seems to have made a big difference. He still sleeps from about 6pm to 5am but is a lot less lethargic during the rest of the day. Go figure.

 

[miles2go]

well not really. The improvement lasted only a couple of days. Since then we split up his 15mg Abilify into 5mg in the AM and 10mg in the PM and not much difference. Now psychiatrist is reducing Intuniv to 2mg and after a couple of days no improvement really -- exhausted and cranky starting about noon, asleep by 6pm. I truly have no other approach to this than to consider raising Abilify -- he is very "up" as the day starts (about 5 am for him) so that getting tired and irritable by 10am-noon seems unavoidable without tamping that mania down. Today was no fun at all.

difficult child -- 9 y.o. boy, BiPolar (BP), Abilfy 15mg, Intuniv 2mg
Me - single dad, about 50
+ assorted easy child kids and cats

 

[HaoZi]

I have seen a lot about BiPolar (BP) medications needing to be tweaked for allergy season. Have you checked into if he can take something like Claritin non-drowsy for his allergies?

 

[gcvmom]

Is it possible he's not eating well enough in the morning so that his blood sugar is bottoming out by 9am? Does he get enough protein in the morning, or is he like my difficult child 2 who would rather have sugary high carb stuff?

Have you considered trying melatonin to see if that helps him get a more restful sleep? Our psychiatrist and pediatrician have declared it safe (it's either a 2mg or 3mg dose in the OTC brands -- can't remember) for both my difficult child's as well as my husband. I didn't notice it helping my difficult child's too significantly, but it did help husband a bit. ANd some people have had noticeable improvements in sleep with it.

 

[miles2go]

thanks for reply;I looked into allergies last season,
and nothing worked, claritin included.
Now after tonsils/adenoids gone he breathes fine,
no snoring. Increasing dose may be the thing to do,
though no complaints from school. This weekend
one meltdown after another.

 

[HaoZi]

If I recall, with springtime allergies then usually back the dosage down a little because the mania goes up naturally in the springtime anyway. Not sure on other seasons, but talk to doctor about other possibilities. My kid got some relief with those breathe-rite strips, but the kid ones are too small and the adult ones are too big on her, so she only uses them when she has to.

 

[miles2go]

Ever since he got on Abilify he eats way more than enough in the morning, noon and evening. His breakfast this weekend has been a bowl of chicken chow mein and he probably has gone for seconds before 9am. He goes for carbs and fat before sugar, although he'll go for sugary cereals as well. A few hours on youtube before I get up might contribute to irritability and fatigue, good lord help us all.
Haven't tried melatonin. He seems to sleep ok, 7pm to 5am or so.....

 

[HaoZi]

Good lord, how do you get him to sleep so much?! Mine runs on about 1/2 to 3/4 that much sleep!

 

[miles2go]

Yea I guess I should count my blessings. The allergy is back I can hear it.
Man the weight gain is hard to deal with; I guess it's a separate thread.

 

[HaoZi]

There's a thread on medication weight gains around here somewhere...

 

[Marguerite]

I'm wondering if the mental effort of his life is so all-encompassing, he can only cope for a few hours before exhaustion sets in.

Marg

 

[miles2go]

yea HaoZi I remember seeing it, don't remember if anything useful came out of it -- when his manic energy is coupled with hunger for a third breakfast, all have to stand back; I can only see minor adjustments (size of the portion etc) possible.
Marg, you bet -- before he is tired (and for a while after) I can hear his brain flying with everything from laws of universe to the latest manga garbage. I wonder if a dose increase is in order even if he is not getting in trouble in school....

 

[HaoZi]

You could take some advice from the diet people: fiber supplement 15 minutes before meal. Just a thought. I've seen the medication weight gain on my kiddo, I know it's distressing.

 

[Steely]

My difficult child was like this his whole school life. Well, it was not the sleepy part so much, as being alert and stable in the mornings, and then falling apart in the afternoons. It was more behavior based than physical, but yet, who knows which comes first, right? Physical or behavior? In hindsight, I wished that I could have gotten the Special Education dept to mandate half days for him, because he just could not do more than 1/2 without melting down. Do you think his sleeping is a coping mechanism? Instead of acting out, he is sleeping?

I am also interested in the seasonal part of bi-polar and medications. I always knew this happened with Matt, spring was the worst, followed by fall. What are the experts saying as to why??? And what helps?