To let him sleep, or not?

[gcvmom]

I've posted before about difficult child 2's tendency to sleep a lot. He went to bed at 9pm last night and he's still sleeping (it's 12:30pm now). I woke him at 9am today to give him his morning Depakote, and I have to do it again in a minute for his afternoon Seroquel dose.

Part of his excessive sleeping, I'm sure, is due to the medication. Part of it may also be the bipolar disorder.

What I'm not sure about is whether I should just let him sleep as long as he wants on the days he doesn't have to be anywhere, or if I should try to keep him to a more normal schedule on the weekends and only let him sleep an extra hour or so? Am I doing him a disservice by allowing the oversleeping?

So bring on the feedback, folks!

 

[rlsnights]

Social rhythm treatment for BiPolar (BP) would tend to say he should keep to the same sleep/wake schedule every day - regardless of school/weekend etc.

 

[GoingNorth]

I've had sleeping problems for years and am, in fact, on the same medications as GVC's son.


Bipolar people have to employ what is called "sleep hygiene". It is imperative that sleep and wakeup times remain the same no matter the day.

 

[flutterby]

difficult child 2 does this. He'll literally sleep for days, waking only to eat and go to the bathroom. And you can't keep him awake no matter what. I've seen him fall asleep standing up.

They are now trying welbutrin to see if it will keep him awake. When he was on Vyvanse, he didn't sleep like this, but the current psychiatrist doesn't want to rx it unless absolutely necessary.

 

[crazymama30]

husband has that problem, but usually after some pretty intense insomnia. He did not go to sleep this morning untill after 5am, and is still sleeping last I knew. He will probably sleep untill 5pm or later. His medications are way off.

I try to keep difficult child on a more regular schedule to hopefully prevent that. psychiatrist encourages it, and difficult child goes to bed at the same time (within an hour) unless we have a special occasion. He does get to sleep in on weekends as I work, but it is rare that he does.

I would try to get him to wake up. Open the curtains, turn on the TV, turn the heat down, cook something that smells good, whatever you can do to make him want to get out of bed.

Good luck. I hate it when husband does this. It drives me bonkers;

 

[susiestar]

I did that as a teen. I started working 3 days a week afterschool and on Saturday at age 14. vary laid back. By age 15 I worked after school every day and all day Saturday. I slept on Sunday. Period. I would get food and go back to bed a time or two. Maybe read a book, but that would be the MOST I did. I would just be so exhausted that my eyes wouldn't stay open.

Teens have strange sleeping habits, in my opinion. What do his doctors say about all this sleeping? Is he mean when he wakes up and grumpier through the week if you get him up and keep him up, or is he nicer, less argumentative if you let him sleep?

 

[smallworld]

I agree with GN -- sleep hygiene is important for kids with mood disorders. You should think about getting your son on a regular sleep-wake cycle.

My son's Residential Treatment Center (RTC) takes this a step further and adds intensive exercise (1.5 hour every morning) and three healthy meals every day. Wake up is 6:30 am. Lights out is 9:30 pm. We're trying to do something similar at home, although our girls do exercise in the afternoon because of early school starts.

My son also does very well on Wellbutrin XL, which is taken in the morning and known as a stimulatory AD. It's the first AD that has not made my son manic (and he's reacted poorly to 5 SSRI/SNRIs). In fact, it is known to be the least likely to cause manic activation. And it has also been proven to help with the inattention of ADHD symptoms. It's been so helpful that we've been able to reduce my son's Seroquel dose from 600 mg to 200 mg, and we're talking about lowering his Lamictal dose. It's something you might want to ask your psychiatrist about.

 

[ctmom05]

GVC,

My young adult son sleeps in much the same manner as what you describe with your son.

Even tho there are medical/mental health issues, it's important to keep enough of a schedule that the person can take care of whatever their daily responsibilities are. Keep good communication going with the doctor or therapist, so that they are aware of his habits and reactions.

Most of the time it helps to keep the sleep <--->activity schedule fairly consistent.

 

[BusynMember]

My daughter, who has always had insomnia, slept nonstop on Depakote. Constantly. She couldn't even stay awake at school. She slept, slept, slept. I would think it's probably the Depakote/Seroquel combo. Seroquel is also very sedating, however my daughter was on stand alone Depakote.

The dose may be too high or it may be the wrong mood stabilizer for him. Some medications make kids sleep because they are so sedating. When he's awake does he seem alert and focused or still sleepy and spacey?

 

[gcvmom]

Okay, I'll see what we can do about sticking to a "regular" wake time on the weekends for him.

MWM, he's very sleepy in the mornings. It seems to get better as the day wears on. By late afternoon, he's much better. Not as good as he was before he started the Seroquel, but better. We tried him on Tegretol, but it screwed up his Seroquel absorption (and it is known to intefere with some medications). I've tried cutting back on the Seroquel, but his symptoms get worse... more hyperactivity and impulsivity.

He takes a morning dose of Depakote, and I don't even remember why, so maybe I need to ask if we should just lump it with his bedtime dose now. I don't know if we can move his afternoon Seroquel to add to his bedtime dose... I just know that if he misses it, he's messed up.

I hate that he's so tired all the time. And I hate messing with medications during school. It really bites that he's had to deal with this for so long... I would really rather it have hit him at an older age -- at least some days it feels like that. It's like he's missing out on so much because of this.... Okay, enough whining.

 

[ML]

I would take a hybrid approach and let him sleep a little extra when he seems to need it but not too excessively. I'd wake him up. Hugs, ML

 

[BusynMember]

Hey, I'm sorry and feel for your dear son. Having a severe mood disorder myself, trust me, I know about the constant fatigue from medication. For thath matter, my oldest son is on medications and is always tired. Unfortunately, that's the downside. There are certain medications I've trialed that made me unable to keep my eyes open--although Prozac is not supposed to do this, it was the worst offender. I would fall asleep at work. You never know what the medications are going to do to you. More often than we wish, they don't do what they are supposed to do and they have horrible side effects that make you wonder "Is it worth it?"

Have you tried Lithium or Lamictal? in my opinion it's not good that he is always sleeping and I think (in my opinion) it's the medication. The medications can also cause cognitive dulling so that school is a real chore. That's another thing my daughter complained about with Depakote until she finally just tossed it in the trash. At nineteen, she could do that.

I hope you find the answer for your little guy. Seems like, as the day goes on and the medications are maybe wearing off a bit, he does rouse. That's good.

I take two medications and have for over fifteen years. To this day, Clonazapen still makes me tired. I try to only take it at night or else I'm zonked. I never did get used to it like you're supposed to. Unfortunately, through tons of drug trials, I've learned that it's common for drugs to be problematic. When they help, it's great. But often it's trial and error. And a royal pain too!

 

[DammitJanet]

I have finally been able to pretty much conquer the insomnia unless I am hypomanic. But only with medication. I still need more sleep that most folks. I sleep from about midnight or so until 9 or 10. On weekends I may get to sleep in till 10:30. Sometimes I get a nap. Not often but normally I do at least lay down during the afternoon because my pain and fatigue is bad.

 

[gcvmom]

Thanks ML -- I did let him sleep until 9 this morning. I don't that's too much -- definitely better than 1pm!

MWM, he tried Lamictal with Depakote for a short time. Eh. It was ok. As far as controlling his manic symptoms, this combo of Depakote ER and Seroquel XR seems to be the best.

I'm going to work with husband to keep difficult child 2's bedtime and rising time as consistent as possible. And I'll talk to the psychiatrist about this continuing sedation issue. Maybe it's something we can improve, maybe it's something we have to learn to live with. I just need to know so I can stop feeling guilty about it.

 

[bramblewoodbabydoll]

I cant imagine this since my son never sleeps and never has. I know my dtr Sprite cannot be woken from sleep unless your armed and wearing a hazmat suit. I cannot let her sleep tho, she wakes up spacy and ready to fight no matter when you wake her and she does not even take medications. We've just started having visible 'in your face' problems with her so she hasnt been diagnosis'd with anything.
I do agree with sticking to a regular sleep schedule. It offers predictablity for the child and sets a rhythem for the body. I also agree with the posts that for individuals with mood disorders its more important than it is for the average person. You could modify it on the weekend to allow for the different schedule he's on but keep the modified plan in place the same each weekend. Just my humble opinion.
I could sleep for 3 days strait during the summer when I was a teen. I still find waking to be the most unbearable and excruciating experience .... moving out of my head and orienting to this world takes me an hour. Getting my body up is like lifting lead.
What is like for him to wake? How is the first hour afterward? Is it an easy transition?

 

[gcvmom]

...moving out of my head and orienting to this world takes me an hour. Getting my body up is like lifting lead.
What is like for him to wake? How is the first hour afterward? Is it an easy transition?

That pretty much describes what it's like for him! He acts like he's moving under water... or through jello. Very lethargic and slow going for the first hour or so. He's a lot better after he eats and has been up for an hour or so.

 

[bramblewoodbabydoll]

For my 11yo, Sprite, we have a routine that the therapist helped us work out. I bring her one of those short cans of coke (her father let her have as much junk food as she wanted and shes practically addicted to carbs and sodas) but anyway its used as a carrot I come in and dangle in front of her. She wakes enough to take a sip and realize the difference between the sleeping and waking world. Then I give her a couple minutes, talk to her calmly about pleasant things to keep her with me (in the waking world). I leave and go fix a breakfast with protein in it that she likes even if its a sausage biscuit that I microwaved lol. I tell her if she moves from the bed to her favorite chair in the living room she can eat in there. I only need to prod just a bit and she comes on. Sits in the chair. I turn on VH1 cause she loves music ... if she is really in a bad mood I turn the news on because undoubtedly something will be on there that shocks/interests her and she suddenly starts talking to me about it! It seems to jolt her and she forgets to be angry at me!
This has become pretty fun even if it is babying her its better than the raging hurricane that explodes otherwise.
I wish someone would wake me this way hehe.

 

[BusynMember]

Did he sleep too much before the medications? That will pretty much tell you straight up if it's a medication problem. These are sedating medications!

 

[gcvmom]

Bramble, I guess we're fortunate in that he's always been a very agreeable and cooperative kid. He just is zonked in the morning.

MWM, he's always needed more sleep than my other two, but now it's magnified I'm sure by the medications. He's been on one type of sedating AP or another for six years, but this is the worst he's been. Having to take Depakote in the a.m. probably doesn't help. Maybe if we moved his 8:30 pm dose of Seroquel earlier, like to 5pm, I might get away with that -- but he might get too sedated to finish homework. It would likely work for the timing of his next Seroquel dose, where I could give it to him when I drop him off at school around 9am...

It's just so dang complicated. He needs that second Seroquel XR dose almost exactly 16 hours after the evening dose because he starts to fall apart then -- it's like clockwork.

 

[gcvmom]

Bramble, I guess we're fortunate in that he's always been a very agreeable and cooperative kid. He just is zonked in the morning.

MWM, he's always needed more sleep than my other two, but now it's magnified I'm sure by the medications. He's been on one type of sedating AP or another for six years, but this is the worst he's been. Having to take Depakote in the a.m. probably doesn't help. Maybe if we moved his 8:30 pm dose of Seroquel earlier, like to 5pm, I might get away with that -- but he might get too sedated to finish homework. It would likely work for the timing of his next Seroquel dose, where I could give it to him when I drop him off at school around 9am...

It's just so dang complicated. He needs that second Seroquel XR dose almost exactly 16 hours after the evening dose because he starts to fall apart then -- it's like clockwork.