Tips and Ideas for helping Sleep Problems.

Lack of refreshing sleep seems to be a problem area that is not always recognised among ADD/ADHD children and adults. We have noticed that those parents, who have allowed their ADD children to listen to the bedtime stories in the Settle and Grow set of CDs, have reported excellent results. The children fall asleep easier and usually sleep the whole night through which they did not do before.

The following notes incorporate quotes from Dr John Taylor and from Dr Frank Lawlis in his book The ADD Answer. How to Help Your Child, Viking Penguin 2004.

Dr Lawlis on Sleep.
Dr Lawlis suggests in the chapter on Healing Sleep that often the sleep problem is missed as a contributing factor to ADD. He gives examples from his practice saying that once he recognises the problem, from among all the other symptoms, it is, very often, successfully attended to. He acknowledges that there are few experts on sleep issues for children in his area of the USA so each practitioner has to do what they can. Mitzi Claasen, Neurotherapist, also says one of the first symptoms she checks and treats is the Sleep issue. When this clears up may other symptoms also clear up.  Dr Lawlis says that there are three main scenarios:

Breathing Problems
The most common indication of this is snoring and irregular breathing. Firstly, one should check with a physician if there are any physical problems. If not, sometimes, a nasal dilator has been found to help as have nasal sprays. (Browse the Net under snoring, nasal dilator.) 

Neurological problems
Dr Lawlis says: “There are a wide range of these but bed-wetting is perhaps the most common. One of the fascinating aspects of sleep dynamics is how our bodies are protected from our physical reactions to our dreams by a neuro-chemical named acetylcholine, which paralyzes our muscles while we sleep. Most of us may have violent dreams, but we don't yell or walk out the door because of this protective chemical. However, when people have less than normal amounts of this chemical, they will act out their dreams. These are the people you have to watch carefully or they'll disappear out the bedroom window.

“Most children who wet the bed do so because they are actually dreaming of urinating. It would make sense that as they begin to mature, changes in their neurochemistry will help stop the sleepwalking, speaking-in-sleep, and bed-wetting episodes. By the way, this developmental time-line does have a genetic factor; parents of ADD kids who wet the bed were usually bed-wetters themselves. “If your child is having these problems, you should explain that bed-wetting is not a fault in self-control, nor is it psychological. Blaming the child for bed-wetting is unfair and it won't help. But it is not a difficult problem to manage. You can work with your paediatrician or look for suggestions on various Web sites. I have had success using what I call bladder stretching. When your child has a small bladder capacity, the urge to urinate occurs more often. By building greater bladder capacity, the child won't feel the need to go so often.” (Dr Lawlis then gives some ideas for this. If you are interested e-mail me.)

Behavioral Issues.
These include Anxiety Reduction, Sleep Breathing Patterns, and Release of Tension via the Body. Dr Lawlis calls another issue “Windmilling”: 

 “Although bed-wetting is a problem for more than a third of ADD/ADHD children, the chief complaint I hear is that when they go to sleep, their minds start racing. This is also known by the colourful name of “brain windmilling”.
In describing this sensation, children complain that they just cannot stop their minds from thinking, which turns into worrying. They think about problem solving, about what their friends are doing, and a million other issues, so that the sleep state seems never to come. And when it does, it is usually about thirty minutes before the alarm goes off. Most people have this problem at one time or another.

“Stress and sleep are a poor mix. It's nature's mean trick that sleep is one of the best cures for stress, but stress often makes sleep difficult. Sleep is a vital restorative process physically and psychologically. But natural sleep is the best form. Sleep medications are extremely problematic because of the possibility of addiction. There are other ways to induce sleep. One of them is based on the same home remedy often suggested for comforting a puppy freshly, weaned by its mother: a ticking clock.

“Regardless of what you have heard, a completely silent, dark room is not the most conducive environment in which a child can sleep. In fact, it is plain scary. A soft light can be reassuring. Holding a security object like a blanket or soft animal can help a child to feel secure. [But check that they are not allergic to it. Ed.]

“Aromas are very powerful in helping the brain settle down, and there are a number of commercial products that use scents such as rose or jasmine that purport to aid in relaxation. [You don’t have to permeate the whole room. From a bottle of, say, lavender essential oil, tip a drop on to your thumb and then wipe this on the nostrils. Or get the youngster to do it themselves. Check that the child is not alergic to the aroma oil first.]

“Researchers have found that recorded low-volume drumbeats matching the frequency of the heart during sleep cycles help induce sleep for patients struggling with racing thoughts. Sleep lab researchers monitored EEG measurements of patients' brain waves when the drum-beats were played and saw that the waves lowered to match the drumbeats, inducing sleep within ten minutes in most cases. There are other sleep-inducing sounds that work. Recordings of ocean waves and a subtle beat on a gong are effective. There are commercial tapes of sleep-wave sounds that are more subliminal than audible but I have not researched their effectiveness.” [This is more-or-less how the Settle and Grow Sleep Starter programs work.]

Sleep Starter Techniques Experts in sleep therapy offer the following suggestions:
  • Establish a set bedtime every night.
  • Avoid resorting to naps or sleeping in to catch up on sleep.
  • Eat lightly before bedtime. Excellent choices of last snacks contain tryptophan such as banana, mild cheese, chamomile tea, and the old favorite, milk.
  • Avoid heavy exercises late in the evening- .
  • Avoid arguing in the late evening.
  • Complete all homework assignments before getting ready for bed.” [End of Dr Lawlis quotes.]
Settle and Grow set of CDs has a choice of five separate tracks as Sleep Starters. These include many of the factors mentioned above. Click here to go to Settle and Grow.
For many ADD/ADHD children and adults the sleep cycle problem seems to be a never-ending. Too little proper relaxing sleep, which is the sleep that comes near the end of the eight-hour cycle, means that the person is not recharged and starts the new day sluggish and at a disadvantage. Then when it is time to sleep at night they may firstly resist going to bed, then when in bed sleep does not come easily, and when it does it is usually shallow not deep refreshing sleep, and often this does not last very long. And so the cycle continues into the next day.

Dr Taylor on Sleep.

Dr John F. Taylor is a classic ADHD case himself and four of his seven children also have the condition. His book, Helping Your ADD Child, Three Rives Press, New York, 2001 is a compendium of techniques and advice for the ADHD parent. Dr Taylor, in his usual practical way, starts by getting you to ask:
 “Does Your Child Have Sleep Disturbances? Here is a list of the most common sleep disturbances associated with ADHD. Count each as occurring if it happens more than once every six months.
  • Sleep talking, incl. muttering and murmuring
  • Sleep walking (appears half asleep, half awake)
  • Nightmares or night terrors
  • Teeth grinding (a sign of magnesium deficiency, one of the most common mineral deficiencies in children with ADHD)
  • Bedwetting (if after seventh birthday)
  • Sweating excessively (a sign of the faulty lipid metabolism that occurs in the majority of children with ADHD; the body is trying to correct its salt-to-water balance)
  • Excessive movement
  • Fitful, disturbed sleep pattern resulting in less than eight hours of sleep.

We now quote from Dr Taylor as he gives suggestions of how to solve these sleep problems. Although he refers to ADHDers the advice applies to all children. (Note that the Teenager has slightly different problems. Go here.)

“Presleep Agitation
Presleep agitation is a significant lengthening of the time spent trying to get to sleep. It involves many ADHD symptoms, usually because of a rebound effect from the wear-off of medication at bedtime. The average un-medicated child who has ADHD takes 40 minutes to get to sleep, which is twice the time children without ADHD take. As many as one-half of children with ADHD who are on medication report some presleep agitation, though its severity in the majority of these cases decreases as time goes on, and it does not represent a major stumbling block to treatment.”
We feel that the best strategy is to adapt one or more of the pre-sleep activities including food, nutrient and medication modifications. Here are Dr Taylor’s suggestions: (The words he and she are used interchangeably.)

“Regular bedtime.
Create and maintain a regular schedule for bedtime and tuck-ins. Have a set routine: bathing, brushing teeth, putting on pyjamas, or getting a drink. Let the clock do the enforcing and have your bedtime companionship and services contingent on your child's accomplishing the necessary rituals by the deadline. "It's 9 o’clock  now" is all the reminder she needs. [A TIME TIMER would be ideal for this.].

“Timing of meals and snacks.
Significant hunger can keep your child awake, particularly if there is an appetite loss side effect and the medication wear-off period occurs shortly before bedtime. Suddenly, your child feels very hungry when it is time for bed. The best solution is to honor his body signals and help him satisfy the hunger with a wholesome additive-free, protein-rich, low-glycemic-index snack.” [Ed: This could be any dairy product except ice cream, e.g.  cheese, small tub of non-sugar yoghurt; a slice of banana bread, or whole-wheat bread with  butter/Butro and Marmite; or fruit: apple, peach, pear. However, we disagree with Dr Taylor with regard to the protein-rich snack. We think that a carbohydrate only snack is more beneficial than one including protein. Carbos help to make serotonin which helps with relaxation and hence sleep. We also recommend a magnesium tablet last thing before sleep. See also last paragraph.]

“Mental focusing. 
Help your child channel her thoughts by playing a tape recording of a bedtime story or music she enjoys. Some children prefer to read; others like to watch television or listen to the radio. The channelling of their thoughts and attention provides a comforting, relaxing experience. Even though not falling asleep quickly, the child is not bothering anyone else at bedtime. .

“Noise insulation.
Create a constant background noise that does not vary, such as from an air conditioner, humidifier or dehumidifier, air purifier, or have your child listen to tapes or music with earphones. [E.g. the Settle and Grow Bedtime Stories.].

“An active day.
Encourage your child to be vigorously active until about an hour before bedtime, so fatigue builds up. A nap during the day can worsen this side effect, especially in very young children. Mild activity before sleep tends to extend and deepen sleep, while strenuous activity too near bedtime has the reverse effect.

“Gentle stimulation.
It is important that your child be calm and not overly stimulated during the last 30 minutes before bedtime. A warm shower or bath is helpful, as are washing and combing hair.
Be careful about petrochemical exposure when selecting the soap. [An exciting TV program won’t help.]

“Pleasant room.
 The ideal sleeping room temperature for most children is 20° to 22°C. Arrange the physical aspects of the room to provide comfort, calmness, and an assurance of safety. Adjust the night-light, blinds or curtains, position of the door, and bedding in accord with your child's wishes. [Some find that a Himalayan Salt lamp, not only provides negions especially useful for those with breathing problems, but the gentle pink glow from the light is comforting and gives a sense of security. Maati now sleeps with one on the floor next to her bed.]

“Elaborate tuck-in.
Especially for the young child, an elaborate tuck-in procedure is well worth the effort and develops a calm and reassured state. Rubbing and affectionately touching him or her, praying together, playing simple games such as writing letters or numbers on his back, telling him a bedtime story, or playing quiz show with questions he is capable of answering can provide rich and rewarding moments of togetherness. Bedtime tuck-in should be pleasant but brief, coming to an end at a reasonable time without frustrating you. The entire procedure shouldn't consume more than 15 minutes. When tuck-in is over, give a good-night kiss or hug and depart quickly.

“Day's review.
Bedtime affords an excellent opportunity to express love and talk tenderly with your child. Review the day's events with a focus on those that were pleasant and fulfilling. During this moment, express your love in a frank and honest way. This exchange at the close of the day is especially effective for a pre-adolescent or an adolescent.

“Bright ideas notebook.
Give your child a notebook for writing down thoughts and ideas that are contributing to wakefulness during the presleep period. Getting the ideas on paper allows her to stop juggling them mentally and aids in preparing her for sleep.” [End of Taylor quote.]
What you eat at night
One of the reasons, but not the only one, for not having a good night’s sleep is what we eat for our evening meal. (This applies to everyone, not only to AD/HDers.) Everyone’s body/brain needs nutrients in the morning to cope with the day; we do not need much before going to sleep. In fact, what you eat in the evening, unless you eat at least three to four hours before going to sleep, will be only partially digested and just sit in your digestive system, fermenting, until your system wakes up in the morning and continues the digestive process.
This is especially so if you have meat and other protein in the evening as this has to wait in the stomach for the rest of the food to pass through. Only then will it be digested by the hydrochloric acid before passing through to the colon etc.

Importance of Breakfast.
The fact that this process starts again in the morning is one of the reasons why many people say they cannot face a big meal for breakfast. But we now know that breakfast is the most important meal if we are to set up our brain for the day. Our body needs a balanced meal for breakfast especially including some protein to help keep the insulin curve from spiking. Also protein helps to make dopamine which is needed for the thinking process.
So if you want to help a person have a better breakfast, start by cutting don the evening meal. If the evening is the only time the mother can do food prep, save some of the meal for the breakfast and lunch boxes. The protein won’t spoil in the fridge.

For notes on the Zone diet. (Go Here.)
For information and tips on sleep for Twilighters (Coming.)
For information on sleep for teenagers (Coming.)

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