Sleep Disorders

[jenetee]

My eldest son is now seventeen and in full time education. When he was a baby he was a dreamboat with sleeping. He slept all night from around 1-2 months and i had to wake him for a feed. Perfect i thought. However he now has had a problem with sleep since he was around 13 but GP's had always advised me that teenagers sometimes have irractic sleep patterns in adollesence. However it is now becoming a problem. It is intertfering with his college days and his assignments. Since the age of 13 my son was unable to drop off to sleep like his younger brother or sister and would stay awake for hours. I suggested everything from listening to music in bed to going to bed early and trying to force his body clock to change. I even suggested and tried herbal sleeping tablets. None of these worked. At school times i used to call him six or seven times before he would drag himself out of bed in-coherently. Sometimes, well quite often he would snap at me and his siblings for apparently nothing. I remember my daughter saying good morning to him once and him snapping back " why are you even talking to me, leave me alone". He would wake up looking like he had not slept at all and would not fall asleep until well after 2 am as he admitted on several occasions. He would seem lazy and lathargic ( a word constantly written on his school reports from year 8) during the day and spring to life at night. When everyone else was winding down he was ready for action. He now sees that he has a serious problem with sleep and has asked for help. Bless him!!!!!!
As i said at the start he is now at college and it is becoming a real problem, i have to moan at him constantly EVERY morning to get up for at least half an hour, then he wanders around the house like a zombie getting ready. He has started having a shower in the mornings too to try and wake himself up, this seems to help very little. He seems dazed in the morning and uaware of time in any shape or form. My worry is that he has always been a gifted student and has always gained strong academic levels, unfortunately his sleep disorder is becoming dominant and i fear for his future. God forbid it should get in the way of his dreams and aspirations. I have made him an appointment with the doctor again, however i feel that it will be mis diagnosed. Anyone give me advice on how to play it at the GP's to get results and diagnosis. PLEASE HELP!!!!!!

[Circadiabsurdium]

Hi, Jenetee

It really sounds like your son could have a circadian rhythm disorder known as Delayed Sleep Phase Syndrome (DSPS). There’s a bunch of info on the DSPS forum on this website, and the topic googles well.

It has been a while since your posting, so I don’t know if your son has gotten any help in the meantime. I think your best bet is to get a referral to a sleep clinic. Circadian rhythm disorders are relatively new to medical knowledge, so it seems like not a lot of docs know about them. It might be easier to get the referral through a psychologist - they are much more likely than a GP to stay up to date on sleep issues. (The American Psychological Association added DSPS to the DSM IV in 2005, so if the psychologist hasn’t heard of it by now, tell him/her to look it up.)

Some advice on sleep clinics: do NOT do what I did 5 years ago and go to a clinic that is only set up to diagnose a few things. In my case, they were only looking for narcolepsy, restless legs, and apnea - which were not at all consistent with my sleep complaints (which were the same as your son’s). I hope that money is not an issue for you or for others reading this, but if it is, be darn sure ahead of time what your insurance will pay for. I got stuck with a gigantic bill (about $2000) for MY worthless sleep study because, although the study was “covered,” the only authorized sleep clinics were considered “out of network” so the insurance only paid something like 20%. No one told me that until it was too late, and they probably will not tell you either.

If money IS an issue, you might confirm a “diagnosis” by having your son spend a week or so obeying his body’s impulse about when to sleep: have him wait until whenever he is tired to go to bed (i.e. 2am) and then not use an alarm clock. If he does have DSPS, after at most a day or two he should settle into a schedule where he is tired at about the same time every night, goes to bed and falls asleep quickly and easily (not tossing and turning for hours), stays asleep, and wakes up spontaneously after 8 hours or however long he needs. Summer break is coming up and that would be a good time to try this.

Treating DSPS is a tougher issue. If you read about “Chronotherapy,” I think you’ll agree that it sounds more like Medieval torture than medical care. The fact that a substantial majority of chronotherapy patients are unable to maintain a “normal” sleep schedule for any reasonable amount of time leads me to believe that that "treatment" is a non-solution. The Emperor has no clothes...but that’s just my opinion.

Some people respond to melatonin supplements, but my guess is that you have already tried that. They didn’t work for me either.

People with DSPS seem more likely to benefit from bright light therapy. Basically, your son would sit in front of a light box for 30 min. very early in the morning, before the sun comes up (the light must fall on his eyes-which must be open-but not directly on the eyes). Some people wake up early to sit in front of the light and then go back to sleep for a while before getting up at the desired “normal” time feeling well rested and able to function like a normal human being.

Thousands of people use light boxes to treat seasonal affect disorder (SAD) with good results (confirmed by good science), but there isn’t a lot of data on using them to treat DSPS, so of course it’s a controversial treatment. But don’t despair - you would expect it to be really difficult for researchers to get funding because most medical studies are funded by Big Pharmaceuticals, and the light box companies just don’t have the funds to compete with that.

The only thing I’ve seen about negative side effects is one article where someone who used a light box for many years went blind from macular degeneration. I think all the light box companies, out of an abundance of caution, have a warning to ask a doctor about use if there’s a family history for macular degeneration. I would expect that if the boxes really caused blindness, it would have happened to more people since so many people use them (an aunt of mine who lived in Alaska for a while says EVERYONE there uses them). But if my opinion is wrong, . . . well, that would really suck . . . But if your son really has DSPS, light therapy might be his only viable treatment option, at least until medical science comes up with a better solution. The best any of us can do is learn as much as we can and then make an informed decision.

If your son wants to try light box therapy, you can get a small unit for about $200 before shipping - just ordered one myself and can’t wait to try it. Ebay probably has used models for less if you’re anxious about spending $200 on what could be a failed science experiment.

Anyway, I hope you (& others reading) find the info useful. And I wish you the best of luck with your son.