Concerns about my child's medication

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My 3 year old was diagnosed as PDD-NOS, with OCD tendencies, hyperactivity disorder, insomnia, and mixed receptive language disorder. He is currently undergoing speech therapy and were on a waiting list to begin ABA therapy. Due to his insomnia and the lack of help from trying sleep therapies his doctor prescribed Clonidine. He gets .005mg at bedtime 9pm every evening. After almost exactly 45minutes the drug kicks in and he passes out on the couch. After another 30 minutes he's asleep enough I can move him to his bed (he refuses to get in it awake) The problem is that after 3-4 hours or at 1:30am he wakes back up and is wide awake, prompting another dose of .005mg (.010mg being his aloted dosage for 24 hours) us waiting for 30-40 minutes for it to kick in while he literally climbs the walls and then after he passes out on the floor waiting another 30 minutes before i can carefully carry him to his bed somewhere around 2-2:30am. He then wakes up around 7. The doctor is leary of putting him on another medication (instead of this not in addition to) because they carry higher side effects. This also scares me however, he has an 18 month old brother who he is waking up every night with his screaming, barking, banging and such and of course forcing mom to get back up for at least 1-2 hours every night. Sleep therapy did not work he was to hyper to focus on it. Has anyone else tried this medication or donepezil? I'm interested in hearing how your child fared on it. We have given him melatonin also it did nothing to help him.

Can you really diagnose some of that stuff at such a young age? Most kids I know cant stay still and are hyper so I dont know how you can be diagnosed with hyperactivity disorder at such a young age.

I wish I could help you in your situation: my son was a horrible sleeper through the preschool years, and the rest of our family suffered with him. At the time, we didn't have a direction to go for help, so we just suffered through it. The one thing I can say is that, even with a child who has a develpmental delay, there is still development and he eventually got better and better at sleeping and the disturbances became fewer and fewer. He was not diagnosed at that age, but also has an anxiety disorder NOS in addition to autism.

My only suggestion is to get a second opinion. Has your child seen a sleep specialist? They may have better tools to help him and a wider range of options in treatement; I would guess that since sleep issues are common in autism you might even be able to find a sleep specialist who understands autism. (There are also many co-morbidities common with autism that can cause or exacerbate sleep problems like seizures and migraines, a sleep specialist can help you figure that out.)

In the meantime, I just want to send along support - we spent years being sleep-deprived because of my son's sleep habits, and it really took a toll on us. I hope you find the help you need.

You may not like this suggestion and it may not be appropriate for your family or your son's needs but have you thought about co-sleeping? I did not intend on it and it did take a long time to ween him off (and he still sometimes visits) but that was the only way he would sleep when he was younger.

He falls asleep on the couch, I would leave him there. At least he's comfortable going to sleep there. If you absolutely can't, maybe move the couch, or get him his own couch if you think it would help.

I would also suggest thinking about what is likely helping him fall asleep on the couch, maybe conversations, people around, TV? Whatever it is, you can fix almost anything later. I would try not to worry about all the things people say you shouldn't do and just do what works.

Like ASDMommy co sleeping worked for me. My husband didn't like it, but he didn't like screaming more.

Do keep your own sleep in mind with any decision you make, though - we tried co-sleeping with DS but it was like sleeping with a live helicopter blade. Nobody slept. When he was little (about the age you're talking about) we got a cheap foam pull-out sofa for his room and we'd take turns sleeping with him as needed, so we at least got some sleep.

"I would try not to worry about all the things people say you shouldn't do and just do what works." I definitely agree with this - I, myself, can't fall asleep without the TV. We've had to figure out how to manage it, because DH can't fall asleep with one, so I fall asleep on the couch and if I wake up in the middle of the night I move to the bed (it's usually easy for me to fall asleep in bed.) If I don't have a TV on, I can't "turn off" all the perseverations in my head, and they keep me awake - it's like having three reality TV shows and a garage band going on in there.

Many TVs come with an automatic sleep timer; maybe if you put a TV in your son's room where he can't reach it and set it up to automatically turn off, that might help? (That was important for me - if I woke up and the TV was on, it kept me awake...double-edged sword, you know.) I'm guessing your son isn't a reader yet (though with an aspie kid you never know) but we turn the sound waay down and put the closed captions on - somehow, trying to focus my eyes to read is what knocks me out.

Again, that works for me. Unfortunately, it doesn't work for DS or DH: DS needs music that turns itself off and a very, very strict nighttime routine (shower, etc.) DH does mindless computer solitaire when he's having trouble sleeping.

A possibly nutty suggestion: can you get someone to come in to do the nighttime stuff with your son for a week or so while the rest of the family catches up on sleep? If I am remembering what this is like correctly - and I have only one kid, so I didn't have to worry about a baby - I was so sleep-deprived that I was totally incapable of troubleshooting and coming up with a viable plan. No matter where you find your help, there will be an aspect of trial-and-error to it, and that will work better if you have good mental resources at your own disposal.

We also coslept. At 9.5 my daughter still comes in sometimes.

Both of my kids sleep with a radio on.

I sleep with the tv on.

You gotta do what works.

When my son was younger, I put a baby gate across his bedroom door. If he woke up at night, I had a few toys near his bed that he could play with. I kept his mattress on the floor so as to lessen his chances of falling. He would just play until he went back to sleep. I let him keep the door open as long as he was quiet (with the gate so he could not wander around the house). Otherwise I closed the door and left him alone in his room. What would happen if you just left him awake in his room?

FWIW I agree that 3 years old is too young to put a child on medication, though I have had my son on meds since age 4. I was told that it was to be just one avenue of "treatment" but once they're on drugs you can't seem to get them off them.

You might want to look at the larger picture and see if there are any mitigating circumstances that would feed into his behaviors.

Does he get tired suddenly without the medication or is it just with the medication? After you administer it, what do you do then? Do you have a bedtime routine for him? Is the rest of the household still active?

At that age though we gave my son 1-2mg of melatonin. It helped somewhat but by age 9 we replaced it with prescription clonidine. At age 11 our son now seems to be able to relax when we give it to him an hour before bedtime. It's not a cure as there are other mitigating circumstances but I've identified a routine that frankly we could be following more closely. To summarize, we:

- administer medication an hour before bedtime
- we try not to feed our son after that time
- we used to bathe/shower him soon thereafter
- put on PJs after bath time
- take him in his room an hour after bedtime
- we spread blankets on the floor to help attenuate noise from outside the room.
- read stories, though we have fallen into the trap of letting them watch TV or watch videos on our iPhones (which IMO is bad)
- at bedtime the lights go out, door gets closed and light blocking curtains are drawn
- a ceiling fan is used to provide "white noise"
- NO TALKING outside of hushed voices during that time and even then only when necessary.
- one of us stays in the room until he falls asleep. Usually it's just a few minutes, especially if it's dark outside already.
- up until recently I would cosleep in an adjacent twin bed but I suspect that my snoring was waking him up so now I rely on him making noise at night to wake me up in our room down the hall. I taught him to call for us and knock on doors. It beats screaming and hearing things nounce off the walls.
- as with bedtime, only hushed tones and keep "down to business" if there are soiled items to attend to.
- once our son is clean again - or has just had a drink of water - we escort him back to his room, lay him back down and stay with him until he falls back to sleep.

Give some of those procedures a try. I'd at least try to find an alternative to the couch. Is his bed/bedroom not comfortable?

We have had some luck this week! I co slept with his baby brother who as a another woman so creatively put it "like sleeping with a helicopter" He is now in his own bed through 3/4 of the night. This gives me a free hand to help keep my autistic child in his bed. I took him off that awful medication and we through hours of research and a dozen other helpful mommies are trying a "homeopathic" method. He has calmed down a lot. The hyperactivity is still present but he will stop and listen, he has been communicating in full sentences and seems to understand that I've told him its time for bed. He has not slept the whole night in his bed waking up around 5 or 6 to go to the couch until about 9 when he gets up but it is much much better. As for co sleeping with him he does not like to be touched in his sleep so that would probably not be a good idea. We got a radio for his room and turned it down real low so as to make it back ground noise. We also got a small lamp to replace the night light so its brighter but still dim. He got to pick a new stuffed animal to take to bed (Thomas the train of course) and i started using lavender spray in his room for a calming effect. It seems to be working well so we're going to keep plugging along. 3 independent doctors diagnosed the hyperactivity disorder we noticed it when he was about 2 but did not get the diagnosis until a bout 6 months ago. He is literally a tornado. As odd as its going to seem my circle of friends consists of 8 children all of them are boys and all of them are between the ages of 18 months (my youngest) to 4 and when we get together for playdate the two boys diagnosed with autism my son (3 1/2) and my friends son (4 1/2) are both diagnosed hyperactivity and it is a difference as noticeable as night and day from the other 6 boys. They literally are bouncing off the furniture. Don't me wrong the other children are running around too but not like this and these two never STOP unless its to pass out!