ADHD Medication Not Working For Your Teen? It May Be a Sleep Disorder

Bedtimes-and-Adolescent-DepressionIt is yet another counseling appointment for Sam who is 13 years old and is struggling in school, home, and everywhere he goes.  He has been diagnosed with ADHD and depression in the past but all of the medications have failed to work and his is getting worse, not better.  He is a bright boy who can do well at school but he frequently falls asleep while doing homework saying that it is too boring.  Socially he struggles with his peers as he seems disconnected, detached, and distracted.  You are beyond frustrated, having tried numerous therapies and medications convinced that something is wrong but unable to identify it.  Finally you begin to believe that he is just lazy.

While laziness may play a factor in Sam’s teenage brain, there might be something else.  Frequently, lack of proper sleep can have waking symptoms of ADHD or even depression.  Without proper REM sleep, a still growing teenager will struggle to stay awake during the day, seem distracted, forgetful, moody, prone to anger, unable to focus for long periods of time, and sleep excessively.  A teenager should get approximately 9 hours of sleep with an additional hour of sleep if going through a growth spurt.  If you are concerned that your child may have a sleep disorder instead of ADHD or depression, ask your doctor to order a sleep study.  This is the best way to diagnose sleep disorders.

Narcolepsy.  The movie version of narcolepsy has a person walking in a mall and suddenly dropping to the floor and going to sleep.  This is not entirely accurate as there are many forms of narcolepsy all ranging from mild to severe.  In a teenager, narcolepsy looks like falling asleep while in class, doing homework, watching TV, or reading.  The teen may also be talking to you one minute, look away, seem to be somewhere else for a second and then return back to the conversation claiming an inability to follow the conversation.  This is likely to cause problems at school and home as it may seem disrespectful to you.  The good news is that once it is diagnosed, proper medication can mitigate the symptoms as well as a strict sleep schedule including a nap.

Sleep Apnea.  During the night, a person with sleep apnea is suddenly startled in the middle of a deep sleep because breathing has stopped.  This can happen many times during the course of the night leaving the waking person to feel exhausted in the morning.  In a teenager, falling asleep during class, jerking while asleep, and snoring are all commons symptoms.  The treatment varies for teens but common practices are to remove the tonsils and adenoids for relief of the symptoms.

Insomnia.  Having difficulty falling asleep at night, staying asleep or not feeling rested could be chronic insomnia.  Without regular sleep a teen seems distracted, depressed, struggles to concentrate at school, is moody, clumsy, and irritable.  Again, early diagnosis is the key as there are many medications which can be beneficial in reducing the symptoms of insomnia.  In addition, a regular sleep schedule is essential to condition your body when to rest and when to remain awake.

While there are more sleep disorders, these are the ones most commonly seen in teens.  Still there are other medical conditions that could be contributing to sleep problems such as Restless Leg Syndrome so it is important to speak with your doctor to rule out any other contributing factors.  However, the most important element in teaching your teen about good sleep patterns is by modeling them yourself.  Develop a relaxing nighttime routine such as reading, yoga, a bath, or a cup of chamomile tea to release the day’s stressors and allow your body to naturally relax.  In addition, do your best to go to bed at the same time every night waking up approximately 7 hours later around the same time every morning.  This routine will not only improve your sleep habits but can aid in weight loss, reduce anxiety, depression and stress all of which can be beneficial for you and your teen.

Repairing, restoring, and rebuilding relationships takes time, energy and effort.  If you find yourself needing more help during this process, please call our offices at 407-647-7005 to schedule an appointment.  Or you can send me a quick email at chammond@lifeworksgroup.org.

To Sleep or Not…

Cover of "White Christmas"

Cover of White Christmas

To sleep, or not to sleep—that is the question:

Whether it is better for the mind to ponder

The outrageous thoughts and dreams

Or to tackle the sea of problems

And by challenging end them.  To wake, to sleep—

Which one—

Yes, which one.  It is some ridiculous hour when by all logic you should be sound asleep yet you find yourself wide awake for reasons beyond your understanding.  So what do you do?  Do you lie in bed trying to get to sleep?  Do you get up and do some work?  Do you turn on the TV in an attempt to distract your thoughts?  Or do you wake up someone up to help you go back to sleep?  Which to choose?

“It appears that every man’s insomnia is as different from his neighbour’s as are their daytime hopes and aspirations.”  F. Scott Fitzgerald realized that one solution may work for you but may not work for your friends.  You are different in personalities, dreams and experiences from others and even at times your personality, dreams and experience changes from part of your life to another.  So finding a solution to the sleeplessness today, may not work tomorrow.  This is why you need to have multiple solutions ready at a moment’s notice.

 “When I’m worried and I can’t sleep I count my blessings instead of sheep…”  Bing Crosby’s gave this advice in the 1954 classic “White Christmas” when his soon to be girlfriend was having a hard time sleeping because of her pestering sister.  This is a reasonable approach which does work on occasion mostly because it distracts you from the thoughts that are consuming you in the middle of the night.  Counting your blessings is about focusing your thoughts on the things you are grateful for instead of the things that need to be done or are causing you anxiety.  This attitude of gratitude has a calming effect and you might find that you fall asleep while counting all of your blessings.

“If you can’t sleep, then get up and do something instead of lying there worrying.  It’s the worry that gets you, not the lack of sleep.”  Dale Carnegie’s advice suggests that is it better to get up and work then to worry.  If you are struggling with a deadline, thinking about the email you forgot to send, or just realized a solution to a problem you have been pondering, then getting up and tending to the issue may be the very trick that allows you to get back to sleep.  The little bit of sleep that you lose in productive work may actually be less than the sleep you would lose lying awake in bed worrying.

“You sleep alright?” asks the railcar employee to Eric Little as they arrive in London just before the Olympic trials from the movie “Chariots of Fire”.

“Like a log,” replies Eric Little waking up from his overnight railcar and looking at the newspaper.

“Aha, must have a clear consciousness,” he replies.  A clear consciousness is one of the many ways to encourage the elusive sleep.  Oftentimes as your mind rests, you become aware of mistakes from the previous day.  If the thoughts that consume you are about your mistakes or other people’s mistakes then it is best to develop an attitude of forgiveness.  Forgiving yourself and others is one way to clear your conscious and allow sleep to return.

“Come, blesséd barrier between day and day,

Dear mother of fresh thoughts and joyous health!”

William Wordsworth concludes in his poem “To Sleep”.  Sleeping will rejuvenate your body and mind and is essential for productive living.  So the next time you find yourself sleepless, change your attitude to an attitude of gratefulness, an attitude of productivity, or an attitude of forgiveness and see if one of these does not help put you back to sleep.

Repairing, restoring, and rebuilding relationships takes time, energy and effort.  If you find yourself needing more help during this process, please call our offices at 407-647-7005 to schedule an appointment.  Or you can send me a quick email at chammond@lifeworksgroup.org.