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Night terrors and anxiety in a child with Aspergers

Filed under:Mental Health — posted by admin on November 25, 2008 @ 7:38 am

Hi there and welcome to this week’s blog post. Whilst driving home today in my car I’ve been listening to the radio; and apparently there are a lot of people wanting to emigrate to Canada from the UK, following current tax reforms here. So a big hello to all you Canadian readers of my blog; and you should expect a few new people with funny British accents in your neighbourhood sometime soon! Anyway radio ramblings aside here’s this week’s article:

Question

I would love to know how to deal with anxiety in Aspie children I have a son, 6 years old, who suffers anxiety and night terrors.  The anxiety can get so bad at times that my poor son will throw up out of fear.

Answer

Although sleep problems are not part of the diagnostic criteria for autism, sleep problems seem to go hand in hand with autism.  Many parents report this as a problem in their children with autism. A new study from the University La Sapienza in Italy shows children with Asperger’s Syndrome have more sleep problems than average children.  Dr. Oliviero Bruni, the researcher, found that children with Asperger’s have a high incidence of sleep disorders and other problems, such as getting to sleep and restlessness, as well as daytime sleepiness. The study, published in the journal SLEEP, November 1, 2007, states that 50% of the children with AS didn’t want to go to bed, 75% needed a light or television in the bedroom, 87% had difficulty getting to sleep, and 75% fell asleep sweating.

There are medications such as Seroquel, Klonopin, Celexa and others that may help your son.  Melatonin has had some good results, as have selective serotonin re-uptake inhibitors.  But avoid the use of Singular for asthma or allergies as many incidences of children having night terrors while taking it have been reported.  Some users have reported very vivid dreams and night terrors while on Strattera or while getting used to it.

Children and teenagers who spend two or three hours a day engaging in exercise have an easier time going to and staying asleep because they are more tired physically.  So, make sure that your son gets plenty of physical exercise.
However, sometimes Aspies who are over-tired experience night terrors, so you have to find out how much exercise is good, but is not too much.

Sometimes keeping a journal of one’s thoughts can help reduce night terrors.  Fears and concerns can be written down and that seems to reduce the brain’s need to process them at night.  Since your son is so young, perhaps he could tell you his thoughts and you could journal them for him.

Counselling may help night terrors.  Also, perhaps a medication is promoting night terrors.  Talk to your son’s doctor about this.

There are two Exploring Feelings books by the highly-acclaimed Aspergers expert Tony Atwood. One is designed to explore and manage anxiety, the other to explore and manage anger. You can read more about them by clicking here. The original program was designed for small groups of two to five children between the ages of 9 and 12 years, with two adults conducting the program. However, the Exploring Feelings program can easily be modified to be used with just one child. The activities can also be modified to be age-appropriate for an adolescent or adult. The program was designed as a treatment for an anxiety disorder or anger management problem in children with Asperger’s syndrome, but the program can be used with children with High Functioning Autism and Pervasive Developmental Disorder, Not Otherwise Specified (PDDNOS). The author also designed the program so that it does not have to be implemented by a qualified psychologist. A teacher, speech pathologist, occupational therapist, or parent can implement the program without having training in Cognitive Behaviour Therapy.

Until next time …
Dave Angel

PS – The new Parenting Aspergers website is coming on leaps and bounds and I am working with an excellent web designer called Valerie (co-incidentally out in Canada!) who is working hard on the final look and design. This week I’ve been working on ways to add Aspergers information using video to the site; which I hope will be another great feature. I am really excited about the potential help this site will be to so many parents.

comments (19)

19 comments »

  1. My son suffered from night terrors until a friend told us about the dye red 40. He said take that out of your son’s diet and it should help. We did and the night terrors went away. The amazing thing is on Valentine’s day, that night he had night terrors. Funny that everything on Valentine’s day has red 40 in it. Truly it has been amazing!!!! If you could please forward this on to the parent it is worth a try!

    Comment by Kristine Franklin — November 25, 2008 @ 9:22 am

  2. Like your name Dave you are an angel and I have found so many of your articles helpfull. My son is 16 and had been suffering terribly over the summer after his gcse exams. Obsessing about what grades he would get and if he was clever enough and trying to cram lots of clever vocabulary into his brain from his dictionary all through the summer and it was so distressing . Uptil now he had always seemed to cope ok and has shown only mild symptoms of aspergers. It was time to get others involved with his life and learning. By the way he passed all 11 gcses and got 1 A 5 B’s and 5 c grades which he then after the initial pleasure pronounced as rubbish and all his cousins had done so much better! He is now studying for 3 Alevels in English History and Geography and mostly has settled down. Luckily his school has an autistic facility and he now has a mentor and help if he needs it .. He still doesnt want any of his friends to know about his aspergers but at least his teachers are aware of it and can support him.

    Once again many many thanks for your ongoing help

    Gaynor X

    Comment by GAYNOR ASTALL — November 25, 2008 @ 12:14 pm

  3. Interesting reading, my son is 7 years and the school have picked up on his behaviour and difficulties in class, think he has asperges, still awaiting to Consultant, seen phscohologist who has referred us. Jack never selept very well from birth, always restless, and now aged 7 needs hardly any sleep.. interesting

    Comment by Lisa Corbin — November 25, 2008 @ 1:02 pm

  4. My son has had night terrors for a while though we have now found an answer for him…His teacher did a project with the class, on native american indians. They talked about dream catchers and they all made them and he was so inspired that when his broke, I took him out to buy one… said a prayer and did a little reiki on the dream catcher and on him.
    So far only one got through… So I told him it was in need of more magic reiki rays. That was three months ago and he’s not even reported a bad dream since.
    Could be worth a try if your Aspie as suggestable as Noah.
    Good luck,
    Imogen

    Comment by Imogen Harris — November 25, 2008 @ 1:31 pm

  5. I would not recommend sleeping medications at all — it is easy for individuals (especially children) to get addicted to them.
    Also, risperidone (one medication sometimes used for Aspies), one of the side effects is “vivid dreaming.”

    Comment by A.M. — November 25, 2008 @ 2:48 pm

  6. My son is nearly 11 now and we have struggled with sleep issues since he started school. The combinations of things we have tried that really work well for him is a specific bedtime routine that has ‘grown up’ with him. Talking right before bed can increase the lack of rest, so we do that generally around dinnertime.
    Reading time has always been a big part of the program, as it is very soothing activity and can be as cuddly..or not.. as needed to help him relax. When we have something going on such a school activities etc., talking about it ahead of time (whenever possible of course) helps immensely as we can pre-plan and include some quiet relaxing/nap time if needed. I have found an herbal supplement that helps him relax, and his school year started out much better than in years past. (Likely a combination of things including him ‘growing up’ of course!) A soothing bath when he was younger has been replaced by a shower. I limit television time including video games / movies etc. so that they end at least 1 hour before bedtime; even holiday specials can be taped and watched at another time! Watching what he eats after dinner is something I have done since he was small; he would eat all the sweets in the house if I didn’t!
    As for the terrors–when he was younger we actually set up a *plan* of what he should do if he woke from a scary dream; it was not unusual for him to come curl up on my bed for a while. We would talk about it very briefly; sometimes he would want to be cuddled and other times not. As a rule, we would return to his room after a short time and repeat our bedtime goodnights. He has a very dim nightlight still, as well as a small fan for white noise and to keep the air moving. Consistency has been the biggest key, even when taking vacations we keep to a schedule, though it’s different that school nights. I have never used weighted vests/blankets etc., however he has a pillow type stuffed animal that he has on his bed to curl up with as its something he can hug as tightly–or not–as he chooses, for as long as he wishes to. He knows no matter where we are, the response is consistent; that is one of the key pieces for him.

    Comment by Cass — November 25, 2008 @ 4:49 pm

  7. Aspies seem to have less of a need for sleep (and less ability to sleep). To make matters worse, some of the medications used by aspies for their comorbid conditions (eg: adhd), such as Ritalin, have further sleep supressing side-effects.

    The result is that you overly imaginative child is awake at odd hours during the night.

    I had bad problems with night terrors as a child. The problems I had weren’t brought on by reading scary books or watching scary films (although occasionally my imagination would draw from them). Usually though, I was scared by what I perceived in the dark.

    My terrors subsided greatly when two things happened. Firstly, my mother explained that waking up in the middle of the night (by scaring you) was your body’s way of “frightening you off to the toilet”. It may be right or wrong.. but I always had to go when I woke up, so I started associating it with a natural thing, rather than the supernatural.

    The second thing my parents did was to get me a bed lamp which I could quickly and easily turn on. I was frightened to take my hand out of the blankets and reach out, but once it was on, the room became friendly again.

    Comment by Gavin Bollard — November 25, 2008 @ 5:53 pm

  8. Night terrors and nightmares are not the same thing. They happen in differnt sleep stages. The child will remember nothing of a night terror unlike a nightmare. In fact they are not dreaming at all, that happens in a different stage of sleep. The best thing to do for the child is to gently guide them back to bed and to hold them tight. They are far worse on you than the child. Overtiredness can cause them as well as a shift in the childs sleep cycle. Try waking them up right after they fall asleep every night for a week. This often helps to reset the correct sleep pattern. Childern who have sleep terrors often sleep walk or talk when they are older.

    Comment by K. Koke — November 25, 2008 @ 6:39 pm

  9. My 13-year-old son recently went through a period when he would stay up after everyone else had gone to bed, then walk around the house and go into his grandmother’s bedroom to watch her sleep! He would also do little ‘experiments’ in the kitchen, microwave, etc.(he is very interested in science…). Fortunately, we convinced him to go to bed at a more decent hour by enticing him with rewards! Now he does go to bed at a normal time and doesn’t walk around late at night anymore. Also he has had sleepwalking episodes since he was very young, but they seem to be getting less and less as he gets older. Being physically active does really help in getting him to go to bed at a reasonable time.

    Comment by Anne Marie — November 25, 2008 @ 10:56 pm

  10. My youngest son is nearly 7 and we are still having problems with him settling into bed.It started when he was 2 and wouldn’t go to sleep unless I layed beside him or on the spare bed. Occassionly he is so tired he falls asleep as long as I pinky swear I am going to come in later but its so tiring every night going through the samed thing. The funny thing is his older brother is the one with asperges and he has never had a problem at night. I’v tried everything. Anyone got any suggestions?

    Comment by Kim — November 26, 2008 @ 2:17 am

  11. my son who is nearly 8 is a terrible sleeper and waking me on average 4 times a night, i was told about weighted blankets and i was not too keen on spending a £100 to buy a blanket that may be wont work, so the ot told us to try lots of blankets firmly tucked in and it is helping, it has not stopped the night mares, or night terrors but he does not get out of bed so often although does cry out for me, and i still some times have to lie with him for a while, so mayb i wil buy one, now in the winter lots of blankets are ok but not so much fun in the summer when he gets over heated so fast any way?i have also been desperate for help, living with aspergers or adhd is hard enough with out doing it with very little sleep.

    Comment by janet marshall — November 27, 2008 @ 1:52 am

  12. I have a fifteen year old son who has asperger’s. He was dignosed at age 6. Back then we had a horrable time keeping him awake.I would pick him up from school and he would sleep all the way home. He would fall asleep doing his homework, eating dinner, and he would fall asleep taking his bath. His doctors told me that he was in a mental shut down from having to try to focus all day. this got better after we started the adderall. He has always had a certin bedtime. He still has panic attacks at times but these are getting better. I know when he was younger he was frightened of everything it seemed like. We could not walk by trees, dogs, I had to be very careful of what he watched on tv, including the nightly news. If he heard about a robbery, or someone getting shot he would panic and it was hard to comfort him. My husband had to quit his night job, because our neighbor got beat up real bad one night and knocked on our door for help, my son freeked out so bad because he keep thinking that if some one could do that to our neighbor(man)then they would kill me and him.He would not sleep and would cry and make himself sick until we both passed out from being so tired. so my husband finaly quit his night job and found one in the daytime. I still have to be careful of what he watches but it is not as bad now that he is older and able to understand things about society better.

    Comment by wendy hammons — November 27, 2008 @ 5:49 pm

  13. I still don’t have my 5 year old in his own bed. I’m getting prepared however. Christmas lights on a slow strobe and timer around the ceiling, music for children by Anthony Miles and mirrors in his room so he doesn’t feel alone. Donna Williams provided me with these tips. Also husband will sleep in the second bed until he settles.

    Comment by Leesa — November 27, 2008 @ 7:34 pm

  14. My 22 yr old aspie son wont go to bed at night but sleeps all day.He is not on any meds.The odd time he will go to bed at 4pm .Hubby spoke about turning off the computers but others use this computer (22 yr old has his own)He has being like that for the past maybe 4/5 years.I have an older aspie son 26 who would go to bed at 6pm if he was let

    Comment by MaryCamilla — November 28, 2008 @ 7:26 am

  15. Working as an ASD Consultant, I regularly make use of the CBT Exploring Feelings management programmes designed by Tony Attwood.

    They are adaptable to different ages and circumstances and can often bring about the desired afect of inner knowledge for the person with ASD to manage their feelings of anxiety and anger and to bring about building a “Tool Box which gives tools to fix issues as they arise.

    Information is power and finding a structured way of working through issues reaps great benefits and decrease the level of uncertainty, fear that many people with ASD can live with.

    Comment by vicki douds — November 28, 2008 @ 3:48 pm

  16. My five year old daughter is PDD, ADHD, FAE. She sleeps with two night lights on, but once she is asleep she usually stays asleep. The only thing that will wake her up is loud noises such as a garbage truch or thunder. Then she calls for me and will want to sleep with me the rest of the night. ( My husband ends up on the couch 🙂 )

    Comment by Connie — November 29, 2008 @ 7:22 am

  17. My daughter is 8 as a small child before her dx she suffered horribly from night terrors (not nightmares) she would wake screaming w/ a horribly terrified face and nothing you could do would console her. We would have to go in and just hold her down until she calmed and then she would remember nothing of it the next day. She hasn’t done that in a while but now does not go to sleep. She used to get up all hourse. Calling infomercials 800 numbers, cooking corndogs in the microwave, etc… We got her her own t.v. and dvd player and put a desk w/ art supplies in her room, and now when she can’t sleep she stays in her room and watches t.v. or sits at her desk and draws. She does have trouble w/ nightmares now though. When on prozac it was horrible, she was afraid to sleep. Quit that and put her on Clonodin for a while which helped in gettting to sleep but getting her to take the pill was a nightmare in itself. So we opt to just deal w/ it. We read stories and I tuck her in and turn down lights. We set a timer on the t.v. and she usually goes to sleep w/in a couple hours. She then wakes 4-5am and reads or draws or watches a movie quietly. We have a baby gate at the top of the stairs in case there is any sleep walking or such. (I talked and walked in my sleep as a child) We do have to be careful though. She gets fearful after watching some things so we closely monitor her shows and she also gets scared of things on her walls or in her room. She has some wall stickers that glowed and we didn’t know it and those scared her. She colored a picture of George Washington and hung it in her room and a couple weeks ago told me George scares her at night because his eyes watch her. We had to move him. These childrens imaginations are wild and really any little thing could trigger a problem… Each parent must decide what works best for their child, but sleep problems happen regardless of meds or no meds or whatever. Our doc said that it is as if the mind of a child w/ Aspergers never shuts off, so they can’t sleep well.

    Comment by Karla — December 1, 2008 @ 12:57 pm

  18. oh, I forgot… she also gets very hot at bedtime. She sleeps in her undies and we go in and cover her up after she is sleeping. We also have a bristle brush that we brush her skin w/ and that helps to calm her down before bed.

    Comment by Karla — December 1, 2008 @ 1:00 pm

  19. My son is 9 and sleep is and always has been an issue. He had night terrors from a very early age, screaming, growling, writhing and lashing out physically often with his eyes open. We couldn’t touch him at all, often being hit and punched trying to calm him or hold him. I just sat in his room quietly (terrified!) until it was over, about 30 minutes. He did sweat a great deal during sleep all the time whatever the season, often stripping off and wrapping himself tightly in a favourite silky blanket. The night terrors are very few now as he has grown, but his fear of actually falling asleep increased. He really is scared of sleep, he fights it off and says that he doesn’t know where he is going and that’s scary. Lots of things in his room have been removed at his request also, certain stuffed animals that seem to stare at him, posters that he sees patterns in etc. Two things have worked extremely well are audio books and soft lighting. Just make sure that the stories are not too stimulating or scary. He also finds it soothing to have a fiddle toy to occupy his hands too, he says that the worst part about bedtime is that his mind can’t shut off and he wants to be busy and doing things. Sometimes I have to lay down next to him (but can’t actually touch his body) for reassurance. There are so many factors involved in his sleeptime that most nights we don’t get to sit down until very late and we can be just as sleep deprived as when he was a baby! Hope this helps someone.

    Comment by Sophie — December 2, 2008 @ 6:13 pm

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