two little girls very little sleep

hey folks just need a little help in getting two little ones to GO TO SLEEP

my two girls are ages 6 and 4 both have ASD diagnosis and we have been at war for around 5yrs now. While sleeping has always been an issue recently the 4 yr old is wide open untill past midnight every night and the 6yr old is up by 3am needless to say this does not bode well for full time dad. any tips or tricks are appriciated my two have come along way any body with girls have any questions hit me I promise I'm way, way, past embarassed or grossed out at this point

so ask anything. I fulltime school and work with my children using various ABA,FLOORTIME,PLAY,and adapted therapies along with a combination of OT,ST,and outside professional intervention, both girls are on GF/CF diets. Its been a long 4 yrs but I've learned alot and glad to share what I've picked up.

Hi Full Time Dad, and welcome to IAN.

You were asking about help with sleep issues. The first thing I would suggest is to consult the treatment team you have now, from the OT to the pediatrician. There a several possible aspects to sleep issues, from habit and routine-related issues to the purely physical.

A recent article on sleep problems and ASDs states: "Insomnia is the predominant sleep concern in children with autistic spectrum disorder (ASD), and its nature is most likely multifactorial, with neurochemical (abnormalities in serotonergic transmission or melatonin levels), psychiatric (anxiety), and behavioral (poor sleep habits) etiological factors involved." Read the abstract here: http://www.ncbi.nlm.nih.gov/pubmed/20218744?dopt=abstract

In this article, they state that treatment for this is generally behavioral (as in making sure not to reward negative bedtime behaviors or night time waking, establishing bedtime routines, etc.) and pharmacological. Melatonin has been discussed as one possible treatment for sleep problems in children with ASD. Read here about a double blind randomized controlled clinical trial: http://www.ncbi.nlm.nih.gov/pubmed/19968048?dopt=abstract

You might ask your pediatrician about melatonin or other possible solutions. You might ask an OT if there are any sensory issues going on that might be involved. Are the girls "hyper-aroused"? Would extra activity be recommended before bedtime, like a major walk around the neighborhood, or would something calming help, perhaps massage to provide deep pressure? Do you work with someone knowledgeable about behavioral techniques, who could recommend how to go about encouraging good sleep patterns and discouraging the exhausting pattern that is in place now?

What might be helpful will depend very much on the individual child, so talking with your team -- or finding some additional help if you don't have all the guidance you need on this issue -- is the first step.

Hi full time dad, can you tell what symptoms you first noticed in your little girls?

just that they seem unable to get on a regular sleep schedule, and now both are showing signs of mild regression,(losing of skills prev. mastered)no changes in diet or medications.

Hi Full Time Dad,
Boy can I empathize. But, I only had one little girl who wouldn't sleep. I wonder if there has been a change in your childre's schedule that might be causing unseen stress. That is what happened to our daughter.
When she entered preschool she absolutely loved it and didn't want school to end each day. But, that is when she stopped sleeping. She would go to bed on time, then wake up a couple hours later and be totally unable to sleep. Sadly for all of us, I didn't make the connection b/c she loved school so much. When her 1st year of school ended, within 3-4 days, she was sleeping mostly throught the night.(She had always had fitful sleep and would wake up briefly during the night).
On a different note, we put our daughter throught nuerofeedback when she was six, to help with her ability to focus. One of the extra benefits we saw was that she began sleeping SOUNDLY all the way through the night. Go figure! She just turned eight and we are about to begin another round of nuerofeedback. This time we're addressing her anxiety issues. Hopefully it will help!
Good luck. Not getting any sleep takes a tremendous toll on the entire family!!!

Hi Full Time Dad,

I have a son, 6yrs old, he has a very hard time turning his body off at night...I see a DAN doc and he is on many supplements, the one he uses to sleep at night is Melatonin. Our kids simply don't make enough of this.

I use a pharmaceutical grade supplement. These are the highest quality, I am very picky as to what I give my son, it has to be organic, with NO contaminants in them to affect his system.

I give him one 2mg tablet that dissolves in his mouth about 20 minutes before bed time and he has no problems going to sleep. Melatonin was recommended through my regular Pediatrician and my DAN doc.

Best-janga5

Hi janga5, and welcome to IAN.

I just wanted to note for our readers that small clinical trials have shown melatonin to help children with ASD who have sleep problems. If you are interested in trying melatonin, please be sure to consult with your pediatrician or other health professional regarding its use, the dose, etc.

Some examples of the research so far:

http://www.ncbi.nlm.nih.gov/pubmed/19452292
(This one focused on adults with autism, and said "Melatonin appears to be promising as an efficient and seemingly safe alternative for treatment of severe circadian sleep disturbances in adults with autism." Please note: they were only testing 6 people in this study.)

http://www.ncbi.nlm.nih.gov/pubmed/19968048
(This one, involving 18 children with autism and/or Fragile X syndrome, supported "the efficacy and tolerability of melatonin treatment for sleep problems in children with ASD and FXS.")

At the 2010 International Meeting for Autism Research (IMFAR), I was able to speak with one researcher who was working to expand previous work on melatonin and ASD by figuring out minimum effective dose, etc. Basically, the state of the science is that small preliminary studies are very encouraging, and it's time for larger scale clinical trials.