My three year old will not go to sleep and wakes up after three hours, fully recharged

by Amy
(Morrisonville, New York)

Question: My three year old has never been an early to sleep child, frequently staying up until midnight or later. However, he used to sleep until about 10:30 in the morning. I am a stay at home mom of six kids and he is my youngest so I didn't mind him staying up late as long as he got enough sleep.

For the past three weeks he has begin waking up at 3:30am and nit going back to sleep. He is a very active child who is always on the go and never rests. I try for an hour of rest each day, but I end up spending most of the time putting him back in bed. I have also tried staying with him, but he becomes aggressive and hits and bites me.

I have five children that go to school and have varying activities that they attend. We stick to girl scouts and in the fall, soccer and baseball in the spring. I have an eight year old with Asperger's Syndrome and that requires us to.have a lot of routines and structure. My eight year old also has ADHD and has sleep problems due to his medication.

I feel like I haven't had a.good.night sleep in 8 years or more. I also go to school fill time online and need the night hours to do my work. Right now my husband watches our son while I do homework but he just accepted a second job to help with our finances. I will have.lost my.help and will no longer gave time to do my school work if I can't get my three year old to sleep.

I am desperate for advice. Our pediatriciantold me to give him benadryl but that just makes him more hyper. Melatonin worked for a week but then he went right back to not sleeping.

Sincerely,
Amy

Heidi's Answer: Dear Amy,

Thank you for your post. I am sorry to hear how difficult things are right now, I so understand that you are tired and feeling desperate, and I realize that's tough. So let's have a look at what we can do to improve things for you.

First of all, have you found any possible causes for his sudden 3.30am awakenings. I'm sure you will have been through a lot, but let me just list some, in case one slipped.

Does your son have any reflux, sleep apnea, discomfort when lying down (and maybe has had since being born), allergies, new teeth cutting, has he been ill recently, had any vaccinations, any new or different stress situation in the house …?

Anything that gives him discomfort somehow and that is either recent, or has been dragging on could (partly) be causing what is happening now.

But also much more 'earthly' causes are possible: a new neighbor with a habit of making noise in the middle of the night, street noise, has it gotten colder in the bedroom, or hotter, a sibling up at night, ...

Not all of these causes would necessarily be directly waking him up, and be THE cause but each can play a role, or be an extra trigger.

So my first suggestion is that you sit down and go through this list (add extra possible causes that you think of). Write down which ones could apply - even if you don't think it's that important right now. Keep those in mind going forward and relieve or take away as much as possible. That will be the first step.

Another important factor to look at will be food. Whether it is for going to sleep or for staying asleep, what we eat has an enormous effect on it.

Allergies can be one aspect. Your doctor has prescribed Benadryl, was that related to allergies. If that indeed made your son hyper active then it probably won't be what you need to improve sleeping … but it may be worth looking into the allergies more specifically and get medical advice for them. That could be medication, but definitely also finding out which (food) allergies he might have and by then avoiding any allergen foods.

But food causes sleep troubles not only through allergies. Many foods and drinks are stimulating for the body. For young children chocolate, sugary snacks and fizzy drinks are usually the main ones. If your son has any of those sometimes, do start avoiding them as much as possible and definitely from the early afternoon onwards. The problem is that the stimulating substances can linger in the body for many hours and they can cause difficulty settling but also wake-ups later in the night.

Next, the nap/rest during the day. He is at an age when many can be without a real nap. From what you write, I would give up on a real nap. However, do foresee an hour quiet time, at a set moment in the afternoon. Make that a pleasant but restful moment. In which he does not have to sleep but sit/lie down and read a book with you or quietly play with some toys.

Next I will suggest you try and change his bedtime. I know you said he's always been a late-to-bed person so we won't do anything drastic. But changing bedtime is such a good help with both staying asleep and getting rid of stuck patterns (fixed nightly awake moments) that it is definitely something to try.

Start with a 15-30 minutes earlier bedtime. Stick to it for 3-5 days and see what happens. Then gently bring it to earlier still, in small steps.. You should either see the nightly awakening disappear, or at least also shift in time.

Make his early evening and pre-bedtime as quiet and peaceful as possible to give his body and mind the chance to wind down. Another helpful 'basic' is to dim the lights well in time before bedtime and of course keep them dim when he wakes in the middle of the night. Then on the other hand when the day starts, and all through the day, do make sure there is plenty of light: that also play an important role in setting his sleep-wake patterns right.

I advise you to start with all the above, which is basically carefully setting the right basics, avoiding any disturbance/cause and then gently readjust his sleep pattern.

As an optional step (which I personally would wait with until you have done a good week of earlier bedtime) you could work with a scheduled awakening. This is a bit of a controversial technique but it can work well (very child-dependent). Only do it if you feel comfortable doing it.

It works like this: for a couple of nights in a row wake him up at about 3.15am. Keep lights dim and everything 'sleepy'. And try to get him to go back to sleep a couple of minutes later. Naturally you may have the same problems to get him back as when he wakes by himself. But the scheduled awakenings can be enough to help him sleep through his awake moment again.

Then finally about the melatonin. If nothing else works, and you doctor does not counter-indicate it, it may be an option to not give up on.

Have you been advised at which moment of the day to give it to him? Since the goal of melatonin is to help regulate the biological clock, timing is important. You may need to experiment with either giving it briefly before bedtime or on the contrary, in the morning. Let me know if you would like more specifics about scheduling this.

Best of luck Amy, also with your studying and work, which I admire you for, studying is such a good thing to do so I hope you will be able to keep it up.

Warm regards,
Heidi