Expert: Dr Billy Levin - 8/24/2009

Question
QUESTION: I have a 10 year old (who is on meds for ADHD but I don't think that matters here) who has NEVER slept well at night.  It's better than it used to be since he is on meds but he still often wakes up in the night.  THe major problem is that he wants to come in and sleep on our floor in my bedroom.  My husband and he has battles before bed and in the middle of the night.  I feel that I agree he should be in his bed all night but if he cannot sleep in there (which isnt' every night) and he will actually sleep in our room, we should let him.  He needs to sleep!  Especially on school nights.  But my husband says he cannot possibly sleep well on our floor and he needs to sleep in his bed, not to mention he is 10 yrs. old!!  He has always done this.  Our household is a battle field.  My son cries and doesn't sleep.  Or he will get up and come in our room and sleep...how good?  I don't know.  Or we can fight, yell and cry at night and no one sleeps.  But I understand sometimes...he is 10.  HELP!!

ANSWER: Unfortunately there is far to little informatiion to even  start giving you advice. I need to know exactly what he is taking, what doses  he gets and  exactly at what time he gets the medication. Also is he on any other medication. I am a little surprised his treating doctor has not advised you what should be done about the sleeping problem!

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QUESTION: I did mention it but I don't want him on any more medication.  He takes Focaline 20 mg. which is a 12 hr. med.  He takes it in the summer at 9:00 am.  During school it's 8:00 am.  He does sleep better since he has been on it but still have this problem.  He goes to bed about 10:30 in the summer and 8:30-9:00 during school.  His time of wake up is not consistant.  Sometimes it is midnight, sometimes 5:00 and sometimes in between.  Each time he says he can't sleep.  That's it.  Does that help???

ANSWER: There are many things to discuss. Firstly neither you or your husband should be fighting with the child as it is not is fault. Rather get advice on what to do for the child's sake. I assume he is on Focalin XR and not Focalin. It is essential to have a routine for going to sleep, not different times for different occasions. Three things could cause insomnia. The condition, the medication and anxiety. The fact that he has a need  to sleep in your room suggests  a separation anxiety needing councilling and medication (Melatonin) Discuss this with your doctor. Focalin XR should be given at 7am on school days and never later than 8am on holidays. A better routine, Melatonin and earlier Focalin XR might improve things.

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QUESTION: Ok...how many mg of Melatonin?

Answer
As I have not examned your child I make comments but I certainly would not dream of taking over his treatment. If you will read my comment I did if fact suggest you discuss it with your doctor. I also suggested I suspect more but it would be difficult to go into detail without examining him and discussing it with you. Once again talk to your doctor or get a second opinion. He might need specific medication for his amxiety.