Anxiety and Sleep Problems

Question

My 11 yr old daughter was diagnosed with Asperger's just about a year ago. She is very very high functioning, well we though until about 6 months ago, when her anxiety took over and she had a mental and physical breakdown. Her anxiety continues to plague her, although, she is better than she was.

Sleeping is a huge issue for her, always has been since she was 18 months old. The hard thing is, is that no calming techniques seem to help or better yet, she is not willing to even try some. Not to mention the fact that nothing is consistent, yet it’s all consistent. That something is always the matter, here or there. She is very smart, very stubborn, and very very pre pubescent. She was always quirky, and pretentious, but this anxiety is very difficult to maintain daily life without know what she can handle and what she can’t. No rhythm or reason. She is on anti anxiety meds, only at night... but sometimes do the opposite. They make her cranky and anxious, frustrated and sometimes they knock her right out. But nothing.... keeps her sleeping. We need to re visit the Neurologist and see if there is something other than anxiety causing such issues. But, for right now, life is different every day and night. It’s getting harder on me, because we have to tip toe around the house at night, to try not to wake her or she cries until I lay with her or she makes me stay on the couch until she falls asleep there. So, I am wiped out too. It’s to the point where I need to take a mild sedative to fall asleep because I am always in anticipation of her waking up.

This is her first year of Middle school was a complete disaster. Beyond disaster. So, for this coming year, I am going to look into alternative education methods that fit her strengths and giftings. So, that is it in a short nut shell. I could type for days, on details of our life with an Aspie, but this is what I feel to share so far. Thanks for listening.

Answer

Re: Anxiety—

While most people associate anxiety with an emotional response to stress, a major factor in stress and anxiety is the physical response to external stimulus. The stress response in the brain sends signals to the body to prepare us to handle a perceived danger or threat, and this induces a physical state of tension that can add to the emotional reaction to problem situations. As the body stores tension over time, a state of chronic anxiety can occur. Proper diet and regular exercise can help alleviate the physical tension associated with stress and help lower anxiety levels.

Eating a balanced diet consisting of whole grains, fruits, vegetables, and lean meats can help strengthen the body’s resistance to stress. These foods contain nutrients that are essential for healthy body function. Combining complex carbohydrates available from whole grains such as whole wheat bread or whole oats with protein helps to keep blood sugar levels steady, avoiding the stress of the sugar crashing cycle that can add to physical stress. Drinking plenty of water helps, too, as dehydration is just added stress to the body.

Avoiding stimulants such as caffeine also helps to reduce stress. Stimulants put the body in a constant state of heightened agitation and can facilitate a kind of false stress response when no stress is present. Refined sugar also creates stress as the body feels a rush of energy and then a crash in blood sugar. Processed foods should be avoided in favor of whole foods as they don’t contain the nutrients needed for strengthening the body’s ability to handle stress.

Exercise also helps to alleviate stress and anxiety. It does this in several ways. Engaging in physical activity increases the flow of oxygen through the body and stimulates the nervous system, and this can help to release the tension held in the body and induce a relaxed state of calm, making it easier to deal with stressful situations when they arise. Hormones such as endorphins are released during exercise, and these hormones help to alleviate pain and create a mental state of well-being. Exercise also helps to create a more positive self-image, provides a distraction from worries, and facilitates a sense of motivation and positive direction.

It doesn’t have to be overwhelming or exhausting to provide benefits against anxiety. Just 10 minutes of moderate exercise a day can create a more positive outlook. Choose an activity that you enjoy. Try becoming a member of a group to provide the added benefit of social interaction and fun. To see benefit, make sure to move at least 3 to 4 times a week, and remember to start small and build slowly based on your level of fitness. Overdoing it too soon can cause problems and make it hard to keep up the routine.

Adopting a more physically healthy lifestyle based on balance is the key to a healthy emotional outlook and reduction in problems such as anxiety. Wellness can be looked at as a lifestyle choice, and making good decisions about diet and exercise is one way to improve the quality of life.

Re: Sleep problems—

Here are some suggestions:

• Accept some awakenings. The experts stress that nighttime awakenings are perfectly normal -- much more normal, in fact, than the elusive solid eight hours people think they should be getting. Most people will roll over and go back to sleep, but those with insomnia become conditioned to feel anxious when they awake during the night. You need to accept that you will arouse some, so reassure yourself in the middle of the night that nothing catastrophic will happen if you are awake for a while.

• Acupuncture may help reduce her anxiety and induce deeper sleep.

• Cognitive behavioral therapy is often used in cases like this, and the experts agree that it could help. CBT aims to stop the behaviors that are perpetuating the insomnia. Typically, a therapist will work with a patient for four to eight weeks -- in sessions that last from 30 minutes to two hours -- to assess, diagnose, and treat the underlying problem, such as relationship worries. The therapist will teach the patient things like progressive-relaxation techniques and point out actions that are getting in the way of deep sleep, such as rehashing conversations that occurred earlier in the day.

• Distract her brain by trying a relaxation technique, like focusing on her breathing.

• Keep the glaring electric clock off the bedside table. Clock watching will only increase your anxiety about being awake.

• Make an appointment at a sleep clinic, which can be a smart step for people with a long history of sleep issues. Most often this involves office visits (which will not necessarily be overnight observations), during which the patient will undergo a physical examination and work with a doctor to assess and diagnose the cause of the sleep problems.

• Modulate her exposure to light, which could reset her internal clock gradually. Too much light at night will push her clock even later, so the key is to keep the lights dim the closer she gets to bedtime. Also maximize her light exposure first thing in the morning. If she can go outside in bright sunlight for some exercise, that would provide a double whammy of wakefulness.

• Pay even more attention to her evening routine and her sleep environment. Good sleep habits don't necessarily solve sleep problems, but they do create a foundation for improved sleep. Good habits include things such as keeping the bedroom cool and dark, using a fan or a white-noise machine to create a blanket of sound, and using the bed exclusively as a place for sleeping -- and not for watching television, for example.

• Take 0.3 milligram of an over-the-counter melatonin supplement about 20 minutes before bedtime since the production of melatonin (a naturally produced hormone that helps regulate circadian rhythms) drops off as we age.

• Try wearing earplugs.

• Use caution regarding over-the-counter sleep medications, since they contain some type of antihistamine, which can stay in the body for a long time. It takes about 18 hours for your body to clear out 50 percent of the active drug. For most of your waking hours, it will still be in your system, making you drowsy.

• Work on keeping her sleep environment quieter, such as using an air conditioner or a fan, as well as blackout shades to block street light.

Some parents enforce a strict bedtime and a regular bedtime routine as a way of calming their child for sleep. Another good trick is to use flannel sheets and to experiment with pajama fabrics until you find one that your child tolerates. Enclosing the child in a sleeping bag or under a bed tent can help. So does playing "white noise" in the background.

Your pediatrician may prescribe sleeping pills such as Sonata, Ambien, Desyrel or Serzone.


More resources for parents of children and teens with Asperger's and High-Functioning Autism:
 
COMMENTS:

•    Anonymous said… How can anxiety be managed in hfa children please?
•    Anonymous said… I also recommend melatonin - completely natural (no script needed) and works very well for my daughter, who is now 16. For the anxiety, she started on Zoloft a year ago and it helps her keep it at a manageable level. That plus cognitive behavioural therapy has been a winning combo. My daughter has improved dramatically in the past year.
•    Anonymous said… I do not have any advise. I will pray for all of you as you journey this rocky road. My Grandson Tyler is an aspie. His Dad, my son, has just written a book, Love That Boy, that may help you not feel so alone.
•    Anonymous said… I hear and feel you. My soon to be 16 year old daughter began severe anxiety and depression right about that age. Sleep has always been an issue;however, we had done several things with her in her early years that have luckily carried over into her teen years that do help. Melatonin helped for a while, but I have found that meditation helps the most. What is happening is that she can't stop the multitude of thoughts that come into her head and leaves her body in a state of fight or flight. Spray a little lavender near her pillow (calming), have her soak in a hot bath before bed (you can add lavender essential oil to the bath too), if she will allow it - lay down next to her and take turns telling each other what silly things pop up in your head while falling asleep. This helps to keep the anxious thoughts at bay. If she is really wound up, try just holding her feet. It sounds strange, but there is a hugely calming effect that this has. On the bright side, my daughter has decided to not depend on anti-anxiety/depression meds anymore and is doing great! Every day is a new day, with new challenges and hopefully some victories as well. Stay strong. She will get through this.
•    Anonymous said… I'd like to know if anyone has successfully gone "back" to school and graduated after experiencing all of the above^^^^symptoms? And if so, what worked for you?
•    Anonymous said… I'm experiencing something simile with my 10 year old daughter who is going through the diagnosis process. It especially comforting to me to read these comment as Esmes symptoms are starting to present themselves more severely now. Never been good at sleep since day1, now she is starting to say she won't go to school on a daily basis, cries all the time, tremendous anger outbursts. It's mentally exhausting for her and us. It's helpful for us as parents knowing this is not exclusive to Esme as everyone knows, we are having to find out a lot of this info by ourselves as the diagnosis process is so slow
•    Anonymous said… Melatonin has worked wonders with our kids. We have also been subscribed Clonodine with success though I am not sure there is much of a difference between them.
•    Anonymous said… Melatonin to help her sleep could work. No sleep, even if she denies being tired, will make her very overtired and emotional and then it won't matter what you do. Sleep is #1
•    Anonymous said… My 7 year old daughter has epilepsy and we thought adhd, but now the neuro is saying he thinks it could be aspergers, we are screening her for it now.... she is a sweet girl but gets bad rage fits all the time and it's not the medicine, she had them before the medicine. If she does have this she is very high functioning, I just can't be sure. But school, sleep every day its a struggle with her when she is not happy. When she doesn't get her way watch out and I don't mean regular kid meltdowns, she doesnt seem to care about punishment or time outs or anything. Rewards barely work on her. I find myself pleading and begging her all the time to stop with the behavior. Once it is over, she is back to her normal self and exhausted. The neuro says it has nothing to do with her epileptic spike. We are going to take her to a psychiatrist soon as well. We recently got IEP for her because of her slow slow pace. She is smart, but can't always focus and can't always complete her work.
•    Anonymous said… My daughter has the same issues. Cannabis oil isn't legal in Oklahoma yet. I wish it was.
•    Anonymous said… My six year old son is the same way, except for instead of anxiety and depression, he experiences anxiety and aggression. He has been a horrible sleeper since day one. We have tried several different meds to help his behavior, different counsellors, sports, and nothing takes his aggression towards our family away. He's fine with everyone else. Ugh. It's a daily struggle I wouldn't wish on anyone.
•    Anonymous said… My son is 13 and had struggled and struggles with all the above! He has good times and bad times that seem to come in waves. I have found a few helpful things....Anxiety medication has really helped calm his Anxiety and that in turn helps his friendships, his OCD And calms his mind so his ticks are not as bad as normal. I also have a weighted blanket, and use Melatonin to help him sleep. If all else fails I lay beside him, just having me with him helps soothes! I've even had late night walks, swinging time on the swing set or having him run laps around the yard to calm him at night. Hope this has given a few ideas to those that are struggling like I am. Each day is a new day! Never know what version of your child your going to see...such a stressful thing! Love and patience above all!!
•    Anonymous said… Not for under 18 though
•    Anonymous said… Our 10 year old use to wake up 1-3 times a night for almost eight years. Melatonin and a weighted blanket has finally straightened out his sleeplessness.
•    Anonymous said… Please check into the safe and effective cbd cannabis oil treatment. It is a miracle waiting for her.
•    Anonymous said… Saphris works wonders for high functioning Aspergers..taken at night sleep for 10 hrs straight
•    Anonymous said… Sounds like my 10 year old boy, our challenges are really more about the anxiety bought about through his Aspy needs for structure, routine etc than the other Aspy challenges. We had not slept through the night for the years and had tried everything from weighted blankets, meditation, counselling, bed routines (multiple), and sleeping medications to little success. In December his Paedetritian put him on a half tablet of anti anxiety medication (Prozac) due to his anxiousness around school and unexpected activities associated with being the youngest of four, He is a different boy. Within a month he was sleeping through the night and he s now sleeping through the night and in his own bed. I am not sure if this will be your answer but stay hopeful and keep trying things. Something will work. Good luck and God bless
•    Anonymous said… This is our 16 year old daughter
•    Anonymous said… This post mirrors my now 18 yr old daughter, eventually had to pull her out of school and do virtual classes. Helped the anxiety tremendously. Last year we were introduced to essential oils and were given a blend to help support her anxiety and she loves it. I have a fb page Essential Oils For All Your Needs, not trying to market it here, but it's got a lot of information on safe oil use and different blends to read about. I wish we knew of these oils years earlier so there wouldn't have been so many years of suffering. Great advice on here-Good luck to your family!
•    Anonymous said… We experienced something similar with our 16 year old son. There is a program called getting your teen out of defence mode that we are finding very helpful. It's put out by a group called asperger experts.
•    Anonymous said… We had the same breakdowns but our little one is 5. The neurologist put her on resperidol and epival when she had her mental break down and it was a god send. We added prozac for her anxiety and she is doing wonderfully and now sleeps through the night.
•    Anonymous said… We use melatonin for sleep. I didn't have high hopes for it originally since a lot of other oils and natural sleep aides didn't work. To my surprise my usual night owl was asleep in under 15 min.
•    Anonymous said… Welcome...to my world. We have a 14 year old daughter. Her high functioning autism comes along with its friends anxiety and depression. The trio are making life so miserable. Getting her to go into a school building is a never ending battle. Academically, she is fine. Well ahead of her grade....she still struggles to go in. Everyday. She hates being there. We even switched from a public school to a private, autism aware, school--thinking that might help. Nope. Sleep has been a thorn in her side from day one. It's been a rough road for her (and I) for at least 6 years. Seems to only be getting worse through the teen years. Hugs back to you mom. I know it's not easy.
•    Anonymous said… What are some of the medications being used. I am thinking it's time for a change and want some ideas.

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