Awake from midnight - any tips?

[Veebs21]

Hi all,

My 3.5 year old DD is having a really bad stint of sleep. She is now up from midnight for the day several times a week and I’m at a loss as what to do.

She was diagnosed as autistic in April, and the bad sleep began about 6 months ago. Up til then she had been a dream sleeper/self settler - she had a period of not going off til 9-9.30pm but that was when she was ready to drop her nap, and she’d be happy in her cot on her own. Since dropping the nap and still now, she goes off to sleep with no issue whatsoever - it’s the night wakings that are the concern. They were few and far between to begin with but now they’re several times a week.

We have been prescribed 2mg melatonin but it’s not working. The issue being that she needs a slow release melatonin but is too young to take tablets whole, so we are crushing them, which makes the release faster and she doesn’t need that. She goes off to sleep just fine on her own.

On the nights she wakes I just don’t know what to do. I’ll sit with her sometimes, if she asks me to, but that ultimately only seems to wake her up more. If I leave the room, she will simply not stay in her room. She will come out onto the landing and sing/scream/shout, often waking up our youngest (she’s 20 months and still in with us as we were hoping they could share a room but that’s looking to be impossible). She will slam her door over and over. Pull all of her books off of her shelf. I don’t really want to put a light on so she can read and encourage/reward the wake up but on the nights she’s up at midnight I’m often getting 1-2 hours max sleep myself - sometimes none at all, which is really impacting my work. Tonight I’m currently 3 hours in to sitting outside her door and putting her back time and time again. First time I’ve tried it but so far she’s not giving up. I’ve learned any attempt at being too firm is very much met with a worse/louder/more combative response so it’s all softly softly - as much as I’m able to on zero sleep myself anyway.

Goes without saying that the days she’s up from midnight she’s an absolute terror and nursery have had several issues with her on these days, being particularly disruptive.

She’s got a weighted blanket but it doesn’t seem to help. We have a solid bedtime routine and I have explained to her why she needs sleep - she is verbal and has full understanding. But once she’s up she’s up. Very occasionally I can get her back off around 6am for a couple of hours but long term that’s just not enough sleep for her.

I just don’t know what else I can do, so any tips would be gratefully received. Has anyone had success with melatonin liquid given at night wakes? We have a paed appointment next Thursday so wondering if I could ask to try that instead.

[LargeLegoHaul]

Can you practice taking tablets? Start with something very small like a 100 thousand then work up to a chocolate chip or tic tac or treat size smartie or jelly tot etc. before moving to a tablet when DD has got the technique.

In the meantime can you ask for another medication e.g. promethazine (you could even buy it OTC but would need to lie as it isn’t licensed for sleep in DC) in addition to the melatonin which will keep DD asleep.

[Veebs21]

Hmmm she’s great at taking liquid medicine but I don’t fancy our chances with tablets at this age. We could try, like you say, but knowing her I don’t think we’ll get too far - she’s quite sensitive to food/textures etc going in her mouth. She’s also very strong willed and I can see the instructions of what she has to do causing her to have a meltdown. Something to work towards though.

Is promethazine like a sleeping tablet? I’m loathed to give her too much medication but we all need sleep so much! I’ll speak to the doctor about it and see what she says.

She gave in not long after my post last night, so that’s quite an improvement from 5-6+ hours we usually have. So maybe I also need to persevere with techniques that work with NT kids too (ie. returning to bed over and over with very little conversation). Maybe it will improve if there’s really no benefit to her waking up.

[LargeLegoHaul]

DC can learn to take tablets at 3. My DC have a medical condition where DC regularly learn to take tablets from 2/3yrs. Tablets can actually be easier for some DC with food sensory issues.

Promethazine is an antihistamine that is sometimes used to aid sleep in DC.

Medication like melatonin will only work alongside good sleep hygiene but it’s about trialling different methods until you find one that will work for you.

[Veebs21]

@LargeLegoHaul

DC can learn to take tablets at 3. My DC have a medical condition where DC regularly learn to take tablets from 2/3yrs. Tablets can actually be easier for some DC with food sensory issues.

Promethazine is an antihistamine that is sometimes used to aid sleep in DC.

Medication like melatonin will only work alongside good sleep hygiene but it’s about trialling different methods until you find one that will work for you.

Great, thank you. I think we have a pretty good routine, but we do need to cut out her bedtime bottle. It's been one of those things that we've kept as it just worked, and then it became part of her routine and if it's not ready when she gets out of the bath, she freaks out. I'm aware that sending her to bed with a bottle isn't good for lots of reasons though, and I don't know if it's contributing to her night wake ups as she's wanting more milk to go back to sleep.

Will speak to the paediatrician about promethazine, thank you.

[MumsyMum31]

Would love to hear the outcome for you! My child has melatonin 5mg she’s 2.5. It puts her to sleep but she o my sleeps for about 2/3 hours max so have stopped it as it’s pointless! She takes the tablet hidden in a spoonful of fruit purée doesn’t even realise not sure if this would work for you! I am so tired!!