13 year old dd falling asleep in lessons

[ReflectiveGilet]

Unsure if I should post in health. Dd2 is in year 8. Her teacher has spoken to her today very kindly about her falling asleep in lessons and encouraged her to talk to me about getting her checked for anemia.

We already have bloods booked end of the month. Gp booked then after prescribing her the contraceptive pill got awful heavy and painful periods. we are 3 weeks in to that. We have had a paediatrician for about 3 years as she has diagnosed IBS and she is medicated for that. We have an appointment coming up so I will be reporting this and asking for help.

She goes to bed around 10 and gets up at 6. She leaves the house for the school bus at 7.15 so not much I can do about that.

This started about a year ago and her teacher is right it’s got much worse. I feel a bit scared now. She is very active, does 4 hours of dance a week which she loves. She is lean and muscly. She snacks like all teens but she eats meat and 2 veg type meals most days. She has a packed lunch because I don’t want her eating friend beige food at school.
When she goes to bed she usually goes straight to sleep. She rarely wakes in the night.
i am panicking as she loves school and gets on with most teachers but she is clearly struggling.
Im worried she doesn’t eat v much at school so we have agreed to much more snacks - friend fruit and nuts etc and some flapjack to try and keep her energy up.

only iced coffee at weekends never on a school day and no pop as a rule just occasionally.

dd1 has never fallen asleep at school and has normal periods and none of these challenges and I feel a bit lost. Dd1 looked a bit tired during her exams but she’s radiant again now.

I don’t even know if the tiredness is linked to the heavy periods and the IBS I feel clueless

i know she’s young so you may not know yet or have considered it but could she be tested for endometriosis? My friend’s daughter struggled for years & it was only diagnosed after she had her ds. It’s worth exploring

Bless her. I'd definitely get her fully checked for conditions like glandular fever, underactive thyroid, aneamia etc, and get her a multivitamin, might be worth looking at magnesium too and make sure she is getting enough protein. Can you check her actual sleeping, if she goes to bed at 10, but struggles to sleep, she might only be getting 7 hrs sleep a night, when a 13 yr old needs 9-10 hours a night. I'd also let her sleep in at weekends so she can catch up on any sleep debt because teenagers build up tiredness and their bodies will try and take it at other times. Better to let her fully rest at the weekend and catch up, as well as an earlier bedtime in the week.

I would recommend a coeliac disease test. I was like this at her age 25 years ago. Falling sleep throughout the day, being exhausted all the time etc and it took years to be diagnosed with coeliac disease. Perhaps the fact she already has diagnosed IBS would support further tests.

I’d also look at monitoring her phone to check she isn’t on it in the middle of the night. I remember discovering my year 8 daughter was awake and on her phone hours after going to bed. We then disabled apps after a certain time. And believe me, we fully trusted her before that 🙈

yep start with iron and ferritin. NHS will say ferritin of 17 is ‘fine’ it’s not, under 70 and my GP even admits you can start to seem symptoms of things like hair loss.

After that rule out celiac.

Then I’d look at things like EDS/hypermobility as that can be linked to things like MCAS and POTS which might be the actual reason for IBS type symptoms. Really I should have got a diagnosis of POTS and ME in high school, but it took decades. Not to the level I was falling asleep, but it was always there in the background as I managed but struggled.

I'd echo a full panel of bloods, THS, iron, ferritin, D, b9/ folate, B12, then look at the results and understand the difference between "in range" and "optimal". I was borderline folate deficient for years but pre easier access to actual numbers and ranges had just accepted that all was normal when it wasn't at all.

DD's teacher once emailed me to say she had been falling asleep in class. Turned out she was sneaking on the tablet for hours in the middle of the night! Fully trusted her too.

Another possibility OP, does she snore? DS was complaining of being tired all the time, went to the doctor and turned out that because he snored so much he wasn't getting restful sleep. Got his tonsils shaved smaller and the problem went away.

Have you tried her with co codamol or feminax for period pains? A dietician and retest for IBS would be a good idea. I often got styes and mouth ulcers as a teen but this was before 5 a day came in. Yes she would gain weight on BCP but prob only half a stone. My sleep I needed much more as a teen so try earlier bedtimes and lie ins on weekends. I also used to fall asleep in scripture lessons (could’ve been that lesson though) as a teen. Anaemia should be tested. Steak and lambs liver I found good for iron levels. She does seem to be doing an awful lot too (dance) so maybe consider cutting or reducing something.

Is there any danger of her purging after eating? She’s definitely eating what you give her? Girls with eating disorders can be very sneaky. If not that then I agree with a previous poster.. coeliac screen. Also has she had screening for thyroid? Had any nasty viruses? I had viral meningitis as a child and that lead to chronic fatigue syndrome.

I’d defo carry on with the tests and I’d bring bedtime forward an hour as I don’t think she is getting enough sleep, and it’s sounds like with the bus she has very long days. can you take her once or twice a week so she can get a little more sleep?

Mine are year 8 and 9 and get pretty tired with having to mask so much. They just wouldn’t cope on the bus everyday.

Could she have PMDD? I always thought this was all
about mental health, but there’s a lot of impact to
physical health too. For example, I didn’t realise my HRT patch (that I use to manage it) had fallen off until I went to change it, but that explained why I was asleep by 8pm 3 nights in a row and felt like i had the flu!

There are a lot of suggestions for various tests etc in this thread, which may well be required, but I’d start with simply getting her more sleep. 8 hours isn’t enough for the majority of 13 year olds, and most tiredness is caused by insufficient sleep.

Poor girl sounds very unwell. To feel a bit tired if you're not sleeping enough is one thing. Actually falling asleep sat upright is not normal in an active teenager.

I hope the blood tests give you some answers.

At puberty she may need 10-12 hours sleep a night.

Healthy sleep duration
Age: 6-13 years 9-12 hours
Age: 13-18 years 8-10 hours
Age: 18 + years 8-9 hours

Hi. Not sure if this will reply correctly. My son had been bleeding slightly from his stomach for years and was very very anemic. Would literally fall asleep at the drop of a hat, also had a smooth tongue (sign of severe anemia) and was eating ice. He was very pale. He is now on prescribed iron tablets and it has made a big difference BUT it took years. His ferratin was non existent at one point. I would double check his ferratin and HB blood tests.

Remove all devices from room as she may waken up later at night and be doom scrolling. If you have done that check for any secondary devices you don't know about.

@Yogalover91i would describe her pre menstrual moods as her being made of glass and very very fragile. This month nothing though since the pill!

It’s really good that you’re going back to the GP for bloods, it does sound like she has anaemia. From reading through your other posts I’m wondering if she has bile acid malabsorption. Which will be making the anaemia worse especially if there is a deficiency in vitamin B also. If possible please ask them to screen for vitamin deficiencies alongside iron, there are different types of anaemia caused by other deficiencies (especially B6/B12) so treating with just iron might not cure it and anaemia can totally knock you off your feet with tiredness.
I have bile acid malabsorption along with IBS and PCOS (although I believe it is no longer called this), the heavy periods meant I was anaemic much of the time and the bile acid malabsorption meant I didn’t absorb the vitamins and minerals which make things worse. A diet containing too much fat can make it worse so I no longer eat fried foods.
I'm lucky that I finally got a really good consultant who ruled out bowel cancer, crohns and other conditions before testing for bile acid malabsorption which most consultants miss, it can present like ibs or crohns. I’ve been struggling since I was 10!
If you can, it would be worth asking for a referral to a specialist and asking them to test for bile acid malabsorption, it is easily treated and also comes with a multi nutrient prescription that is much better than over the counter supplements which should help reduce tiredness.
Good luck

See if you can get her bloods done sooner, I was horrendously anemic at school, also if they give her iron supplements look at the research about taking them every other day to improve absorption, and you must take them with vitamin C such as orange juice or fruit, do make sure she’s eating enough at school. My anemia was due to undereating but hers is likely her periods, and the more anemic we are the heavier the periods for some reason. She might also have a problem storing the iron or an absorption problem, if the iron is low so make sure they’re checking all of the iron bloods including storage. Also check for vitamin D and b12 levels. Also if it’s low but not “dangerously low” and they try and fob you off with dietary advice, tell them how much she does eat and ask if it could be an absorption or storage problem. ask what the optimal levels should be, not just the normal levels. Also get them to repeat her bloods after 4-6 weeks on supplements if they prescribe anything. Sounds awful, at least she finishes school in a couple of weeks for summer xx

See your GP again . I've known students have serious underlying health problems. Without wanting to worry you , get her checked to rule out conditions .
I cannot recall any 13 year olds falling asleep in lessons

In addition to so e of the other suggestions, things to perhaps look into would be idiopathic hypersomnia, me/CFS or long covid.
Viruses can make everything worse regardless so try and protect her from catching them if you can. In particular there are things you can do to reduce household spread. Masks, ventilation, HEPA filters, private vaccines etc.

Are they testing thyroid function? I went through 2 hellish years of feeling awful, eating and eating and losing weight, everything thinking I had an eating disorder, exhausted all the time in my teens. Thyroid wasnt checked because "teenagers dont have thyroid issues" Guess what, I did. This was 1990s, but once treated I felt so much better.

Came here to suggest glandular fever. I had the viral bit (cold/cough) but it was weeks later that I began falling asleep in lessons.

At that age I would go to bed at 9 and get up at 7. 8 hours isn’t enough sleep for most young teenagers.

I have two 13yo. Recently started insisting that screens are off by 830, showers and bed by 9 on a school night. It’s made a big difference. They get up about 630/7 for sch.