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So many things are going well that it is just awful that DD13 DYS is dealing with terrible sleep issues. She takes 2 hours to fall asleep (sometimes more), and while I thought it was recent, she says it became this bad last Fall. Once she falls asleep, she stays asleep, but she is so tired during the day. Her bedtime is early - 8am - as she has to get up early for 8th grade. We used to do melatonin which was amazing, but the long term use is not recommended so we stopped after 2 years. I am sick to death of hearing "sleep hygiene". We follow all the suggestions, and it makes absolutely no difference. Ideas anyone?

From my experience of multi-month insomnia caused by stress, the only thing that has short-circuited sleep deprivation consistently is exercise and exposure to sunlight throughout the day.

Early morning, vigorous exercise would force your DD to wake and build a natural sleep cycle again. If she spends most waking hours with exposure to direct sunlight, and consumes a high-protein diet (especially foods high in tryptophan later in the day), these will provide natural support to her circadian rhythm. It will take some short-term pain, though. I found daily exercise was what was needed, and there was a period of about 2 weeks where I had to force through some pretty extreme exhaustion to naturally fall asleep within 20 minutes at a desirable time.

My DS is only 8, so the things that work for a teen might be totally different, but I'll share in case it helps.

We used to do early bedtime, but DS would end up lying quietly in bed for hours waiting for sleep to come. He would frequently still be up at midnight after being put to bed at 8. He would then wake up on his own around 7. He never seemed tired, but we figured it couldn't be good for him. And we did manage to fix it for the most part, so here is what we now do:

Shower at 8:00, family reading time at 8:30, quiet reading time in bed from 9:00-10:00 with a low light, lights out at 10:00. Now instead of falling asleep at midnight, he falls asleep shortly after 10, often by 10:30. He wakes up on his own by 8 each morning. During the nighttime process, if we notice yawning we accelerate the schedule. This usually only happens when DS is sick though. The goal is to have him start trying to sleep when he is at his most tired. Too soon and he activates his brain from boredom and can't turn it off, too late and he has missed the window during which he is physiologically prepared to sleep and has to wait for the next window.

As a person who also suffers from issues with falling asleep I know that I can't go to bed until I am exhausted. If I get into bed early in the hopes of getting extra sleep (like if I have to be up early the next day), I will end up falling asleep even later. And it's because being awake in bed with nothing to do brings on the thinking. Once I'm thinking about things I don't seem to be able to stop. Then I often get good ideas and decide to get up and write them down so I don't forget. Which leads to being up at 1:30 typing emails to my sons aide at school about a better way to handle transitions from the sensory room back to class. Which leads to falling asleep after 3am. So I have learned not to ever get into bed unless I am feeling ready to drop. For me reading keeps me up because I get to into the story and suffer from one more chapter syndrome. If I had a responsible adult there to insist on lights out maybe that wouldn't be a problem, but our family is short on responsible adults. I like to do boring repetitive stuff to help me get tired, like organizing the files on my PC or reading the methods section of a study. Hey, it works

Hope this helps/at least gives you something to think about. Good luck.

If it started in the fall, it could likely already be chronic. Cognitive behavior therapy for insomnia is the only evidenced-based non-medication treatment for insomnia, and has equal efficacy to hypnotics within a few weeks, and higher efficacy afterward. It is typically an 8-week program that requires sleep restriction, so patients are often VERY sleep deprived for 2-3 weeks, then they really start sleeping. It is recommended to use a trained sleep physician or therapist, but if there is no one nearby, you can try following instructions online. You can read more about it at https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677. Good luck!

I feel you. MY DS8 has always been a wretched sleeper. For almost a year I thought we had it mostly solved, but here we are, and suddenly he "can't" fall asleep on his own again. So he'd been falling asleep in my bed, coming there in the middle of the night, or falling asleep on the couch. For the moment I've just given up and am letting him fall asleep on the couch, because the more he stresses out about not being asleep in his bed, the worse he sleeps--a cyclical problem.

Just as an idea, what if you let her read (a paper book, not on a device) in bed at 8pm for a bit? Laying down to read with just a small light on often helps me settle, and is less torturous than just lying awake thinking about how you're still awake. Maybe she'd fall asleep sooner if she got her mind off it.

I ended up taking DD to the doctor because it was time for her annual, and I thought I could make sure there wasn't a physical reason for the sleep issue (she has always had sleep troubles - ADHD is one reason). I had no idea if this new doctor would have any suggestions as we moved to a new country where medical care can be tricky, but she actually had some ideas, and some of them are those posted above by you all. It was worth it to have DD there as she actually listened to the doctor vs. discounting my advice!! We also found out that DD has low vitamin D and is slightly anemic. Hasn't there been research about the connection between vitamin D and sleep?

So, more aerobic exercise, use melatonin for one week then wean off gradually (to get back into sleep rhythm), try to sleep 30 minutes in darkened room, and if not, do 10 minutes of very boring work in a dim room (fold clothes or something) and then go back to bed, etc. The doctor said the longer she lays there the more the brain has time to think think think. She had a couple other ideas as well. The doctor seemed to understand how hard it was to turn off one's brain which was just nice to hear!We shall see how this all works.

My son's pediatrician said long term melatonin can be done one month on, one month off. I think it was a placebo effect for my son. When he took melatonin, he believed he would fall asleep, so he would do sleep hygiene and not stim. Otherwise, he stims for about 2 hours before he can sleep. Meditation helps him relax and sleep when he remembers to use it. He has ADHD too.

Re: placebo effect, you can buy sugar pills online. So if you're dispensing melatonin, you can use te placebo effect by still giving your child a pill on the days he is on a melatonin break

Bright sunlight at midday is what helps reset the body clock - according to someone who has suffered through this for years. I tried it for myself and am happy to say that it helps. Can your DD go outside to the playground or some such place during her lunch hour? There is no guarantee that it would work, but, no harm in trying. Also cut out the electronics at 6:30pm or before that if her sleep time is 8:00 pm. Good luck.

Interesting! I will check into this.

We are getting near the end of 8th grade so except a tea break, no going outside during the day. I might see if DD sleeps better in the summer when she is outside more of the time. We have always made sure she quits electronics 1 hour before bed. Perhaps it would help to close it down even earlier. It will be something else we can try once she is off melatonin..This week has been no nice as DD is going to sleep quickly due to the melatonin.