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Doctor Blake
Doctor Blake, Psychologist
Category: Mental Health
Satisfied Customers: 146
Experience:  Ph.D., Ed.S., NCSP Clinical Psychologist; 15+ years of experience; dual licensure
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Our son just turned 11. He had a bad nightmare about a year

Customer Question

Our son just turned 11. He had a bad nightmare about a year ago, in which he was alone in the world. It occurred shortly after we buried a cat which had died. Since that time he has been afraid of getting a similar nightmare and it is very difficult for him to get to sleep. He now usually sleeps in our room, prefers the light on, wants us to sleep first, has a little music making animal. Sometimes he falls asleep well, often though, in particular when he is overtired...he gets very worked up making falling asleep even worse. What is this condition called? What would you recommend to do?

Thanks! XXXXX
Submitted: 3 years ago.
Category: Mental Health
Expert:  Doctor Blake replied 3 years ago.

Good morning, and welcome to JA.

 

It is both inappropriate and unethical to diagnose over the internet. Your son has what could be described as insomnia (initial). It doesn't constitute a mental disorder at all... but he has established some poor sleep habits as the result of a scary nightmare.

 

What you essentially have to do is retrain your son to sleep in his room. I realize that this sounds rather simplistic - but there's really no need to go delving for stuff that might not (probably isn't) there. Here are several steps you might want to consider:

 

1. Make the external environment conducive to sleep. This means making certain that over-stimulating things in his room are removed, and under-stimulating or relaxing things are present. Some kids (and adults, actually) really benefit from the simple noise of a fan blowing all night or even a "white noise" machine. Music can be distracting but if he finds it relaxing, great. I would avoid music with lyrics, if at all possible. Your "music making animal" might just fit the bill here.

 

2. Make the internal environment conducive to sleep. This means making certain that your son sufficiently fatigued when he goes to bed that he'll drift off to sleep and not end up thinking too much instead of sleeping. Several natural ways to assist with sleeping include:

- relaxing foods. I know I sound like gramma, but milk and turkey were recommended to aide in sleep for a reason. Tryptophan is a natural agent that assists with sleep... and is present in both.

- relaxing drinks. No soda or other caffienated beverages afternoon until bedtime. That includes those "energy drinks" as well!

- relaxing at the correct times. Make sure he gets up on-time (not sleeping in) and takes no naps during the day. This will disrupt night-time sleeping.

- relaxing supplements. A non-prescribed dietary supplement to consider might be melatonin to aide in sleep disturbances. This is a naturally occurring substance produced by the body (specifically the pineal gland) and is used to treat some forms of insomnia and circadian rhythm sleep disorders. It is non-addicting and does not disrupt the natural REM cycle. In my experience, a typical dose (3mg) takes effect in roughly 20 minutes and allows natural sleep without grogginess or irritability in the morning. Regular use can restore non-sleepers to routine sleep patterns in a matter of 1-2 weeks, then melatonin can be (but doesn't have to be) discontinued. Please note - I am not certain what, if any, effects melatonin may have in conjunction with other medications... and if your son is on any, he should consult a medical doctor first. Melatonin (at least in the USA) can be purchased over-the-counter at any grocery, drug, or supplement/vitamin store.

 

3. Reinforce the appropriate sleeping behavior. Simply put, you may want to withhold a valuable reward until he displays appropriate sleeping behavior. The "schedule of reinforcement" will depend upon the degree/intensity of his sleeping problems. If it's a relatively mild problem, it could be as simple as...

- On Monday, if you sleep one night through in your room, you'll get <REWARD> on Tuesday for 30 minutes.

- Once he's successful on one day, raise it to two. So, if you sleep on Tuesday and Wednesday night through in your room, you'll get <REWARD> on Thursday for an hour. if no success, drop back to one, etc.

- If he's made it up to three nights in a row, you've probably got the problem licked! Thursday, Friday, and Saturday nights=2 hours of <REWARD> on Sunday. Then you can move up to week long intervals until you feel the new habit has been established.

 

If the problem is more difficult, then you might need to break it into half-night increments. I would avoid using this option from the outset - because it establishes the belief (in him and in you) that he won't be able to make it. Remember - NO <REWARD> (whatever you all select) until he's following the prescribed schedule. (If he gets the reward for doing nothing, he won't do the task. If we got a paycheck for not showing up to work, would we go?)

 

I appreciate your care and concern for your son, but I don't think we're dealing with any deeply internal emotional issues here - we've just gotten into a bad sleeping pattern. Establishing good "sleep hygiene" will go a long way toward getting him to your goal. If, after you have tried all three of these suggestions for about a month, the problem still persists - then you may want to consider consulting with his pediatrician and/or a licensed mental health professional for further advice.

 

I hope this was helpful. Although this is an inconvenient problem right now - just wait five years - when he starts asking to borrow the car! (Humor is also a good idea to help keep the mood light. This doesn't have to be a scary assignment... make it a fun challenge and something cool that will earn him <REWARD> time!)

 

Thanks.

 

* FEEDBACK ENCOURAGED. Please contact me prior to leaving negative feedback so that we can resolve the matter. I am eager to work with all JA clients to provide them with useful/helpful answers. Thanks again.

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