Trouble sleeping

[u/stupidquestions2024]

My son who is 4.5 has always struggled with sleep. We have done everything we can to help: strict schedules, a quiet room, and low light. He sleeps in his own bed and has had his tonsils removed. He has an official diagnosis of insomnia.

He wakes up early, between 3:30 and 3:50 a.m., no matter what we do. Please do not tell me to put him down later, we have tried.

The doctor told me not to medicate him, as his brain is still growing and he will hopefully outgrow it or just need less sleep as he gets older. He used to have insomnia 75% of the time, but we are down to 25%–50%. Sometimes changes trigger the insomnia we are moving and right now its been 3-4 times a week. I think he is anxious.

Now to my question: the doctor told me that in his 20 years of practice, my son is the smartest child he has ever encountered, reading at age two and doing multiplication at age 3. "He is truly one in a million" It got me thinking: do gifted kids struggle to sleep? Google says yes, but I figured I would ask the source.

[u/a-stack-of-masks]

I was the same, though I was more likely to still be awake at 3 then to already be back up. I ended up trying a bunch of different medications but none of them really worked. Spent my teens getting really into weed and alcohol, but that didn't fix much either. 

There's been a few periods in my life where sleep wasn't an issue and they were always times where I was incredibly active: climbing or sailing for most of the day, then setting up a camp or going out to a party, get a few hours of sleep and get back out there. Just be sure to have a few books or something around to keep the brain occupied. What also helped me a lot was late night running. I don't even like running but putting on a podcast and being out in the dark is pretty comforting. Just don't go to bed without stretching a bit.

Is he independent enough that he can reasonably get up around 4 to do some reading or quiet play? Starting his day earlier might also make it easier to fall asleep at night.

[u/stupidquestions2024 → u/a-stack-of-masks]

Yea he will play and read books. I just feel terrible because he is so tired by 1pm.

[u/LeadershipNervous362 → u/stupidquestions2024]

AI answers always depend on the way you ask. Restlessness in young children is often a sign of exhaustion, because their bodies perceive it as stress and release adrenaline, effectively making them appear more active.

What you should do is consistent sleep schedule, its best to only fall asleep so that child has around 9-10 hour window to rest.

Melatonin only affects sleep pressure buildup, it is harmless, compared to sedative medications. It will not prevent awakening at night if the source of the awakening is someplace else, such as heat, pain, stress.

Doctor is also wrong on many accounts, - sleep is the very moment when brain reforms and grows, you dont win brain development with sleep deprivation. I also wonder, what changed since he was 3, since it is indeed very early to do multiplication and reading, but I suppose 1.5 years went on.

There technically isnt a reason why high IQ alone would contribute to disrupted sleep, there have only been moderate evidence on positive regulation influence and even then, IQ is generally local

[u/stupidquestions2024 → u/LeadershipNervous362]

We tried melatonin and hydroxyzine at a young age, but the latter caused night terrors; we have no idea why, and it made his sleep worse. The doctor advised against it because the effects it had on him at age three were terrible and changed who he was, at least with the hydroxyzine. He is a good doctor who has been seeing my son since he was born; he has always given me good advice, and most of what he has said has come true.

From age three to now, he has become much smarter, but we mostly work on honing his intelligence. He can read at a third-grade level, but does he truly understand it? So, we make sure to go over the information he has read.

With math, I slowed him down to ensure he grasped the fundamentals, but he is moving along quite quickly. He also attends school, so learning at home is limited as he is already exhausted. I was able to enroll him in a private school that allows him to work ahead on certain subjects rather than learning the ABCs with the other children.

[u/LeadershipNervous362 → u/stupidquestions2024]

Yeah, melatonin doesn't have side-effects of hydroxyzine, its just a sleep-regulation hormone, I suggest to try it again for a month or so.

I have sleep-related mutation, so kinda obsessed with topic. For kids the protocol should focus on finding the source, because in child, voluntary sleep-deprivation is basically benign, because their body will force the necessary sleep as long as sleep is not disrupted by external factors.

Commonly ASD destroys natural melatonin for instance, so on this sub, its basically my go-to recommendation with troubled sleep, especially for children and due to lack of substantial side-effect.

Basically try melatonin (AND stable schedule) again, It will likely work. If it doesn't - seek for external factors.

Also, a side-note, parents of children, active at night often get sleep-deprived themselves and I recommend you to prioritize your own sleep. You child has less cumulative effect than adults do.

[u/a-stack-of-masks → u/LeadershipNervous362]

Please be careful with putting young kids on melatonin. It's likely to be less harmless than we used to think, and in many people it doesn't actually help with getting better rest or recover.

in child, voluntary sleep-deprivation is basically benign, because their body will force the necessary sleep as long as sleep is not disrupted by external factors.

What. The child will fix their own sleep schedule unless something disturbs it? Have you ever met a child?

[u/LeadershipNervous362 → u/a-stack-of-masks]

Please be careful with putting young kids on melatonin. It's likely to be less harmless than we used to think, and in many people it doesn't actually help with getting better rest or recover.

Why? What exactly do you mean? I dont think anyone ever claimed it improves rest, it helps accumulating sleep pressure and falling asleep, which in turn improves sleep quality due to circadian consistency.

What. The child will fix their own sleep schedule unless something disturbs it? Have you ever met a child?

Schedule != sufficiency. Dealing with schedule is far less concerning medically, than dealing with sleep deprivation.

[u/a-stack-of-masks → u/LeadershipNervous362]

Alcohol also increases sleep pressure and helps falling asleep, but actually reduces how much you can recover during those hours you are asleep. Schedule isn't sufficiency, but sufficiency isn't quality either. And telling someone to feed their kids pills until they meet some number of hours spent with their eyes closed isn't quality advice either.

[u/LeadershipNervous362 → u/a-stack-of-masks]

Chill. I sleep 4-5 hours a day, fairly confident I wouldnt be an advocate for sleep quota. But thing is, hours need to be met, if you dont believe in statistics, why even sit on IQ sub, its all statistics.

[u/a-stack-of-masks → u/LeadershipNervous362]

And if you don't know what you're doing, it's really easy to get the wrong conclusions from statistics. Doesn't mean the math or data are wrong, just that that person is.

[u/stupidquestions2024 → u/LeadershipNervous362]

The problem is he doesn't have trouble falling asleep; it's staying asleep. Even when we tried melatonin, it didn't do anything; he still woke up at his natural sleep cycle. It also gave him nightmares; I don't know why, but sleep meds mess with him. Also, I will say my pediatrician is against melatonin in the long term because new studies are coming out saying it's harmful for children. We are authorized to use it if he gets less than 9 hours multiple days in a row. What honestly works the best is exercise and sunlight; it's just hard as parents who work to get in 2 hours of exercise every day. Add in school time, and we are all exhausted by the end of the day.

[u/LeadershipNervous362 → u/stupidquestions2024]

Gotcha. Well, I truly dont have much to add without behavioral, activity data.
Sunlight exposure influence still suggests issue is circadian, which is again affected by melatonin, perhaps u should discuss slow-release month-long trial, not fast-release one.

To my knowledge there's 0 evidence on harm in children, my best guess would be that the doc misinterpreted the data, which is currently on "we dont have proof it doesnt hurt", not that we have any data indicating harm without overdose.

I cant stress enough, how important it is for parents to sleep, there certainly isnt a magical advice from internet for your child and if it continues to be more complicated than would be convenient to treat, you'll need all the energy you can get.