18 year old is up at night, asleep during the day
Do you have any experience with sleep assessments for teens, or particular sleep clinicians or clinics that work with teens? I would be grateful to hear your story. We're contemplating whether such as assessment would be worth pursuing for our kid.
Here's the context, FWIW: Our 18-year-old daughter is trying to find her way through generalized anxiety and depression, which has manifested variously over the years as OCD behavior, disordered eating, heightened risk-taking, etc. (She's been through CBT, DBT, nutritional counseling, talk therapy, psychiatric meds, and more. She spent a year in a combination of wilderness and an RTC and has been home for 18 months since "graduating" from RTC.)
For the last 11 months, her primary maladaptive coping strategy has been deeply disordered sleep. Her circadian rhythm is inverted: She usually wakes up at 5pm and goes to sleep anywhere from midnight to 4am. She sometimes sleeps 17 or more hours at a stretch, and occasionally goes for four or five days with almost no food while sleeping nearly non-stop.
Not surprisingly, she's dropped out of school, can't even contemplate getting a job, and doesn't often see friends. Life is going nowhere.
She is almost two months into a med transition from antidepressants to mood stabilizers, which her psychiatrist prescribed on the theory that perhaps the sleeping is part of a bipolar II depressive cycle. We've seen no improvement in the disordered sleeping as she titrates up on the mood stabilizer.
So: While our impulse is to say, "This is just the latest iteration of her anxiety," we also think (and her therapist and psychiatrist agree) that she should get some formal sleep evaluation to rule out any underlying health issues.
Anything you can share about your experience--including recommendations for particular clinics or practitioners--will be appreciated. Thank you so much.
Parent Replies
I would call Dr. Nick Pakzad at MUIR Pulmonary Critical Care and Sleep Medicine. The front office and Dr. Nick is thorough, kind and considerate.
I changed from California Sleep Center (formerly in Alameda and moved to San Leandro) for my sleep issues. The problems with California Sleep Center were:
1. No one answers the phone or returns calls; and
2. Main doctor spent little or no time with me regarding my problem.
In fact, when I switched from them to Dr. Nick's practice, the staff called to see if they could get some records (I provided them everything that I had) and NO ONE answered the phone for 3-4 days.
Hi,
It sounds like you've been trying lots of things. We looked into a sleep clinic and there was a respected one at UCSF that you need to get on a waiting list for. Instead, we saw Dr. Cooper in Berkeley and she was terrible. It's not worth your time to see her, plus she was humiliating for my daughter. The piece of the puzzle that you haven't addressed is checking to see if there is any underlying medical issue which may be playing a role in her mental health issues. You don't mention if your psychiatrist is more along of integrative care or not. I mention this because sometimes infections (for example lyme disease complex, EPV, bartonella, etc) affect different stages of sleep and can have mental health presentations. So you want to rule those out too as their treatments may affect how she responds to her psychiatric treatments, restorative sleep, and her circadian rhythms. Good luck.
I'm so sorry that your daughter (and you) are suffering. This may not be related, but I highly recommend a new book called Breath by James Nestor. I'm still reading it but based on the studies cited about blocked airways and disturbed sleep I've made an appt for my teen to get evaluation by an orthodontist who specializes in airway disruption (Dr. Ferrari, in Kensington). There's another in Pleasanton, I can find the name if you're interested. Sleep apnea is a real problem, even among young people. After the evaluation I'll see if a sleep study is needed. They rent out the equipment overnight for $250. There are also apps you can use to record her sleep. Good luck!