Any ideas? 31 month old sleep has gone downhill :(

[Sam-n-Max's Mommy]

Hi everyone,

DS is 31 months old.  For the past month, his sleep has been atrocious.  He dropped his nap back in the beginning of August (after having gone on and off of them for a few months).  He seemed to handle it very well and was sleeping through the night for about 11.5 hours (he has always been low sleep needs, and even when he was napping in the months prior he was totaling 11-11.5 hours per day).  Over the past month, he wakes up 1-2x per night.  Sometimes he resettles on his own, sometimes I have to go in just to reassure him and he goes right back, other times (like last night), he goes from zero to inconsolable in no time and tries to dive out of his crib (which he has been successful at before).  We have ordered to pieces to convert his crib into a toddler bed, which I am dreading since I don't think he's ready and it will be a disaster, but it is now a safety issue so we have no choice.  Anyway, his wake times have been getting earlier, which have been only giving him 11 or a little less than 11 hours of sleep at night.  Even though he is low sleep needs, I think that extra half hour makes a difference.  The past few nights BT was 6:30 (as opposed to 7).  He falls asleep within five minutes.  Wednesday night he slept from 6:30-6:10 with no NWs.  Last night, he slept from 6:30-5:50 with an NW where he tried to dive out.  Probably took him about 1/2 hr to fall back to sleep, DH sat in the room. 

I think the EW could be from OT, but I don't think NWs necessarily are, but maybe.  All of his teeth are in.  I do suspect that maybe he is having some GI discomfort because since June he has had this random vomiting in the middle of the night.  The GI specialist gave him new reflux meds which work *most* of the time.  He's not vomiting as frequently, but I still think maybe his stomach is bothering him.  (His BMs are very inconsistent meaning the consistency changes from one BM to another and he can go up to 4 times..plus he gets horrible diaper rash).  We are in the process of getting a second opinion with another GI, but in the meantime, do you think discomfort is causing the night time issues or routine? I try to give him a catnap in the car sometimes to keep any OT at bay, but he will rarely take it.  I'm at my wits end, I'm so tired and am very worked up that he's not getting enough sleep. 

Routine before issues started --
7:00 BT
6:30 WU (on occasion a little earlier or later)

Any ideas? Thanks!
Nicole 

[Buntybear]

Hi, if you think it our be food have you kept a food diary to find some common foods? Even if you haven't yet it might be worthwhile for your second opinion doctor? Also note BMs, the vomiting, NWs and any rashes.

Have you tried to eliminate any foods previously?

[Sam-n-Max's Mommy]

Hi - thanks - I haven't kept a food diary, but I will try that. To be honest, he doesn't really have *that* much variation from day to day in his diet, but I guess the type of veggie puree I use in his pancakes or french toast in the am varies and the type of sandwich he has each day varies (ie peanut butter and sweet potato, avocado and "cheese").  He loves berries, so it's mostly different kinds of berries and grapes that he eats.   I will keep a food diary and note the BMs/vomiting/etc.  The only foods we eliminated from his diet were gluten, casein, and egg, that was in April, on doctor's orders -- not because he was showing signs of intolerance, but because his blood work showed and intolerance and she felt these could be things that were contributing to his speech delay.  She now is convinced that he has a yeast overgrowth, but I'm not so sure that that would necessarily cause the bad sleep.

Last night was horrendous.  Up at 12:30, I went him told him it was ok and to go back to sleep, I left the room, he started screaming, went back in and he was trying to dive out of his crib, so of course I stayed there.  DH came in and ended up pulling him out of the crib (which unless he's sick we never take him out in the MOTN) because it was hard to stop him from diving out.  He was just crying and crying and wouldn't go back to sleep.  Didn't want to be rocked, didn't want to rest of me, kept running for the door crying open, open.  He finally was back to sleep at 3am .  I feel like OT is a different -- it's more of a wake, cry out, and then back to sleep, not a long NW like that.  With that said, this is the first LONG NW we've had in awhile.  He has still been waking early, although he slept in until about 7:20am this morning after falling asleep at 6:45 -- but, that was with a 2 1/2 hr NW. Going to try to nap him, but even on a bad night he usually won't, but maybe today will be different.  I am so frustrated because he can't tell me what's wrong and I really don't know if it's discomfort, OT, or something else

[Buntybear]

Is he having any naps now that he NW and EW? I imagine that OT must be creeping with those 2 going on.

So did eliminating those foods change anything? Vomiting points to an allergy or reflux I think. Is casein dairy? I guess he had reflux when he was a baby - was he dairy free then?

[Sam-n-Max's Mommy]

I always try with a nap - but am usually unsuccessful.  Since the NWs and EWs have been worse lately, I've been trying to drive him around to fall asleep, but he still won't.  That's not even an option for the next few days with the hurricane here.   We're going to try to nap him today and hope that because it's dark out he'll maybe fall asleep.  fx

Well, when we went gluten, casein, and egg free in April, it didn't really change his sleep, except for the fact that he was waking from naps much happier (since he had been napping back then) than he had been before (he frequently would wake screaming and that went away).  Recently, he wakes up crying (not screaming) in the am and he used to wake up very happy. 

He is on Prevacid for reflux, but on occasion he still vomits in the middle of the night, even on it.  I think he is on the highest dose possible.  He had reflux as a baby and was on Zantac up until June, when the MOTN vomiting began - that's when he went on Prevacid.  With that said, he never vomited in the MOTN as a baby and was on the same dose of Zantac for a very long time, which made me think that he was growing out of it.  He was not dairy free as a baby, but we had big problems with bfing and then went on a gentle formula, which he did well on.  He was never able to tolerate regular milk, so his ped thought he was lactose intolerant.  He seemed to tolerate Lactaid well, but could also tolerate regular yogurt and cheese. 

I wonder if he's developed a corn or soy allergy/intolerance.

I know he must be OT at this point, even though he is usually pretty pleasant during the day.  I am scared to have an earlier BT than 6:30 because he usually doesn't tack, but maybe I have no other choice at this point.  I really don't see how he could be UT with no nap, so I've ruled that out.

Thank you for your help with this

[Buntybear]

Hi, hope you are safe and well after Sandy 

He does seem to be getting a good 11 hours at night which must be OK for a low sleep needs LO?? On no nap days Olly often won't tag on either  I think at this age that the EWs are tend to be OT and so I would keep with the 6.30pm BTs.

As for his discomfort I have asked for some more eyes about the reflux as I am not sure about that. I do know that a lot of relfux kids can be sensitive to dairy and soy so if you did want to trial an elimination  would start with them 

[my3girlsjde]

Hugs hun

My gut here is saying discomfort and ot. Any idea when you'll get to the next GI specialist?

I'm wondering if a growth spurt has triggered a reflux flare and perhaps your los Prevacid needs to be readjusted for weight. Would a paed be able to take a look in the meantime? I really do think some kind of discomfort is at play here but not sure if reflux or allergy or intolerance related reflux is the cause iykwim. I think that's where your GI specialist would know best but I'm hoping you can see a paed for additional meds to make your lo comfortable at night.

Try not to worry so much about AP when your lo is uncomfortable or ot. Your main goal is to get out of the ot loop and then progress from there iykwim.

I hope you get some answers soon re medical specialists. I know how hard it is when something is up with their tummy and sleep is so easily affected.

[Sam-n-Max's Mommy]

Thanks, ladies.  Sorry I've been MIA.  We were in a few different hotels and then at my parents once they got power back after Sandy.  I kind of just did what I had to do during that week to keep us all sane.  We still have sleep issues, but now they are different ones! We didn't have any NWs while away, but all EWs (plus daylights savings time).  His diet changed a bit while we were away.  For example, he usually eats chicken nuggets for dinner -- they are gluten, dairy, and egg free.  While we were away, he was forced to eat grilled chicken (which was unbelievable because he is such a picky eater, but now he really likes it!) because I obviously couldn't make them and the kind we buy in the store weren't available.  However, he did have the other kind at my parents house and was fine, so not sure they are the issue.  Additionally, he drinks a smoothie called fruit and protein by Silk (it's soy based) and wasn't able to have that at all.  Maybe some kind of soy intolerance?  It could also be that his new probiotic started to kick in.  I'm not sure. 

I have to get back on the ball about getting the new pediatric GI, we just got back to our house on Wednesday, so things are a bit unsettled.  Going to work on it today.

Our new sleep issues (well we had experienced this a little bit before Sandy, but not to this extent) include not wanting to get into his crib and very short nights (as a result of it taking him too long to get down for bed and then EWing).  I am going to start a new thread about this because I *think* the issue with the crib is that he wants to be in a bed, but could be misreading it. 

Thanks for everything