Sleep paralysis

[MomSA]

Our BPD 20yr old daughter has major sleep issues. She complains of nightmares, sleep paralysis and insomnia. Is there anyone here who can offer input? We are taking her to a psychiatrist on July for assessment for anxiety, possible ADD and the sleep issues. I am reticent to have her on anything other than natural meds, but if this is all as severe as she says perhaps I do need to open up to it.

Our objective is to better understand the struggles our child faces and to learn the skills to improve our relationship and provide a supportive environment and also improve on our own emotional responses, attitudes and effectiveness as a family leaders

[Sunfl0wer]

My son has severe sleep issues, has a diagnosis of narcolepsy with cataplexy.   He can have symptoms such as: sleep paralysis, hypnogognic hallucinations, cataplexy, sleep drunkiness, and more.

I rarely hear other people complain of sleep paralysis without either narcolepsy or some other neurological issue such as a TBI. (Brain injury)

Imo, the thing to do is a sleep study +MSLT.
What is important to insist first time around is the full sleep study including the MSLT.  The MSLT is an “add on” part of the test that they often do not perform until after doing the sleep study without it, yet without this part of the test added, you can not get a diagnosis of narcolepsy ruled out (or diagnosed) if needed.  (Stands for Multiple Sleep Latency Test). So if the MLST is not initially included then the whole darn testing usually has to be repeated to add it on.  I hate this “procedure” way of testing folks because if someone has sleep apnea, then they CAN get a diagnosis for that via the basic sleep study, yet, imo, someone complaining of “sleep paralysis” should have the opportunity initially to rule out/in narcolepsy.  (The MSLT should always be added initially when the patients complaints are any part of narcolepsy symptoms)

Imo, sleep paralysis is a serious neurological complaint and should be taken seriously and the testing for helping sleep issues is pretty objective and can help sort out a course of treatment. (IF they add the MSLT to the test)

For most sleep disorders, the main course of treatment is sleep hygiene and maybe meds.  The sleep hygiene is extremely important and something that can be easily googled.  My son had a treatment team that included a sleep psychologist to discuss and hold him accountable for sleep hygiene issues.  It was hard stuff, but he now kinda has it mostly managed best he can.  (My son does not have BPD)

[MomSA]

Thank you for the info.

So I battle with finding the balance between my daughters truths and lies as well as her need for drama.

We do not have medical aid so everything comes out of our wallet. I am more than willing to help her with this, but I also know her sleep hygiene is shocking.

With BPD, telling her to do anything like get off her phone for an hour before bed, exercise, spend time in the sun, cut the sugar and alcohol...sets her off on a rage

[livednlearned]

I have a child on the spectrum (soon to be S18) with sleep issues (and depression/anxiety) and I no longer ask him how he slept or make suggestions about better sleep hygiene. I believe he does have sleep issues, and I also believe there is some comfort for him in using sleep as a way to explain why other things in his life don't work.

I mostly validate him, "I can see how exhausted you are, and yes, it's going to be rough today."

I used to offer advice which teenagers absolutely love  

Then I tried validating questions, "Have you found anything online, a support group or advice about what others have done to help them?"

Now I just nod. If I can't help it, sometimes I say, "Let me know if you want to take this to the next level."

Meaning, if he wants to go see a doctor, I'll help him navigate that.  

S17 has had three surgeries this past year to deal with a wound that won't heal. If he had better sleep hygiene and diet, it would probably heal faster given his age. He's essentially on bedrest -- doesn't help sleep hygiene -- and hates being homebound. If that doesn't motivate him to get a handle on sleep issues, I don't know what will.

Better diet and better sleep are intensely personal issues and require a lot of self-discipline and motivation. Giving him advice just made him angry and made me felt defeated and helpless.

When he is ready to make his health a priority, I will gladly be there to walk with him.

[MomSA]

Thank you for the reply...I do hear you.

The thing is she is wanting to take it to the next level but only with meds...I want to take a holistic approach.

Surely because I am paying I get to have some say in the treatment?

[GaGrl]

Perhaps a medical professional can explain sleep hygeine, and she will receive it better than coming from a parent. Also, options can be paid out for her to try, escalating from natural to meds.