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Question 9: I read your article and response to the question of meds. I found it very informative. My question is: What about meds. for something like a sleep disorder. The inability to sleep through the whole night or not all on some nights. My husband and I are going through these night wakenings with our 8 year old son. It just wouldn't seem to stop. Our neurologist, a pediatric neurologist prescribed clonidine for him. One quarter at first and now we are up to a half tablet. Have we seen any benifits? I don't know. The frequency of the night wakenings has lessened. But I find myself going to sleep at night praying that the med. won't have an adverse affect on him while we are asleep and unable to notice. Hope you can help us out? S.H., Texas, USA.

Hello S.H.:

I am leery to discuss specific medications for specific disorders simply because it is not my professional training as a future psychologist. What I can suggest in general however is that close monitoring of the medication for effectiveness and adverse effects as you've been doing is always a good plan. Also, only switch or change dosages one medication at a time -- otherwise you cannot know which action caused the changes you see and it makes the 'med-game' that much more frustrating and difficult to win. Remember that there will always be side effects; your neurologist should be available to you to discuss these with you, and you will have to decide whether the gains are worth the costs.

Briefly, and speaking strictly from the research as this is not my prescribed area of expertise, clonidine side effects are not too bad (relatively speaking): common ones are sedation (probably why it was prescribed) and hypotension (lowered blood pressure); the latter side effect can cause some lightheadedness and is also what makes the person drowsy. This information comes from Sandor, P. (1995) Clinical Management of Tourette's Syndrome and Associated Disorders. Canadian Journal of Psychiatry, 40, 577-583. My personal experience with clonidine also included dry mouth.

As a good night's sleep is THE bedrock strategy on which the success of all other strategies is affected, and since you seem uncomfortable with the use of medications, one final thing I will mention is that you may wish to take your son to a sleep clinic or to a psychologist with some specialization in sleep disorders. A clinic can monitor your son's sleep and diagnose and treat any specific sleep disorders. There are many behavioural strategies that can be very successful in treating sleep disorders and, if nothing else, these are both professionals that could suggest other potential medications for you to try if you or your son decide clonidine is not for you.

I hope this helped!
Dr. Dunc.

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