4.5 yo always tired

[byjove]

We are struggling a bit with our 4.5 yo. She always seems to be tired and is quite grumpy during mornings/evenings and weekends. She is usually a happy and cooperative girl at school (full day). She sleeps 10.5- 12 hrs most nights, and she usually takes a 45min- 1 hr nap at school on weekdays when she gets closer to the lower range of night sleep (avg 11 hrs). They are outside all day and very active at school. On weekends she usually naps one day for 2 hrs.

This morning she got into trouble at school (very, very unusual for her) and teachers and us parents alike think it was because she was tired. She usually is well behaved at school but was doing some of her disruptive behavior- things we usually see on the weekend when she is tired. They let her take an extra long nap at school today and she was perkier this afternoon.

She had her tonsils out last summer for moderate sleep apnea and the doctors told us to expect sleep to be better- and in some way it has (snoring and restlessness has stopped). But this just seems like a lot for her always being so tired.

We’ll see her pulm (for asthma) this week, who originally put us on to the sleep apnea (and had a sleep study done). I’m guessing we should push for another sleep study. Any other advice?

Maybe I’m overreacting, but I’m worried about the k transition this fall and her having to wake up earlier plus no nap if she is always this tired.

[Tlex]

Hmm my 4 year old gets a similar amount of sleep and I'd be concerned too in your shoes.

For reference D1 is very active but sleeps 7-7 and often naps 45m-2hrs, but the naps fluctuate.

[klondike]

Is her asthma well controlled? When DS2 is having an overall harder time like when grass seeds, he's cranky and doesn't sleep as well. Has she had bloodwork done recently to check vitamin levels, iron etc?

[byjove]

Apr 9, 2018 16:12:44 GMT -6 klondike said:

Is her asthma well controlled? When DS1 is having an overall harder time like when grass seeds, he's cranky and doesn't sleep as well. Has she had bloodwork done recently to check vitamin levels, iron etc?

As far as we know her asthma is well controlled- she hasn’t been showing symptoms. We also give her Zyrtec and Flonase regularly (drippy noses flare her asthma).

She had a bunch of routine blood work done in January and everything was normal, but I don’t think it checked all the different vitamins.

[misskilljoy]

Could you get her iron levels checked? Iron deficiency causes fatigue/tiredness and irritability.

[boycebear]

Yes, get her iron levels checked. I'm currently on medication for low iron, if it's still low in a month, I have to see a haematologist. I was like your daughter...getting adequate sleep, but still being exhausted all day. My bloods gave no indication of why my levels were low, I'm not lacking anything apparently, but sometimes it just turns out that way , could be similar for your LO?

[byjove]

Her iron was good in January. Would it change that quickly?

[boycebear]

Apr 9, 2018 16:39:12 GMT -6 byjove said:

Her iron was good in January. Would it change that quickly?

Honestly...anything is possible, I would say yes, it could. It's worth asking for another check.

[klondike]

Apr 9, 2018 16:26:02 GMT -6 byjove said:

As far as we know her asthma is well controlled- she hasn’t been showing symptoms. We also give her Zyrtec and Flonase regularly (drippy noses flare her asthma).

She had a bunch of routine blood work done in January and everything was normal, but I don’t think it checked all the different vitamins.

Zyrtec completely wired DS & made him a monster. Like he'd give a nasty answer when I just asked if he wanted ice cream. We switched to Claritin.

edit: It didn't matter what time of day we gave it. It was an instant change once we stopped and the Claritin works better anyways. We do that in the morning along with fluticasone (rx flonase), flovent inhaler & albuterol as needed.

[GhoatMonket]

If you have ruled out medical issues do remember she could be growing and the seasons are changing. If it's been screwy weather where you are, that can play a role as well. Learning new mental skills can be tiring as well, so if they are learning new things in school, that can be contributing as well.

[cmb]

Zyrtec knocks me out, but wires up DS1 so it’s a possible culprit.

Have you ever tested her thyroid? When DS1 was going through his trial to see if he went into remission, he got a lot more tired and slept more once his TSH started to rise above normal levels

[byjove]

Apr 9, 2018 16:48:10 GMT -6 klondike said:

Apr 9, 2018 16:26:02 GMT -6 byjove said:

As far as we know her asthma is well controlled- she hasn’t been showing symptoms. We also give her Zyrtec and Flonase regularly (drippy noses flare her asthma).

She had a bunch of routine blood work done in January and everything was normal, but I don’t think it checked all the different vitamins.

Zyrtec completely wired DS & made him a monster. Like he'd give a nasty answer when I just asked if he wanted ice cream. We switched to Claritin.

edit: It didn't matter what time of day we gave it. It was an instant change once we stopped and the Claritin works better anyways. We do that in the morning along with fluticasone (rx flonase), flovent inhaler & albuterol as needed.

That’s a thought. Maybe we’ll stop it for a few days and see what happens.

[byjove]

Apr 9, 2018 17:04:23 GMT -6 cmb said:

Zyrtec knocks me out, but wires up DS1 so it’s a possible culprit.

Have you ever tested her thyroid? When DS1 was going through his trial to see if he went into remission, he got a lot more tired and slept more once his TSH started to rise above normal levels

We have not to my knowledge, but thyroid issues run on both sides of the family. That’s something to remember.

[byjove]

Apr 9, 2018 16:51:12 GMT -6 GhoatMonket said:

If you have ruled out medical issues do remember she could be growing and the seasons are changing. If it's been screwy weather where you are, that can play a role as well. Learning new mental skills can be tiring as well, so if they are learning new things in school, that can be contributing as well.

Definitely the winter that won’t quit here. I’m hoping that’s all this is!

[klondike]

Apr 9, 2018 17:06:08 GMT -6 byjove said:

Apr 9, 2018 16:48:10 GMT -6 klondike said:

Zyrtec completely wired DS & made him a monster. Like he'd give a nasty answer when I just asked if he wanted ice cream. We switched to Claritin.

edit: It didn't matter what time of day we gave it. It was an instant change once we stopped and the Claritin works better anyways. We do that in the morning along with fluticasone (rx flonase), flovent inhaler & albuterol as needed.

That’s a thought. Maybe we’ll stop it for a few days and see what happens.

I really would give it a shot. I also don't think DS was getting restful sleep while on it. He was alseep, but didn't seem completely rested after a full night. I hope you can figure it out & she feels better. Dealing with a tired cranky kid is no fun, but they aren't really enjoying their days either that way.

[cyprissa]

Albuterol late in the day can also be a culprit. When DS1 has had it, he sleeps restlessly and seems more tired. It’s sometimes unavoidable but definitely a consideration.

[cmb]

Apr 9, 2018 17:08:24 GMT -6 byjove said:

Apr 9, 2018 17:04:23 GMT -6 cmb said:

Zyrtec knocks me out, but wires up DS1 so it’s a possible culprit.

Have you ever tested her thyroid? When DS1 was going through his trial to see if he went into remission, he got a lot more tired and slept more once his TSH started to rise above normal levels

We have not to my knowledge, but thyroid issues run on both sides of the family. That’s something to remember.

It runs on both sides of ours as well. We caught his at 13 months due to no teeth. It doesn’t hurt to ask for a thyroid panel to be added to a blood draw if she doesn’t get better with summer coming or changing meds.

[icedcoffee]

No extra advice but I just wanted to chime in. I have a daughter who recently turned 5 and I would say that is a normal/good amount of sleep for a kid her age. I don't think you are overreacting!! Hopefully you can figure it out soon

[byjove]

Apr 9, 2018 17:18:03 GMT -6 cyprissa said:

Albuterol late in the day can also be a culprit. When DS1 has had it, he sleeps restlessly and seems more tired. It’s sometimes unavoidable but definitely a consideration.

Oh yes, the albuterol definitely drives her up the wall when we have to give it around the clock. She hasn’t needed any in a few weeks, so I can’t blame it on that this time...

[byjove]

We saw her pulm today and he thinks since her lungs are doing well and she seems chronically congested, that we should do some allergy testing and see if there is some environmental component (dust/mites, etc) that might aggravate her while she sleeps. We're also going to take a break from the antihistamines for the testing and also to see what that does for her. If everything comes back normal/no changes, he thinks we should consult with the sleep doctors. This is all makes sense to us, so FX we'll get to the bottom of this.

[spottedprincess]

byjove , I have no advice for you, but it sounds like you have a good plan to finding the problem. FX for you.