פרק 43 : הפרעות שינה עם ד”ר אורית סטולר נוירולוגית ילדים

Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
דר אורית סטולר (00:40):
Autism.
Okay, I see them growing here.
I have patients who are already20 plus and also the families.
There is something.
There is no doubt that it takesyou to a different place, but I
think that the marriage ingeneral it took you to a
different place.
So it's just a different thing.
And then it's really a test ofthe strength Of the person,
where he comes from, what powershe has and what relationship he

(01:05):
has.
You can talk about this forhours and hours.
There are some that therelationship, on the contrary,
strengthens and there are somethat break.
There are a lot of jobs thatshow a very high probability of
relatively high divorce amongparents of special needs
children and basically it's thebasis of what's there, and

(01:26):
basically it's the basis ofwhat's there.
So whenever they come out of myexamination, I always tell the
parents that they need to investin the relationship.

אנה אברהמי (01:39):
They have to because otherwise it's
complicated.
The truth is that I didn't getit, but the truth is that it's
the tree.
There's also a really nice bookcalled Far From the Tree.
I heard about it, I didn'tforget, and it's really nice
really.
But there's a very big partthere for parents, for special

(02:00):
needs that really makes thedifference between getting out
of the closet and we have thisepisode of the rise of a special
family, and he says there thatit takes the relationship to the
edge.
To the edge like either itstrengthens or it breaks.

One of the problems I have, from the place
I'm in, as a person who isinvolved in research.
I will soon introduce myself,like what I do, but the problem
is ומחקר.
אני תכף אציג את עצמי מה אניעושה, אבל הבעיה היא בהכללה ואחד
הדברים שאנחנו רואים בכנסים.
אני יושבת בכנסים, יש כנסיםבינלאומיים של חוקרים לא של רופים

(02:35):
, אלא יותר של חוקרים ששם אנייותר אוהבת ללכת, כי שם יש את
הדברים החדשים, ויש המון ש andthere are new things.
And there is a lot of talkabout the difference between
those who are profound autism,those who are the autistic
children in the lower class,what we call them.
They are an individuality initself that, in a certain sense,

(02:57):
is neglected, is notstrengthened right in the world
of research, because when I dowork, it is easier to take the
children who are verbal andconnected Thank you, and their
voice is.
Now.
There's a very nice study thatI always tell about that took a
group of neurotypical people anddid this game of passing a word

(04:08):
, that they pass it.
You know that you pass a wordand it has to pass from one to
the other yes, like a brokenphone, right, a broken phone
that you connect to the word.
And they took one circle ofneurotypicals, one of the
autists in high-profile and oneof a circle, one of the

(04:29):
neurotypicals, one of theautists in high-level work and
one of this, one of that.
And between us, theneurotypicals, the message
passed.
Among the autists in high-levelwork the message passes
perfectly.
They communicate well.
The problem was in this one,this one.
There it was established.
And I think that when we talkabout these in high-level work,
we talk about a differentcommunication.
שכשמדברים על אלה בתפקוד הגבוה.
אנחנו מדברים על תקשורת אחרת.
שאנחנו צריכים לגשר.
אנחנו מדברים שפות שונות.
יש לנו תרבות שונה וצריך כמולהתפגש, כמו ללכת לסין.

(04:51):
אתה צריך ללמוד את התרבות, אתהשפה.
זה משהו אחד, אבל אנחנו צריכיםלזכור שבתחת In DSM-5, I believe
that in DSM-6 there are somechanges there is this group of
profound autism that we slightlymute their voice.
In the world of research, in theworld of communication, we hear

(05:13):
them less.
And also the parentalexperience there is very, very
different, because being aparent of a child with a high
job is not necessarily easier.
I think you're always on theedge that I'll do a little more

(05:34):
and he'll be normal.
I'll do a little more and he'll.
This is as good as it gets.
But I'm assuming that youunderstand that you're dealing
with life quality and qualitylife and not combining them.
But everyone is a world full ofus.
We need to really separate andbe careful not to do the
analysis that was done in DSM.

(05:55):
Unfortunately.
Then I thought it was right.
Today I think it's not a goodthing for everyone, but we'll
see what happens.

Okay, not that we got involved no notv kez lo
bishu ze itkanasmo Tishmi regaAmosal agid lach shenachno
moklitot eser dakot kulelpiteron bayotechniyot ve'a
seharot sheniyamdu shaloshpahamin Ze lo.
It was very exciting and I'm sohappy you're here.
I'll show you how to present itas it comes to you.

(06:25):
It was important for me to sayabout the subject of the common
language.
I signed with my 8-year-old sonthe inspiration for this
podcast David for Minecraft.
I gave him Minecraft because heloves Minecraft.
We got there and it.

(06:47):
It was, at the same time, anexciting and exciting experience
.
Okay, because he entered thereto the people of Sugu.
They, in a second and a half,connected Everyone.
He entered to children whoalready know each other and

(07:10):
around this Minecraft.
They are like communicatingThank you and the joy that he
had on his face that's what wasalways also also makes you happy
and also makes Reema happy whenshe says I'm not of his kind,

(07:34):
like he has here a group that hefound.

But I think that, anna, I think that this
experience also makes a child ina normative development she can
endure.
But it's great.
It's great because I thinkthat's where we need to go and
whenever parents come to me soat a young age I often speak, my
language is let's see how wegive the child the maximum of

(08:01):
tools to allow him to integrateinto the world and to be, in the
end, an adult, independent andhappy in the world and to play a
role.
By the way, that's also what Iwant for my children.
I want them to be independent,happy and happy.
After that, I want more.
Yes, I want them to be renewedwith people I love and I want
them to be in university and Iwant and want, but in the actual

(08:26):
line, I want them to besatisfied, independent and
active.
Now, when you hold on to thisbasic thing, then in the first
stage, in the young children, myalways recommendations to the
parents are let's bring themhere First of all.
Let's bring them here.
But when I get to the stagewhere I see that the child is
already active let's say a childat 6, 7 years old then my
advice is let's look for wherethe child is good, what

(08:47):
motivates him, let's strengthenhis strengths, Because a child
or a person on the train isfirst and foremost a child.
He is first and foremost aperson and, like all of us, we
are born from success.
So if the child is good atmusic, you will teach him to
learn music.
Then you will teach him to workat the communication clinics
all day, shalom to learn to draw.
If he's good at taking pictures, he'll take pictures.

(09:12):
The problem is that mostautists are really good at
sitting in front of a screen anddoing things Right.
So here you need to see how youtake something functional.
You know Good.

So, dr Oritz Toller , you came here because you were
talking about sleep.
Let me introduce you because Ifeel like I'm going to hear some
very, very important speech, soI'll introduce myself to you
because I think you have somevery important talent.

So I will introduce myself First of all.
Thank you, anna.
It's great and I'm very happyto be a part of it, because I
think that these places that youcreate a platform that allows
parents to listen in their time,in their place.
One of the problems is thatthere are people who are

(10:09):
available to listen to you whenyou say why that it's not good
that they arrive at 3 am.
Shalom that parents receivethat.
Sometimes I hold my head and Isay God, keep like, where did
they get this thing from?
So a word about me.
And then it started.
So I'm a neurologist forchildren.

(10:31):
I'm not a psychiatrist.
I'm a neurologist for children,a specialist in neurology and
development of the child.
I finished the apprenticeshipwith children in Meir in Kfar
Saba and then I moved to Ichilov.
There I did my degree inneurology and development of the
child and then I was more thana decade in the doctor's office
in the autism center.
It was also a diagnosis thatover time I got worse at the old

(10:54):
age, especially at the young.
I did a pharmacological surgerythat treated a pediatric
patient with autistic childrenand I was responsible for the
alutaf drug in autistic childrenand I was responsible for the
treatment, which is a lot around.

(11:16):
The issue of.
It started with food and sleep.
It was things like that.
I believe that they are thebasis for us human beings in
general and they were, werealways in focus.
And then I got involved in theissue of medical cannabis and in
the end I finished, a few yearsago, a very large study oncabi.
I took myself to run thechildren's development center in

(11:37):
the Sharon district.
I found a framework, a center.
First of all, maccabi I'm not aperson of medical schools.
I've always worked in medicalschools and I was able to find a

(12:01):
lot of motivation over thecountry.
Not just in Maccabi, but allover the country are some kind
of black box.
There are patients who don'tknow how to handle it and there
is a lot of good will and veryhigh motivation to do something
good.
There ויש המון רצון טובומוטיבציה מאוד גבוהה לעשות שם

(12:25):
משהו טוב.
ואני מרגישה ברת מזל להיות חלקמאיזשהו ניסיון לעשות שם השינויים
על כל כך הרבה רובדים.
אפשר לדבר על זה פודקאסט שלם עלכל הבעיות שיש, כל כל מה שצריך
לעשות.
אבל באמת חשוב לי להגיד.

(12:46):
But it's really important forme to say that there are
professional people, and veryqualified people.
People spend a lot of money tocome to me to do tests.
In my case, I think I'm doing amuch better job, especially in
the hospitals in Maccabi.
But not for that we met.
And what about sleep?
So I'll tell a short story andthen we'll start.
There was a family member whocame to me with a lot of
behavioral problems and I was inthe pharmacology department and

(13:10):
I started taking amnesia.
I started thinking the child issick, the child is not
communicating, and the child isthis and that, a lot of things.
And then, in such a natural way, but without any expectation
that something would happen, Iasked a question.
I said, okay, this child ishealthy, by the way, he eats
well, he sleeps.
And then he said, wow, hedoesn't sleep.
What does that mean?
He doesn't sleep?
So they said no, a six-year-oldchild was beaten on the hands

(13:35):
of his parents.
She is abusing his mother.
And then she, quietly, quietly,like a baby, she put him in the
bed.
This happens around 12.
And then she tells me I have 10minutes to do, a workout to get
ready to do, because I knowthat at 12.30, maximum one she
wakes up again.
And, in short, I saw a family indistress.

(13:56):
His animals don't sleep at allat home.
They went to sleep at the houseof his grandmother who lives
not far.
A couple of parents whosemother left work.
First of all a woman withdepression, a pediatric patient,
the father.
I asked him tell me a little sohe was sure he would get a
promotion, but he did notsucceed in achieving the
promotion.

(14:16):
All the friends who were in hisposition, he was no longer in
touch with them.
In short, a family in distress.
And then I said they lefteverything.
First of all, let's take careof the sleep, because a child
doesn't sleep.
He says that the whole familydoesn't sleep.
And if the whole family doesn'tsleep, how can they act?
And then I went and looked andyou see studies that show
Clearly that sleep disordersAffect or one of the parents who

(14:42):
doesn't work.
They work from home.
There is a lot more anxiety,depression, anxiety.
There is a lot more use ofpsychiatric drugs in the parents
and the children.
The probability of childrenwith children who don't sleep is
much higher than in the otherparents.
So I understood that.
From my point of view, when wetalk about autism, this is the

(15:04):
emergency situation.
This is a, so because of that,it's very important for me to be
here, and because of that wemeet.

Wow, because I don't know how, at least once a
month, a parent who takes a babyand goes to the streets and
starts crying Because from themoment he starts with urology

(15:50):
and all the fever and all thatattacks it Again.
That's why this podcast existsand everyone says that time is
the most important.
But you see, it's only half ayear and it's about sleep.
I can't Not agree with you more.
And it's exactly.
I always say it.
It's like it's against theGeneva Agreement.

That is, they hold you in a bed, not human.

it's impossible not to sleep, and I also advise
sleep for babies.
So I also decided to come to myfamily and just see how, all of
a sudden, everyone starts to bemore healthy after two or three
months.

No, it's amazing because when you think
about sleep, we spend a third ofour lives in sleep.
That is, if a person lives 90years, 30 years, he sleeps.
When you understand thesenumbers, you understand that we
sleep so much.
And then the question is whathappens there this year?
Shema Yishen Kilo kshata mevineta misparim eyle eta mevin
sh'nachnu kol kach harbe zmanyishenim v'az ha-shelay ma korey
.
Shama be'etzeh ba shena azotiLama Z'lo rak anachnu Z'kol

(16:51):
ha-chayot yishenot Afiloha-dolfin yesh lo shnei mochot
ve'mohach.
What do you need to sleep?
That's a question and it's afascinating topic, because what
we're, first of all, it's atopic that has been studied for
20 years.
You see the trend of jobs thatgo and try to understand better

(17:17):
all this subject of sleep.
And when we talk about sleep,there are a few things you need
to understand.
Sleeping is not a privilege,it's something that is a need.
It's a need on many levels, forexample I'll give an example.
For example, we know that let'ssay, a psalter player, someone

(17:38):
who has a concert in a psalter.
So the first thing they tell aperson is to play your piece, go
to sleep and get up tomorrowand you'll be much better.
And there are amazing worksthat show the ability, for
example, to give people somekind of routine of four days to
study and then, for example,they do it at 10 in the morning,

(17:59):
they do it at 10 in the eveningand then they do it again at 10
in the morning and you reallysee the accuracy and the quality
improve after the sleep.
It's the issue of clarifyingthings.
We know that in sleep there areconstant processes in which

(18:21):
memories turn into somethingthat is lost, both memory and
learning.
It only happens in sleep.
That is, if I want to study fora test, the best thing I need
to do is read the material andgo to sleep.
This is the place where sleep,the material becomes mine.

(18:42):
In fact, it goes through someprocess of loss in the right
area of the brain which itremains with me.
But I also want to connect thisto other places, for example,
cancer, right, so cancer and theimmune system.
Today we know that people whodon't sleep get more sick and
they have more cancer, moreinfectious diseases, for example

(19:16):
, people who work in hospitals,for example, nurses and people
like that.
Shalom Yeter, machalot levaviyotYeshe arbe yoter asmanah
v'sakeret le'anashim sheloyeshenim V'dikaon v'shinuim
b'matzav haruach ze barurshanachnu royim arbe yoter
V'yesht ta'alich, norah ma'anyen, shigilu otorak v'shanim
haachanot shani ani lo yatech,let'er otor v'.

(19:37):
That is, there is a cleansingprocess Because what happens?
The brain works, it needs a lotof energy In this process of
energy consumption.
We consume substances that thebody does not need and it
happens in the brain.
This substance that happens isthe substance that makes us feel
the beauty, it makes us want togo to sleep.
And what happens in the sleep?

(19:57):
The cells in the brain, the CSF, absorb the brain and just make
a sponge cleaning all thismaterial that we have cleaned
and we don't need and allows usto function.

Wow, and if we don't sleep, it's like passing a
smart tooth instead of washingyour teeth.

Right, it's the easiest thing there is.
And what are the advantages ofthat?
Wow, that is.
Sleeping is not a privilege,it's something that is a waste.
People who don't sleep, theirquality of life is less good,
money problems.
I always say, when I didsupport in children's medicine

(20:40):
and I was in the hospital, yes,now, in our time, there were no
demonstrations and there was noall Shalom.
The child's mood is the same,right, the other thing I was in
a movement all the time.
I was afraid that if I sit Iwill fall and I ate junk.
I ate everything on my handjust to stay in peace.
The stone was damaged.
The mood, the function, themood.
You are shorter, you are moreannoying, you are impossible

(21:00):
when you don't sleep.

So sleep is not a privilege and it's not a right,
but it's a right.
You're inevitably, I don't know.

Right, right, no, totally.
We also need to remember thatfor every age I'm still a
pediatrician there is the numberof hours of sleep that we need
for them.
That is, the number of hours ofsleep for babies is different
than for a child in the middleand we need to remember that for
everyone.
There are his recommendations.
Within the recommendationsthere is a line.

(22:24):
There is no right and no wrong.
There are adults who have sixhours of sleep and there are
those who need eight or nine.
So there is some kind ofbiological framework that exists
.
So if I need a little bit ofsleep and let's say I can deal
theoretically with, let's say,in the ideal world, I say I need
six hours of sleep, I oftenbenefit from the five, but I pay

(22:58):
for it at some price, which isnot always clear.
Shana, when they reach my agethere are other things.
There is the transition age,there is hormone and there are
other things that enter, thatinterfere.
So the sleep problem is a bitdifferent.
But when they talk to me aboutchildren, I have to adapt the
expectations to the age that is.

(23:18):
You cannot expect an adult tosleep 12 hours.

You have to adapt it.
Let's talk for a moment abouthow sleep habits are created and
what needs to be done, forexample, even in regular
children.
How does this mechanism becreated?
Besides, I'm tired, I'm tired,right.

So first of all , we know that I'll divide it
into two.
There's the biological part andthere's the environmental and
behavioral part.
There's the biological part andthere's the environmental part.
In the biological part, firstof all, there are people who
have genetic disorders thatcause sleep disorders.
Those are people who have areal damage to their DNA, which

(24:00):
you see in families.
For example, the issue ofrestless leg.
It's something that runs infamilies.
You see the parents like this,you see the children like this,
and then it's anotherintervention, it's a violation
of itself that you have to dealwith.
But if we're talking about sleepin general, there are a lot of
systems that are involved in it.
But the big things I'll put thebig things and we won't look at

(24:24):
the resolutions of the colnicin, but the big and not look like
the results of the colonic acid.
But in large, basically, in thearea, if I go from the back
inside, there is an area wherethere is a part of the brain
that collects the light, whathappens around, and actually
releases to us a hormone calledmelatonin.

(24:45):
Melatonin releases its Q or therelease to the brain.
ובעצם מפריש לנו הורמון שנקראהמלטונים.
המלטונים משתחרר הוא הקיוש שלואו הגירוי לשחרור הוא הדברים
הסביבתיים, שזה האור.
אז אם אני רואה הרבה אור, אזהמלטונים יורד.
ואם אני נמצאת במקום חשוך, וזה,אז זה יירד, למשל to the airport.

(25:08):
So there's fluorescent light.
This fluorescent does aninabitia on the release of
melatonin.
Basically they don't want to bediluted on the airport floor.
On the airport floor it's aplace that doesn't have day and
night.
Actually.

Or that the employees don't do it
intentionally so that we don'tfeel tired and don't go home.

Right, right, so this is fluorescent, so the
light is one place we have andthe melatonin is what creates
the beginning of the sleep orthe entry into sleep.
And we'll go back to melatoninbecause here we have a place to
talk about it in terms ofabsorption.
But there are other substancesthat are released.
For example, as I said, let'ssay, physical activity, fatigue,

(25:45):
also mental, let's say, if I'mvery, very focused, then the
body, the effort in the brain,releases this waste that I
talked about earlier.
Also, it, when the levels rise,is what makes us feel the
fatigue.
Because of that, we recommendpeople to do physical activity
during the day, to be active, tocreate this material so that it

(26:07):
will be useful to us, so thatit will make our sleep better.
So, in order to sleep, from aphysiological point of view, you
need to have no genetic problem.
You need a biological clockthat will work with sleep and
sleep that is activated in theenvironment, and you need to be
busy and active and create yourfirst cues.
But I want to talk a little bitabout the things of the

(26:29):
environment.
ואתה צריך להיות עסוק ולהיותפעיל ולייצר את הסימנים ה-QOs
הראשונים שלך.
אבל אני רוצה לדבר מילה עלהדברים של הסביבה ועל האורטיסטים,
כמו שדיברת קודם כל.
עכשיו אני אתחיל עם הילדים עלהרצף.
אחד הדברים שאנחנו רואים במחקריםזה שלהרבה מהילדים על הרצ, thank

(27:10):
you, but you need to use it ina way.
That's also in a way.

(27:31):
That's also in a way that'sl'aider à la maison.
מפחיד, תחשבו איזה פחד זה ללכתתישון.
אתה רוצה מנעים ואתה לא יודע מהקורה.
לך, מפחיד ממש.
אז צריך להתאים את הסביבה, אזלהכשיך את הבית, להוריד את הקצת,

(27:54):
להתחיל לדבר בשקט יותר.

אי אפשר ללכת תישון כשכל הבית צועק.
אני, I would have been quieter.
I would not have done it withmy film.
No, but look, you have tocreate an environment that
invites sleep.

So one of the things I always tell the parents
come on, keep the house okay,turn off the television.
You need silence, you need toallow to feel Like, let's say,

(28:26):
if you go to a spa, for example,something.
When you go in, the smell, thelight, the pressure goes down,
everything will be quieter, youstart to breathe slower, you
feel healthy before they come toyou, because what they do there
, they put a dark room, theycreate an atmosphere that
invites this peace.
This needs to be brought home.
So it's impossible't expectfrom a child that the parents

(28:50):
are screaming and laughing andthere's a mess and now you have
to sleep, sleep there.
It doesn't work like that.
We'll lose.
You can't force him to go tobed.
You can force him to go to bed,but sleep is not.
It won't work.
I'm joking, huh.
So the thing you need to do isto make the house feel good, to
make the house feel good, tocreate air.

(29:10):
When we talk about childrenwith autism, it's very important
the temperature, the sleep, thebed.
Sometimes all you need to do isput on the child such a heavy
sleep because he needs theweight from children who have a
problem with their feeling, withtheir tactile, that they are
always looking for a deep touch,that they are always looking.

(29:31):
A heavy seed can solve part ofthe problem for us.
For example, we need fences.
Parents sometimes put fencesthat are not suitable.
We sometimes need to put fenceswithout too much pollution,
something quiet and not right.
First of all, let's start withthat.

(29:58):
There is nothing that includeseveryone.
Shalom T'argishu.
Ma'a temperatura T'arichu ma'atemerifim T'staklu misaviv ve'az
tegidu li ima davar haze mat'imOlai shama a ba'aya Haya a
mishpacha she ba'a elay ve'asinuta targil haze ve'istabe'a ve'a

(30:24):
yeled kol pamוקר.
כשאתה נכנסים לחדר, תצלמו את החדרשהוא הולך לישון ותצלמו את החדר
שהוא קם.
ומה ראינו בתמונה?
שהאור של הפנס?
רחוב נחבה, כן, נחבה.
אז מה שהאבא עשה, חמוד בחיי, מהאנשים עושים לפעמים?
הוא התקשר and asked them not towear the mask because he could

(30:46):
sleep.
So listen, sometimes people dostrange things, but we solved
the problem of the outside lightnot being able to see until
there was no outside light.
So you have to look and see,right, you don't always need
drugs, but sometimes you needenvironmental things.
So first of all, you have tocreate the light, the
temperature, the environmentalconditions, and then there's the

(31:09):
part of the routine.
Every child, including me, Ialso believe that you, and
certainly children on the train,love routine.
Knowing what's keeping you iscreating an anxiety and silence.
We love routines becausethere's something predictable
about it.
So to create a routine aroundthe sleep and you can use

(31:32):
pictures that have the clearorder and then to take off the
velcro every time Now I clenchedmy teeth, now I washed, now I
ate, now I'm reading a book andnow I go to bed and go to sleep
Okay, to turn it into astructured routine and a plan.

(32:02):
That is there.
Okay, that will disappear.
It's the most terrible thingyou need to do now.

But if things are like this, if they don't go out,
it's some kind of circle withwhat you can't get out of.

So we're starting a speech, anna, to say,
wow, what fun we're going tosleep now.
What fun for us.
Do you know what fun it's goingto be?
We're going to rest, to sleep,to be relaxed.

That's the end you have to start with that,
Although it's very interestingto me.
I really feel like I'm startingto lose weight, Although I got
my period today.
No, but I want to say that youcan remember all this, talk

(32:45):
about the change in a positiveway and organize the room and do
this, and that you can do itwhen you have the strength as a
parent.
Okay, Because, for example, I'min a kind of secret place
that's been seen so far, and thehouse, everything is raw.

I think that when I hear this voice, that
it's a voice that I hear thatthe parents feel that there's no
capacity to make any process,that they're tired, that they
can't anymore, that they're nolonger active.
This is the stage that I doturn to medical intervention.
Sometimes, okay, because I feelthat there's no one to work.
Sometimes, okay, because I feellike I don't have anyone to

(33:29):
work with.
Okay, you can't give a drugalone.
But first of all, you have tofeel a little bit and then.
So let's talk a little bitabout what options I have and
how I think about drug treatment.
First of all, it's not mypreference.
It's always my preference.
There are a lot of people todaywho are sleep experts, who
deserve to be approached and getadvice.

(33:50):
There are sleep advisors.
A lot of them are in the market.
There.
There is no competition.
I sometimes hear crazy thingsand there are some great ones
and some you caught me, so I'mgoing to go back to what I was
saying.

No, no, I'll say it .
It's fine, you say it.
I went to be a sleep assistantbecause I wanted to get rid of
people to use Super Nanny'stools.
Okay, and I like all this DrSpock thing.
He got it back.
He got it back on his own, onthis annoying method.

(34:31):
Okay, the private units I didthem for free and the groups I
did them almost for free.
I need this very much from therecommendations, from the things
I personally.
I have four children.
I didn't believe in this way.
First of all, I'll start withthis.
We're talking about cry it out.
Yes, yes, I don't, for the sakeof it.

We're talking about this method of
accommodation.
Yes, we're not talking aboutthis.

We're talking about this treatment method that they
teach a baby when they put himin the room and they let him cry
, and all the variations of thetwo minutes and the five minutes
and to go back, all thevariations are suffering and a
real injury in the brain of thebaby.
Don't do it.
I think it's a injury in thefaith.
It's a injury in the faith,ממשית במוח של התינוק.

(35:28):
אל תעזור את זה.

אני חושבת שזה פגיעה באמון, זה בעיקר זה, פגיעה
באמון.
אני אחלק את זה גם לשתיים.
אני חושבת שהורים שבאים ואומריםשהילד לא ישם.
ואז הם מספרים לי שהוא קם באמצעהלילה.
ואז השאלה שלי כשאתה?
When he comes to the bed, hefalls asleep immediately.
If they tell me, yes, he has nosleep problem, it's a problem
with sleep habits.
If he doesn't manage to fallasleep in the parents' bed, then

(35:53):
it's already a sleep problemand then we have to talk about
it.
But if the child falls asleepin the parents' presence without
a problem, it's a habit.
Now, let's say, a parent comesand tells me first of all, I
want to take a step back andtalk.
When we talk about sleepproblems in children, but in

(36:13):
autistic children in particular,first of all, it's very
different.
80% of children on the chainhave sleep problems.
The difference between sleepproblems of a child on the chain
and a child with a developmentdisorder, which is much less
than that, let's say, in thisregular population, about 5-6%
of the children have sleepdisorders.
In children with disabilities,we're talking about 25%, 50%,
depending on who you're talkingto.
In autistics, we're talkingabout 80%.

(36:35):
But what's the difference?
That for children, the recipedoesn't work if we don't hurry.
That is, they also see adultswho don't sleep, so we have to
help them.
Okay, when we talk about sleepproblems, we talk about how many

(36:56):
problems?
Usually we talk about insomnia,which is difficult in sleep
itself.
There are sleep problems inother places that we will not
talk about right now.
There will be no time.
When we talk about insomnia, wedivide it into several parts.
There are children who do notmanage to sleep.
They enter the bed and they donot sleep, and it can take an
hour, an hour and a half, andthey are waking up.
They can't manage to relaxthemselves, they don't manage to

(37:20):
breathe and get into sleep.
And there are those who havebiotic behavior that they don't
manage to get into the roomthemselves which then you have
to see how we increase themotivation and how we change the

(37:42):
language.
And there are those who just getup to destroy their mother and
then they just leave the roomevery two minutes and run away
Right.
And then the question is whythey do it and what is the
reward?
What do they get as a result ofit?

(38:02):
Yes, when you wake up and youcan't go back to sleep, so
that's a problem.
And then we have the childrenwho wake up very early, the
early wakings.
So first of all, let's talkabout what to fix and what not
to fix.
First of all, we talked aboutevery age has its own length of
sleep that he needs to sleep.
I expect a child to wake up inhalf an hour.

(38:23):
I expect that after a year ortwo the child will have a
routine of Shabbat Shalom andagain, we expect that the waking

(38:44):
up will be according to thetime of sleep that he needs and
not so early.
That is a child who woke up at5 in the morning.
Of course there is some problemNow, when you talk about
integration, it depends on where.
So, for example, a child whowoke up in the middle of the
night and does not manage towake up.
So my first question is how?

(39:05):
How did he sleep in thebeginning?
Because if I have a parent whotells me that he goes into the
bed with the child and he hugshim on the back and he makes him
feel nice, and that's how thechild sleeps at 8 o'clock in the
evening.
So when he wakes up at 3o'clock he's waiting for the
same thing to go back to sleep.

He doesn't know how to sleep.
This is in young people.

young people not necessarily, if I take big
children, even children say 7 or8, if they're used to calming
down with a screen, with an iPad, when they wake up at 3 in the
morning they'll want their iPadand the iPad wakes them up.
It hurts in the sleep.

(39:48):
So the habits how you calm downat first, they want their iPad
and the iPad wakes them up.
It hurts in sleep.
So the habits, how you sleep atfirst, will affect how you
sleep in the middle of the night.
When we talk about sleep,everyone has sleep cycles, all
of us.
All of us.
Every hour and a half we reach asleep stage that is between
sleep and awareness.
Okay, this flexibility, okay,when you have a partial

(40:12):
awareness, it's not sleep.
The brain waves, they'respecific waves and you're a
little aware of what's happening.
You hear what's happening.
Now, if I'm autistic and I havea sensory, sensory sensitivity,
I'll be exhausted, exhausted atthis stage and I don't have to
go back to sleep because I wakeup, I smell, I hear, I'm angry,
everything.

(40:32):
If I'm a person who has OCD andI'm obsessive, I had a girl who
what she did was wake up.
She would leave the bed,arrange the bed, arrange all her
things, go back to bed and goto sleep.
But it's too, את המיטה, מסדרתאת כל הבובות שלה, חוזרת למיטה
והולכת לישון.
אבל זה יותר מדי פעולות בשביללחזור לישון.
אז אם יש מחשבות תורדניות, זה גםכן יכול לפגוע.

(40:55):
זאת אומרת, אני צריכה כל מקרהלקחת ולפתוח אותו ולנסות להבין מה
הסיבה שבגללו he doesn't manageto recover in the beginning,
doesn't manage to recover first,or why did he get up early.
And the intervention will be inthe same there is behavioral
intervention and then there ismedical intervention for each of
the situations.

So let's talk for a moment about things that can be
taken and not done.
I will ask you about themelatonin that we mentioned that
does not come from a doctor,but from these kind of red-hot
dogs that I know, without alabel, in iHerb and in Israel
it's no, no, no, and melatoninhas to be labeled, right.

(41:37):
So can you jump in if you know,if you're sure you know?

So I want to talk first of all.
Why is melatonin legal forchildren with autism?
We said earlier, there is logic.
After all, it's pretty safe andits safety profile is also very
known.
And it's also very safe, thatis.
I have no problem.
It's something.

It's a coincidence that it's easy for me to give it
to her, because I know shedoesn't have any symptoms of HIV
usually Because I know shedoesn't have any symptoms of HIV
in general and it's notfamiliar Because I had mothers
that I knew.
As you say, the woman doesn'tsleep for five days.
You can't give her pills fromthe stress and I brought her the
melatonin and she didn't giveit to her daughter because she

(42:24):
was afraid it would cause her.

So it's not.
It's a natural substance.
The body releases it.
Now there's this market in theUnited States, in Canada, where
they put it in OTC.
They put it in the supermarket.
In other words, in the UnitedStates you can go and buy milk,
bread and melatonin and thereare complete supplies.
And I went to visit my family.
There are little kids.
They give every child a bottlebefore he goes to sleep and it's
like something terrible in themainstream there.

(42:48):
I don't like it.
Okay, it doesn't have to belike that.
No, I don't like it.
Now, one of the things thathappens with this that it's OTC,
that it's over the counter inthe United States, and that's
what you're inviting in iHerb isthat there's no criticism about
it.
That means, do your job.
Is that there is no discussionabout it?
That is, they did a job andtook from a lot of companies and

(43:09):
measured what is inside.
Is there a connection betweenwhat is inside this jelly bean,
inside this doobie, to what iswritten on the box?
Are there differences betweendifferent boxes?
There is no unity at all.
That is, for example, there arepatients who buy from IARP
because it is much moreexpensive and it is very
sensitive.
These doobies are small.
There are patients who buyL-Bi-I-R because it's much more
sensitive and it's verydangerous.

(43:29):
These pills or pills there areall kinds of methods it's very
easy to give and then theycontact me and say the child
doesn't sleep.
So I say, okay, buy again,invite again, because maybe the
next class will have L-Bi-I-Rand it won't.
You know, there's norestriction.
That means you can take one, 3mg, l'macharat, 5 mg.

(43:50):
אין על זה שום פיקוח.
מה שבטוח.
הדבר היחידי שהם מפקחים כשזהתוסף מזון בצורה כזאת, זה שזה
יהיה בטוח שזה לא יכול להרוג אתהילד.
שאין בזה ריאלים, אבל אף אחד לאמפתיח שיש בפנים על בא� and the
amount they say there is.
But one of the things we know inmelatonin and in sleep in
general that the placebo effecthas a very important place.

(44:13):
So it also works.
So I'm not against it.
But I want to talk about whathappens in Israel.
In Israel you can get melatoninand you can get it in the form
of syrup in a long-termpreparation.
And you can get melatonin andyou can get it in the form of
syrup in a raw preparation andyou can get it in.

(44:34):
So there is melatonin.
You need to request it in a rawpreparation, usually as syrup
or there are small balls thatyou can swallow them or stick
them.
But there is this In Israel.
It only takes a lot more.
It's more complex, much simpler, much more easy to order it,
recommend it in iHerb or throughthe internet.
But in Israel there is a drugthat I have been using a lot in

(44:55):
recent years.
It's called Sleneto, which isbasically like a syringe.
Those who have we know thatthey are over 55 years old with
problems with their eyes theyoften get a syringe.
That is melatonin in a liquidform.
שמייל 55 עם בעיות שינה, הםמקבלים הרבה פעמים סירקדין שזה
מלטונים בשחרור מושאה.
זאת אומרת, שאתה לוקח את הכדורויש שחרור של מלטונים בהתחלה

(45:16):
שעוזר לך להיכנס לשינה, ואז יששחרור איתי לאורך כל הלילה כדי
לאפשר ל� Shabbat Shalom.
First of all, it's rare we knowexactly if I say there's 2 mg,
there's 2 mg, I mean there's 5,because it's a drug and you get
at first the 5 mg and then youget the 5 mg released at night
and it really helps those whowake up at night.
So in Israel the solutions formelatonin are actually 3 options

(45:39):
.
We have the online invitationand I don't cancel it.
I'm not one of those who sayGewalt.
No, I think if it works, itworks.
I can fully understand itsadvantage.
It's easy to give it, itdoesn't cost much.
There are many advantages.
There's the second option forchildren whose only problem is

(46:31):
to enter the cell.
Yes, from the.

(46:56):
שפתרתי את הבעיה עם זה.
וממצאים על זה די הרבה זמן.
יש ילדים שבאיזשהו שלב פתאום זהמפסיק לעבוד.
אז צריך לבדוק למה.
אז אני עושה לפעמים חלון, שאנימפסיקה לתקופה קצרה ועד מחזרה,
ואז זה חוזר לעבוד.
אבל magiim lematzav sheamalatonin ulo apitaron az

(47:20):
yestanu pitronot nosofim avalani kodem yishal otahana im
yestachot sheilot legabeamalatonin vim no az ani yavor
letipulim acherin Koimko anirota lagid lach masho benogea le
tzerkadin Ani lakachti otor anirashmuli otor ki y Zaman mizman
mizman At nisit parm.

Ahad liknot tzerkadin ba beit merkachet hem
mitnayagim aleich kilu at konahheroin.
Ken benora Le ritalin le inanshal ha ritalin hem nu hem
choshdim pachot Ki katuv laim kikshem lamedu ha rokachim ze
amur laim.
So when someone who is 30 yearsold comes to them, they say

(47:58):
you're trying to get rid of it.
You're trying to get rid of itand I stopped taking T-Rex.
I just decided to do it once amonth.
It helped me.
But all this matter is just andnot here and yes, here.
So who?

There is no medical advice.
I will say such a thing.
There is no excuse.
It's a decision that iseconomic.
I think it's not doctor at all.
There's no reason for that.

I know now.
I had a sense of humor from myneurologist.
I had a sense of humor inaddition to the fact that I
would present to them every timeyes, she's conscious, and this
is the matter of thisbureaucracy sometimes and that's
what I mean.

(48:40):
For example, if I go to somekind of network network store
and there was a really niceseller there, I will always go
to Facebook to write to themabout it, and even if there was
a really bad seller, I will alsowrite to them about it, Because
sometimes the business ownerjust doesn't understand why the
businesses don't go.
He just has a reminder that hedoesn't like people.
Anyway, leave it sorry.
How do we convince them to takeit Again?

(49:03):
I think we have the potentialfor the dogs of iHerb here at
home All of them, by the way andwe need to move forward to
something more pleasant and fun.
And I don't convince not thebig one and not the small one to
take something that is not adog at night, not the syrup and

(49:24):
the balls.
How do you have an experience?

So, first of all, the boys, the company that
created us for Neto, did a fewthings.
One, they have a number ofphones that you can call and
there isיווי 24-7 או 8-8.

אני חושבת שהם עובדים אני חושבת אם זה היה 24-7,
זה גיוני.

אני חושבת ש אני יודעת שהם עובדים עד מאוחר בערב.
אני לא זוכרת בדיוק את השעות,אבל צריך לבדוק.
אבל פתחו קו חם כזה שיושבות שםאנשי.
But they developed a hotlinewhere professional people sit
there who can help and hear theprivate story and try to help
and do it.
I can say from the clinicusually with the Sloneto there

(50:12):
is no problem.
That is, either I tell theparents to put it in a cup with
milk, for example, so it ismixed, and then they just take a
cup of milk or chocolate orsomething like that.
It's a good idea.
But I have to say that a lot ofkids I've been using this
sleneto for years and a lot ofkids just take it.
It's written, it's smaller thana cigarette.
They just put it.

(50:47):
The kids themselves take it andput it in their mouth.
I have videos that parents sentme.
There were parents who came andsaid how do I give it, is it
possible?
They came and said how do Igive it, is it possible?
And then I gave them all kindsof ideas and then after a while
they send me a video.
They say here, take this.
He takes it, he puts it in hismouth and it's over.
You know, sometimes we're insuch a hurry and the child

(51:10):
doesn't even care.
It doesn't even move him.
So the great thing is, itdepends on how we approach it
and what we say.
Like that, without much, youhave to do it simply, not to get
into pressure before it happensat all.
Do it simply like that you werea slaneto.
I think you need arecommendation from a
neurologist or a psychiatristchildren, I think and then the

(51:35):
family doctor can continue withit.

But it's also a problem because you can't solve
it.
But I just write it down.
The meaning of it is 500 yearsand still to go and find this
neuropsychologist.

You're right.
I don't know if today doctorshave already developed it.
We need to see if doctors todaycan write it down.
It could be that if there's adiagnosis of autism in the
system, if it's written ASD inthe system, then it could be
that children's doctors can alsowrite it.
I need to check it.
I'll tell you.

I'll check it before I leave the show and I'll
write it in the comments.
There are no symptoms.
What are the?

symptoms.
There are almost no symptoms.
The things that cause anything,first of all, everything
changes.
And the things that cause them.
They are not things that areconsequent.
That is, I cannot say, forexample, that I give to a baby
Ritalin.
Then I can tell the baby I mean, I always tell the baby that

(52:38):
there is a high chance thatthere will be a decrease in
appetite, there will be adecrease.
I can't say the same thingabout the platonists.
I can say it when I give Prosa,I can say it, I can say it when
I give Trisperdal, but when Igive the platonists there are
all kinds of people parents,come to me sometimes and tell me
things I don't know if it'srelated or not related.

(53:01):
Look at the symptoms of thecamomile.
It's a fear of God becauseeverything is written there.
When I did the study Listen tome, this is weird I did a study
on cannabis here.
I'll tell you how do you writethis list.
It's a mess.
I did a work on cannabis and achild was sick.
He was sick probably because hehad a virus, but I'll write it

(53:23):
as a is possible because thechild takes cannabis.
So what do you do with this?
So I already understood withtime that the it's a good

(53:45):
solution.
It doesn't have to be the firstsolution.
First of all, you have to doenvironmental behavioral things
and I can recommend you to greatwomen who are really
professional people who can talkabout it and give very smart
advice in the field.
But there are cases in which,like you, tia Ardana, when you
tell me I'm tired, I haven'tslept, אנשים את אומרת לי אני
עייפה, אני כבר שנים לא ישנה, איןלי כוח, אין לי כוח.
אז, במקרה הזה, אני אגיד בואיניקח טיפול תרופתי, נשם קודם כל

(54:09):
תשנים.
ואחרי שאת ישנה, נכניס התערבותהתנהגותית ונוריד.
את זאת אומרת קודם כל, אני צריכהלייצר איזשהו שקט, מה שנקרא
ולאפשר.
אני רוצה לדבר על עוד אפשרויות,טיפול תרופתיות שקיימות.

(54:31):
לא לכולם מלטונים עוזר.
זה שאלה מה הבעיה?
אם הילד הוא מאוד, מאוד חרדתי,למשל, או יש לו אובססיות מאוד
משמעותיות או מחש, or he has verysignificant obsessions or
extraordinary thoughts, it's notcertain that the melatonin will
solve the problem.
In such a case I have to lookat what happens all day long.
And if the child is constantlyin anxiety, in obsessions and

(54:55):
constantly in a loop withhimself, the melatonin will not
solve the problem.
Maybe he will calm down, butwhen he wakes up he is not sure
that it will help.
And then the intervention needsto be in a different group,
because I need to treat whatleaves him the air, the fever.
So I would go to anothertreatment.
I would go, for example, toEsus Arise, like Prozac or

(55:22):
things, if the child is inconstant silence.
That is, he is one of thosechildren who the knowledge of
these children, who areconstantly in motion, constantly
in silence.
They are not able to basethemselves at any stage of the
day.
So why would they basethemselves at night?
That is, they are not able toreach this state.
This silence is so internalthat then I would go to a group
of other drugs, I would maybedrink a resperdal.
הם לא מצליחים להגיע לרוגע הזה.
האי שקט הזה הוא כל כך פנימי.
שאז הייתי הולכת לקבוצה שלתרופות אחרות, הייתי אולי שוקלת

(55:45):
ריס פרדל, אולי הייתי לוקחתקנאביס רפואי, אולי הריפלי.
הייתי הולכת לקבוצת תרופות שהיאשונה ז.
The problem of sleep is visibleto what is happening during the
day and then the interventionwill be if I have a child who is
quiet, or a very violent childor a child, so the resperdal may

(56:06):
also break me all day, but itwill also allow the child to
sleep and I will improve it.
Because a child who does notsleep we have already said so
there are more behavioralproblems, more violence.
There is more cognitive damage,memory problems, problems with
memory, problems with money,problems with language, problems
with growth, because the growthhormone is released.
That means you have to look atthe child as a whole and see if

(56:26):
I can.
If it's just sleep, then Iusually go to the platonist as a
first choice.

Wow, okay, but well , but to go and try, because
that's what we want.
I want to encourage oursponsors to do Not to say it
doesn't suit me, not to say Idon't give doctors a chance not
to say that To go and check andtry and understand what the
price is.
In the end they will think thatthis podcast will be a dream by

(56:57):
doctors' companies or somethinglike that, because we just
recorded a episode about Ritalinthat I encourage you to try.

Don't say no is .
I want to clarify something.
I believe that sleep disordersneed to be solved.
With sleep disorders we need tochange the environment, the
routines, the routines.
That's the solution.
I don't like children on medicaltreatments.
I think our job as parents isto give them a basket of drugs

(57:36):
so they can live and developwithout the addition of
chemicals.
But when I hear you, kilimkidei sheim yukhlu lichyod
vlitpatech blit ossefet shelchimikalim Aval kshani shomat
otach betor dugma she dibrakarega az biga ze igati la tipul
atrofati Veaz yeshamu trofotAval ani ruta nora chashuv li

(58:10):
lagid od mila Vim yesh mesershani ruta laavir Shabbat Shalom
Shema Shirot o'er.
It could be that he has, ah, itcould be that he has
obstructive sleep apnea, that hehas a problem with breathing at
all, that he's blocking such asleep, that there is so the
intervention in these cases.
Or it could be that he hasepilepsy.
It could also be or allergies.

(58:31):
I have a daughter who suffersfrom atopic dermatitis, asthma
of the skin.
Listen, it's hurting you, I'mgoing to get a haircut.
You get up in the middle of thenight and you get a haircut.
The treatment is not melatonin,it's not Risperdal, it's not
Ariplai, it's to treat the skin.
Children with reflux.
The treatment is not melatonin,it's not Risperdal, it's not
antacids.
It's to treat the reflux, it'sto give them antacids or to

(59:02):
increase the bed.
So we have to remember and ifthere's something I want you to
take from today, from thisconversation of ours, that
children on the chain are firstof all children and they can
have sleep problems because ofchildren, stubbornness, go to
bed when you're stubborn.
I wake up sometimes with aheadache.
It's terrible, it's unbearable.

So we have to deal with it.
Udi Kargan has a great part inthe stand-up where he says he
ate a lot of pizza before bedand then he wakes up.
And he wakes up from half ahangover, half something, and he
says it's exactly that, dr OritStoller.
Thank you so much.
It's been a pleasure.
Thank you for the opportunity.

(59:46):
It was really exciting and alsofree and also funny and also
very, very inspiring.

I just have to say thank you, dana, first of
all, for the opportunity to bepart of your initiative.
I think it's all very important.
I think there's no one like anexperienced owner.
The ability to bring all thisand to allow a platform for
people to get information issomething that everyone needs
information from elsewhere.

(01:00:11):
It's a platform that issuitable for some people and
it's wonderful.
So keep doing it and thank you,tamshi filasoto ve'kuda.

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.css-14f5ked{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:2;overflow:hidden;}פרק 43 : הפרעות שינה עם ד”ר אורית סטולר נוירולוגית ילדים

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.css-r6mb8g{margin:0;word-break:break-word;display:-webkit-box;-webkit-box-orient:vertical;box-orient:vertical;-webkit-line-clamp:1;overflow:hidden;}United States of Kennedy

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פרק 43 : הפרעות שינה עם ד”ר אורית סטולר נוירולוגית ילדים

United States of Kennedy