Autism & Sleep
Sleep can be a complex issue for autistic children, with many experiencing unique challenges that impact their rest. Let’s explore the specific types of sleep difficulties reported by autistic children, the reasons behind these challenges, and factors to consider when working towards improving sleep.
Common Sleep Difficulties in Autistic Children
Autistic children often report experiencing a range of sleep-related challenges that can make it difficult to get the rest they need. One common difficulty is taking a long time to fall asleep, even when feeling tired. This can be particularly frustrating for both the child and their parent/s and may arise due to difficulties winding down at the end of the day, heightened sensory sensitivities or a busy mind that struggles to relax.
Frequent night wakings are another common sleep difficulty reported by autistic children. This can include waking up multiple times during the night and finding it hard to fall back asleep. These night-time disruptions can be caused by sensory disturbances, anxiety, or a strong reliance on specific sleep associations, such as needing a parent nearby or a particular object to feel safe and comfortable. Additionally, some autistic children wake up very early in the morning and are unable to return to sleep, which may be linked to disruptions in their circadian rhythms or environmental factors like early morning light.
Irregular sleep-wake patterns are also common. Autistic children might have varying bedtimes and wake times, making it challenging to establish a consistent sleep routine. Some naturally have an irregular sleep-wake cycle, which can further complicate efforts to maintain a steady sleep schedule. It’s very common for autistic children to require less sleep than allistic (non-autistic) children.
Why Autistic Children May Experience More Sleep Problems
There are several reasons why autistic children are thought to experience more sleep difficulties than neurotypical peers.
One significant factor is the difference in melatonin production and metabolism. Melatonin is a hormone that plays a crucial role in regulating sleep-wake cycles. Research suggests that some autistic children may produce lower levels of melatonin or experience a delayed release of this hormone, making it harder for them to feel sleepy at bedtime. These differences in melatonin production and metabolism can lead to challenges in both falling asleep and staying asleep throughout the night.
Sensory sensitivities also play a major role in sleep difficulties for autistic children. Many autistic individuals have heightened sensitivities to sensory stimuli, such as light, sound, and touch. These sensitivities can make the sleep environment more challenging, as even small disturbances can be disruptive and prevent the child from falling or staying asleep. For example, a slight change in room temperature or a faint noise outside the window might be enough to wake an autistic child and prevent them from returning to sleep.
Anxiety and heightened arousal levels are additional factors that can interfere with sleep in autistic children. Many autistic children experience higher levels of anxiety, which can make it difficult to relax at bedtime. This anxiety may stem from a variety of sources, including worries about the upcoming day, fear of the dark, or concerns about being alone. Furthermore, autistic children often have higher baseline arousal levels, which means their bodies are more alert and ready for action, even when they should be winding down for the night. This heightened arousal can interfere with the natural sleep process, making it harder to transition into a state of rest.
Social and environmental factors also contribute to sleep difficulties in autistic children. The need for routine and predictability is a common trait among autistic individuals, and any changes in the sleep environment or bedtime routine can be particularly disruptive. Even minor alterations, such as a new bedding material or a change in the timing of bedtime activities, can cause significant sleep disturbances. This need for consistency can make it challenging to implement new sleep strategies.
Factors to Consider for Improving Sleep
While sleep challenges are more prevalent in autistic children, there are several strategies and considerations that can help improve sleep quality.
One of the first steps in supporting better sleep is creating a sensory-friendly sleep environment. It’s important to consider and accomodate your child’s unique sensory preferences when setting up their bedroom. For instance, using blackout curtains can help children who are very sensitive to light. Fidget toys can provide stimulation and repetition for children who require sensory input to wind down. Some children may benefit from the gentle pressure provided by a weighted blanket. There are hundreds of ways to support and accomodate each child’s unique sensory profile at bedtime and it’s important children are involved in deciding what these accomodations involve. Maintaining consistency in the sensory environment at bedtime is helpful, as it reduces disturbances and creates a stable, predictable setting that supports sleep.
Establishing a predictable bedtime routine is another key strategy for improving sleep in autistic children. A consistent bedtime routine helps signal that it’s time to wind down and prepare for sleep. This routine might include calming activities such as reading a book, listening to soothing music, or taking a warm bath. Predictability will help your child feel secure, safe, and ready for sleep. However, it’s essential to allow some flexibility within the routine to accommodate the child’s needs and preferences. For example, if the child prefers a specific order of activities or needs extra time with a favourite bedtime story, these adjustments can be made while still maintaining the overall structure of the routine.
For some families, melatonin supplementation may be a helpful. Melatonin supplements can sometimes assist in regulating sleep-wake cycles and making it easier to fall asleep. However, it’s important to consult with a healthcare professional before starting any supplements to ensure they are appropriate for your child’s specific needs. If melatonin supplements are used, it’s crucial to monitor their effectiveness and adjust the dosage under professional guidance to optimise their impact.
Addressing anxiety and supporting your child’s emotional well-being are also important factors in improving sleep. Techniques such as mindfulness exercises, deep breathing, or using visual schedules can help reduce anxiety and create a more calming bedtime experience. Cognitive Behavioural Therapy for Insomnia, delivered by a neuro-affirming practitioner, can improve both sleep and anxiety symptoms. If anxiety is a significant issue, its a good idea to also work with a psychologist or therapist who understands autism.
Maintaining a consistent sleep schedule, with regular bedtimes and wake times, can help regulate your child’s internal clock and promote better sleep. Even on weekends, it’s beneficial to keep your child’s sleep schedule as consistent as possible to avoid disrupting their sleep patterns. If your child’s current sleep schedule is irregular, making gradual adjustments rather than sudden changes can help your child adapt more comfortably.
The Path to Better Sleep
Improving sleep in your autistic child requires a commitment to understanding their unique needs so you can provide the accomodations and supports they require for getting excellent sleep. Don’t be tempted to compare your child to others. Instead, look at the child in front of you. Are they well-rested? Are they happy with their sleep? Do they feel good during the day time? If the answer is no, seek support.