Here in the U.S., April marks more than the return of spring flowers and showers — it’s also National Autism Awareness Month. Autism is a growing concern not just in the U.S., but around the world: it’s estimated that 1 in 68 children has ASD (Autism Spectrum Disorder). That means that even if you haven’t been personally impacted by autism, you likely know someone who has.
A diagnosis of ASD presents numerous challenges to families — challenges related to learning, to physical and social development, and (the number one thing we tend to concern ourselves with around this site) sleep. It’s estimated that anywhere from 40% – 80% of children with ASD diagnoses have significant sleeping issues related to their diagnosis.
Why do Autism Spectrum Disorders Affect Sleep?
Unfortunately, there’s no specific, easily-identified reason why children with ASD are more likely to have difficulty sleeping than those without. This is probably because ASD is a variable disorder in itself. The way it manifests, and the problems it causes, vary from child to child.
There are, however, some general theories as to why ASD may cause sleep disorders:
- Social Cues: Children with ASD typically have a harder time reading social cues than other children do. This can make socializing hard for ASD children; it can also make bedtime hard! ASD children are less likely to register the social cues that it’s time to go to sleep (seeing their siblings putting on pajamas, listening to mom reading a bedtime story, etc.) They have difficulty seeing these as pre-bedtime rituals the way other children likely would.
- Increased sensitivity to light, sound, and/or touch: Some children with ASD under-respond to stimuli like light and noise; others over-respond. This is commonly referred to as Sensory Processing Disorder (SPD). It should be noted that while a large percentage (70% – 80%) of autistic children also have SPD, autism and SPD are separate diagnoses. So a child can have one without having the other. Children who are hypersensitive to stimuli may have difficulty sleeping. For example, a child who’s extremely sensitive to light may find even a dim nightlight distracting. Or a child who’s hypersensitive to sound may be awoken by even the faintest noises. And a child who is extremely sensitive to touch may find the feel of sheets next to his skin unbearable.
- Low levels of melatonin: The hormone melatonin helps regulate the human body’s circadian rhythms (or daytime/nighttime cycles.) For most of us, our melatonin levels rise when it gets dark outside, making us sleepy; then, they drop off when the sun comes up, helping us feel awake and alert. Children with ASD, however, have lower-than-normal levels of melatonin, which may explain why they sometimes have difficulty falling asleep and staying asleep at night.
- Anxiety: Feeling anxious can make any child sleepless. Children with ASD, however, are especially prone to feelings of anxiety; a large percentage of children with ASD even suffer from anxiety disorders.
Effects of Sleep Disorders on Autistic Children and Their Families
Poor and interrupted sleep obviously affects a child with ASD’s nights, but this kind of chronic sleep deprivation may also affect his daytime behaviors. Sleep deprivation has been shown to have the same negative effects on children with ASD as on non-autistic children: increased irritability and aggression, depression, increased hyperactivity and emotional problems, and behavior problems.
And of course, the child isn’t the only one affected — parents and siblings feel the effects, too. Siblings, as well as parents, may suffer sleeplessness right alongside a child with ASD, and that kind of endless sleep deprivation can take a serious toll (maybe even put your marriage or relationship at risk.)
Helping Children with Autism Spectrum Disorder Get a Good Night’s Sleep
The first step in helping your child with ASD get the rest she needs is to make sure that her sleep disorder isn’t related to something else. Make sure that her sleeplessness doesn’t stem from sleep apnea, teeth grinding, Restless Leg Syndrome (RLS), or another physical cause. Once you’ve ruled these out, you can begin implementing meaningful solutions.
Consider the following ways to help your child with autism get the sleep he needs:
- Keep a sleep diary: Keeping a sleep diary can help you identify any patterns in your child’s sleep disturbances and then work on solutions that match the problem patterns. And if your child is older, it can be a way for him to take ownership of his sleep disorder and become a partner (instead of merely a bystander) in the problem-solving process.
- Develop a bedtime routine: Children with autism spectrum disorder must have predictable daily routines to help them feel safe and make sense of the world around them. Therefore, a bedtime routine (which is helpful for all kids) is especially crucial for ASD children. As you build a bedtime routine, try to build it with intention: don’t include any patterns or routines that you know you’ll have to break later (even if they’ll make your life easier in the short term!) Also, keep in mind that children with autism don’t respond well to abrupt and unexpected changes. So it’s probably best to ease into the new routine.
- Evaluate the sleeping environment: If hypersensitivity is an issue for your child, evaluate their bedroom to see if anything there may be causing problems. Then, work to create a sleep environment that’ll be restful and soothing for your child. That could mean installing thick carpet to muffle noise (if your child is sensitive to sound) or hanging room-darkening curtains (if your child is sensitive to light). For children who are sensitive to touch, weighted blankets have been shown to help. However, if you have a toddler, you may want to consider a weighted blanket for your toddler. It’s less expensive considering they will be growing by leaps and bounds. In addition, you may even need to consider a custom-made bed designed specifically for autistic children if your child is getting out of bed and wandering the house at night, and you have concerns about their safety.
- Consider medication (but only as a last resort!) Vitamins and other supplements, like melatonin or iron, may help improve an ASD child’s sleep and are considered good options, as long as they’re administered under a healthcare provider’s supervision. We advise that you always speak to your doctor before giving your child any supplements. Sleep medications should be a last-resort option, and they should only be used once a family has considered any sleep associations or schedule problems, and even then, we recommend they only be used in conjunction with some of the strategies listed above. Otherwise, the sleeping issues will likely return full force once the child stops taking the medication.
If you feel that your baby or toddler may be showing signs of ASD behavior, we recommend you consult your child’s healthcare provider for further information and testing.
Today, we live in a day and age in which families affected by ASD have abundant resources for help and education available to them (although there’s certainly room for more research into causes and treatments). And we here at the Baby Sleep Site count ourselves among those resources! We’re dedicated to helping every child, including those with special needs like Autism Spectrum Disorder. Autism Spectrum Disorder can present many challenges for families, to be sure, but it doesn’t have to mean years of sleep deprivation.
Have you been personally impacted by an Autism Spectrum Disorder diagnosis? Share your story!
Please be sure to pick up your FREE copy of 5 (tear-free) Ways to Help Your Child Sleep Through the Night, our e-Book with tear-free tips to help your baby sleep better. For those persistent nighttime struggles, check out The 3-Step System to Help Your Baby Sleep (babies) or The 5-Step System to Better Toddler Sleep (toddlers). Using a unique approach and practical tools for success, our e-books help you and your baby sleep through the night and nap better. For those looking for a more customized solution for your unique situation with support along the way, please consider one-on-one baby and toddler sleep consultations, where you will receive a Personalized Sleep Plan™ you can feel good about! Sometimes it’s not that you can’t make a plan. Sometimes you’re just too tired to.
Article Sources:
Autism Society
http://www.autism-society.org/about-us/national-autism-awareness-month/
National Institutes of Health
https://www.nichd.nih.gov/health/topics/asd.cfm
Web MD
https://www.webmd.com/brain/autism/helping-your-child-with-autism-get-a-good-nights-sleep
Sensory Processing Disorder Foundation
http://sinetwork.org/
SensoryProcessingDisorder.com
https://www.sensory-processing-disorder.com/autism-anxiety-overload.html
Science Daily
https://www.sciencedaily.com/releases/2010/05/100502080232.htm
Autism Day-by-Day Blog
https://autismdaybyday.blogspot.com/2012/03/sleep-deprivation-and-our-mental-health.html
The National Autistic Society (based in the UK)
https://www.autism.org.uk/about/health/sleep.aspx
Autism Support Network
http://www.autismsupportnetwork.com/news/establishing-positive-sleep-patterns-young-children-autism-spectrum-disorder-2271623
SensaCalm
https://www.sensacalm.com/
Noah’s World LLC
https://noahsworldllc.com/
@ Sharon — thanks for sharing this tip! Based on your feedback (and April’s, in the second comment), it sounds like there are lots of good things to be said for melatonin supplements 🙂
My daughter is 6 years old and moderately autistic (not high-functioning). She began to struggle with getting to sleep around the time we started Early Intervention at 2 and a half. She had been sensory underresponsibe, but waking her up sensory-wise made regulation almost impossible. We tried routines, weighted blankets and animals, benadryl, and struggled with sleeplessness. When we finally tried melatonin, at the suggestion of an OT, it worked like a charm! She’s been taking melatonin at bedtime and if she wakes in the night at least 2 hours before wakeup time since she was 3 and a half. It has saved our sanity and hers. She behaves much better now that she’s getting sleep!
@ Kerry — thanks for sharing your thoughts! So true (for both kdis and adults) that a good night’s sleep makes such a difference.
Several of my students deal with sleep issues. It is incredible to see how their day is affected for the worse or better depending on the amount of sleep they get. The number of autistic cases has increased to 1 in 88. Thank you for using your page to giving awareness to this disorder.
@ April — thanks for this feedback! I’ll do a little research and try to update the article.
@ April — so glad to hear you found a solution to your son’s sleep issues! I read a lot of articles in preparation for writing this, and many of them cited melatonin as a really great solution to ASD-related sleep issues. And it doesn’t carry the same risks as sleep medications, since it’s considered a supplement, and since melatonin itself occurs naturally in the body. Thanks for sharing your story, April!
My 5 yr old son has autism and melatonin has been a miracle in our house!! We give him a “sleepy vitamin” every night before bed and he is asleep within 20-30 mins. Before we found the product we use he would lay in bed for at least an hour sometimes several hours before finally falling asleep. His little brain just couldn’t shut off on its own for him to go to sleep!!!
I would also add: seizures.
My client’s child has autism and like many children with this disorder, he has seizures. Wouldn’t you know–most happen when he is sleeping. In fact, they were overlooked at first because they occurred during his sleep.