When the sun sets and the evening sky starts to darken, families of children with autism often gear up for a night of fighting. The child resists even thinking about going to bed, and once there, the child either can't fall asleep or can’t stay asleep.
Autism and sleep problems are common. Children struggle with this issue because of their disorder, not due to an inner sense of belligerence. Even so, it's a frustrating issue for parents. They need restful sleep to help their children, and their children need that rest to function at their best.
When a child with autism can't sleep, a visit to the doctor is in order. Underlying health conditions and some medications can hinder restful sleep.
With those steps taken, families must work to address the sleep problem at home with lifestyle alterations. If those don't help, a therapist might.
Autism & Sleep Problems
It's remarkably common for people with autism to struggle with sleep problems. Those issues can look very different from child to child.
Some children with autism live with:
- Disrupted sleep. A 2019 study found that 80% of autistic preschoolers live with this problem. They may fall asleep, but they awaken over and over throughout the night.
- Delayed sleep latency. Many people fall asleep as soon as they climb into bed. But researchers say it takes a person with autism 11 minutes longer to fall asleep than someone without autism.
- Poor sleep quality. Deep sleep stages are restorative. When we slip into them, our tissues heal and our brain cells rest. Researchers say people with autism spend less time in these healing sleep stages and more time in the light stages of sleep.
Just as parents may come to dread the approach of bedtime, so do many children with autism. They envision long stretches of darkness where their minds race and their bodies tingle with activity. They might know they should be asleep. They may desperately try to fall asleep. But sleep eludes them night after night.
Researchers aren't entirely sure why autism and sleep problems often coexist. But some new studies may shine a light on the link.
In 2019, researchers in Washington state identified a gene associated with sleep latency and sleep quality problems. In studies with mice, they found that eliminating this gene led to poor sleep quality. That gene is often missing in people with autism.
Future studies may help researchers to illuminate missing or altered genes, and that work could help them develop therapies for people with autism. Unfortunately, the results are years or even decades away. For now, families must focus on simpler methods to amend sleep problems.
Take These Steps to Ease Sleep Problems
Start your search for solutions with a visit to your child's doctor. Experts say sleep problems in autism are often tied to stimulating autism medications that can keep a child awake around the clock.
Co-occurring autism disorders, such as digestive disorders, can also cause insomnia. A doctor can address these issues and help to ensure a better night's sleep.
If your doctor can't help your child to sleep better, don't give up. There are plenty of other options to try.
Melatonin is a natural substance associated with deeper sleep. You'll find plenty of products like this lining pharmacy shelves all across the country, but experts recommend pharmaceutical-grade melatonin for people with autism.
You should also talk with your doctor first about:
- Dosing. How much should your child take? What happens if your child takes too much?
- Side effects. Some people feel groggy the morning after taking melatonin.
- Safety. Few studies about the long-term effects of melatonin are available. Your doctor can tell you more.
Change Your Child’s Routine
Stimulating television shows, violent video games, and graphic novels all spark a child's imagination. The images they conjure can stick with a child and impede restful sleep.
Don't send your child with autism off to dreamland with a computer or tablet. Instead, come up with a soothing way to introduce sleep to a busy brain. You could try:
- Warm baths. Raising your child's body temperature can help muscles to relax, and that could send the child off to sleep.
- Quiet music. Choose soft piano pieces or soothing electronic beats.
- Gentle reading. Send your child to bed with a suitable, sleepy book that lulls the brain to sleep.
Keep the routine relatively short, advises Autism Speaks. About 20 minutes should be enough to prepare the mind for rest.
Set a Sleep Schedule
Many people with autism crave consistent schedules. Add bedtime to your daily plans to help your child prepare for a restful sleep.
Choose a time in which your child is typically sleepy but not overtired. Tell your child that this is the new bedtime, and you'll be using it from now on. If your child dislikes transitions between activities, mention the upcoming bedtime a few minutes before it arrives. Use a cue, like the clock or a picture, experts recommend. Stick with that prompt every day.
Change the Child’s Diet
The way your child eats throughout the day, including the hour or two before bedtime, can affect when sleep arrives.
Experts say you can change your child's:
- Caffeine intake. Avoid all drinks with caffeine, including soda. Choose plain water or herbal tea instead.
- Fatty food consumption. Steer clear of foods with a high fat content. Try protein-rich foods instead.
- Large evening meals. Skip big helpings within two or three hours of bedtime.
- Large drinks before bed. Limit fluid intake in the two hours before bedtime, so the child doesn't need to get up to visit the bathroom.
Prepare the Room for Sleep
Think of your child's bedroom as a sleep sanctuary. Most things in that space should help a child either feel sleepy or stay asleep.
Experts recommend transforming your child's room by:
- Blocking out light. Place dark curtains or blackout blinds over the windows.
- Dampening noise. Pad the floor with thick carpet or rugs. Keep the noise level low throughout the house.
- Adding soothing smells. Use soft essential oils to block out kitchen smells or other stimulating scents.
- Removing distractions. Take down bright or scary posters, photographs, or images. Paint the walls a soft, bland color.
Work With a Professional to Improve Sleep Quality
Some people with autism benefit from these steps, and after a bit of practice and consistency, they start sleeping with ease. Others need a bit more help.
Therapy can help people with autism deepen their understanding of the disorder. They can also learn skills to help them fall asleep and stay asleep. For example, a therapist might help to boost verbal skills, so someone with autism could explain to parents what interventions are needed to ease the path to sleep. A therapist could also teach relaxation techniques, such as breathing exercises, to enhance relaxation so sleep comes easier.
If you've tried at-home care and still can't help your child to sleep, talk with an autism therapy specialist about techniques that might help.
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Melatonin May Help Address Sleep Disorders in Youths With Autism. (March 2020). Pediatrics.
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