Around 80% of people with autism spectrum disorders (ASD) experience sleep challenges. Many families report sleep dysregulation as one of their greatest struggles, as it affects not only their child but the whole family. Common sleep challenges that children with autism experience include insomnia, sleepwalking, sleep apnea, repeated nighttime awakenings (including difficulty falling back asleep), reduced REM sleep, and daytime sleepiness. Sleep is crucial for many aspects of daily functioning, so identifying and addressing sleep challenges is imperative to prompting a child’s health and wellbeing.
Impact of Sleep Challenges
Sleep challenges can negatively impact a child’s development and overall well-being. An inability to get a good night of sleep can intensify the symptoms of autism, such as communication deficits and stereotypic behaviors. Poor sleep is associated with higher levels of harmful behaviors such as aggression and self-injury. Poor sleep is also associated with a heightened symptoms related to ADHD, OCD, and depression. Despite all of this, many sleep disorders are treatable. Addressing the symptoms and underlying disorders can make a significant impact on your child’s life.
Supporting Your Child’s Sleep
If you are concerned about your child’s sleep challenges, you are not alone. There are many ways to address these sleep concerns, so your child (and the whole family) can rest a little easier.
Consult a Medical Professional
Depending on the severity of your child’s sleep challenges, consulting a medical professional may be the best first option. A sleep study and other medical evaluations can rule out medical conditions that may be affecting your child’s sleep. If there are underlying medical or mental health challenges, behavioral strategies alone are likely to be less effective.
Sleep Hygiene: Creating a Predictable Sleep Routine
A calm and predictable sleep routine can help improve your child’s sleep hygiene and establishing positive sleep patterns.
Here are some ideas of ways you can improve your child’s bedtime routine
- Keep a consistent bedtime each night
- Keep the bedroom as dark as your child will tolerate
- Keep the room quiet or provide calm, soothing sounds such as white noise
- Turn off screens at least 30 minutes before bedtime
- Engage your child in calming activities such as a warm bath, gentle yoga, or reading a story right before bedtime
- Avoid caffeine, particularly close to bedtime, including caffeine in sources such as chocolate
It’s important to note that what works for one child or one family may not necessarily work for another. For example, some children may prefer sleeping in complete darkness; Others may need a night light or other light source for comfort. Similarly, for some children, a warm bath can be a soothing bedtime activity. For others, it may be a highly stimulating activity that makes it more challenging to fall asleep. Accommodations should be made to meet your child’s unique needs and preferences.
Use Visual Supports
Many children with autism are visual learners. Outlining expectations, including bedtime routines, in a visual format, can provide your child with reassurance and help them understand the bedtime process. If your child has bedtime resistance or difficulty falling asleep (sleep onset delay), try a visual schedule of your bedtime routine. You might also consider reading a social story with them about the bedtime routine to get them better acquainted with it.
Manage Medical and Mental Health Conditions
Up to 95% of people with autism have one or more comorbid medical or mental health challenges. These may have an impact on your child’s sleep habits. For example, co-occurring anxiety or ADHD diagnoses may make it difficult for your child to unwind and fall asleep at night. Your child may also struggle with sleep due to gastrointestinal issues or seizure activity. If sleep disturbances are caused by other conditions, it is important that those are identified and managed by a medical or mental health professional.
Pharmaceuticals or Supplements
Generally, medications or supplements should be used as a last resort. However, this decision is best made collaboratively with your child, yourself, and their medical team.
Many families opt for over-the-counter sleep supplements such as melatonin. Melatonin is a naturally occurring hormone that helps initiate sleep. Research has shown that people with autism commonly have lower levels of this hormone, which can impact their ability to fall asleep at night. Supplementing with melatonin may improve your child’s ability to fall asleep at night.
Magnesium is another supplement that many families try. Magnesium is a mineral that our bodies need for many functions, including sleep. Research has shown that magnesium supplements can improve sleep and reduce gastrointestinal discomfort.
Prescription medications to support sleep challenges may be recommended as well, especially for those experiencing more severe sleep disturbances. If you feel your child may benefit from supplements or medications to improve their sleep, speak with their pediatrician or a sleep specialist to discuss this further.
With many children with autism experiencing sleep challenges, you and your child are not alone. However, you don’t have to accept sleep difficulties as a permanent part of your lives. Sleep is a necessary component of a healthy, fulfilled life. Try the ideas previously mentioned and see how your family can achieve better sleep soon.
Of all the tips discussed, it bears repeating that any concerns you have about your child’s sleep should be discussed with a trusted medical professional. Many sleep challenges are due to underlying medical conditions and therefore, behavioral strategies such as modifying your sleep routine may not have a significant impact without medical intervention.