For many people with autism, getting a decent night’s sleep is a near-impossible task. Getting to sleep and staying asleep are common problems for those with autism spectrum disorders.
This might lead to an increase in certain symptoms, such as repeated activity, which can make it even more difficult for them to sleep.
It’s no surprise that parents of children with autism are concerned about their children’s sleep. However, this is also one of the least-studied elements of autism.
As of this writing, the following is what we know about the causes, effects, and therapies of sleep disorders in autism:
How common are sleep problems in children with autism?
About 80 percent of autistic children experience interrupted sleep according to a 2019 study, one of the largest to examine the incidence of sleep issues in autism. Children with autism have twice the rate of sleep issues as children without autism or other developmental conditions.
What types of sleep problems are common in autism?
Autism is associated with sleep disorders such as insomnia, which causes people to take 11 minutes longer to fall asleep and frequently wake up in the middle of the night. There are some persons with the illness who suffer from the disorder that causes them to stop breathing numerous times a night.
People with autism may also have less restorative sleep than the normal population. In the rapid eye movement (REM) stage, they spend roughly 15 percent of their slumbering time, which is crucial for learning and remembering. Most neurotypical persons, on the other hand, sleep for about 23% of the night in rapid eye movement (REM) sleep.
Does this lack of good sleep have consequences?
Poor social skills are exacerbated by lack of sleep, according to increasing data. A lack of sleep might cause children on the autism spectrum to display more severe repetitive behaviors and have a harder difficulty making friends than those who obtain adequate sleep. They also have a lower average IQ than the general population. However, it’s not obvious if these issues are the result of insufficient sleep, the cause of it, or a combination of the two.
A 2009 study indicated that children with autism who have difficulty sleeping are more hyperactive and readily distracted than their peers who get a good night’s sleep.
Why do people with autism have difficulty sleeping?
Many persons with autism have additional disorders, such as gastrointestinal issues, ADHD, or anxiety, all of which have been shown to interfere with sleep. Constipation cramps, for example, may keep an autistic person up at night. Sleep difficulties may be caused by sensitivity to light, sound, or touch. The relationship between sleep disorders and depression in autistic persons isn’t apparent, although it’s possible that they’re both connected.
It’s possible that these other diseases could necessitate the use of sleep-deprivation drugs. Sleep deprivation is a common side effect of stimulant medications, which many patients with ADHD take.
Certain genetic alterations have been linked to sleep disorders in people on the spectrum. People with autism are more likely than the general population to have mutations in genes that regulate the sleep-wake cycle or those linked to insomnia, according to research. Melatonin, a natural hormone that regulates sleep, may be affected by mutations in people on the spectrum, according to some research.
What kind of effects do sleep problems have?
If a youngster does not receive enough sleep, it can have a negative influence on his or her health and well-being. Sleep deprivation has been linked to the following traits in children with autism:
- Behavior problems have risen sharply.
- Poor cognitive and learning abilities
There’s a strong likelihood that if your child isn’t sleeping, you aren’t either. According to one study, parents of autistic children sleep less, sleep worse, and wake up sooner than parents of typically developing children.
How can researchers assess sleep problems in people with autism?
This sort of sleep test, polysomnography, is the most widely used and comprehensive. During sleep, it measures brain waves, eye and limb movements, and breathing patterns. Typically, it is done in a lab because it requires a large number of sensors, wires, and computers.
For people with autism, the gold standard procedure isn’t always practical because of their specialized nighttime habits. At least one research group has attempted to address this issue by bringing polysomnography equipment into the homes of people with autism.
Actigraphy, in which a wristwatch-like device records a person’s movements throughout the night, is a less arduous sleep test option. The device can be used at home to keep track of how much time a person spends sleeping each night.
Family interviews or sleep diaries can also provide researchers with valuable information regarding sleep habits. People’s recollections make these procedures error-prone, though.
How can I help my child sleep better?
Children should only be given sleep medicine as a last resort. The quality and quantity of sleep that autistic children get can be improved through a variety of dietary and lifestyle adjustments and natural sleep aids:
- Caffeine and sugar should be avoided before bedtime.
- Be consistent with your child’s bedtime routine by bathing, reading a story, and putting them to sleep at the same time each night.
- Reading a book, offering a back massage, or playing quiet music can help your youngster wind down before bed.
- At least an hour before night, turn off the television, video games, and other stimulating activities.
Your child’s bedroom should have thick carpeting, heavy curtains, and a door that doesn’t squeak to keep him or her from being disturbed at night. It’s also a good idea to pay attention to your child’s sensory requirements when selecting the room’s temperature and bedding.
- Melatonin is a sleep aid that can be given to children before bedtime by their pediatrician. A common application of this dietary supplement is to assist people to overcome jet lag. In autistic children who have difficulty sleeping, it may help to normalize their sleep-wake cycles, and research thus far indicates that it is safe and beneficial.
- See if bright-light treatment is an option for you. If your child has trouble staying awake during the day, try exposing them to strong light for a few minutes in the morning to assist balance their body’s production of melatonin.
Would better sleep improve the quality of life for people on the spectrum?
Maybe. This has not been the subject of big, conclusive research. There is some evidence to suggest that children with autism and typically developing children who receive sleep surgery to treat sleep breathing problems have improved social communication and attentiveness, and their repetitive habits have decreased as well. In a short study of autistic children who used melatonin supplements, parents reported similar gains.
Angela Maxwell-Horn, an assistant professor of pediatrics at Vanderbilt University in Nashville, Tennessee, says better sleep “is not going to heal autism.” However, according to her, children with autism who return to a regular sleep schedule appear to learn better, be less irritable, and engage in fewer problematic behaviors.
How do I know whether my child has a sleep disorder?
The quantity of sleep each youngster requires varies. Generally speaking, the following are the recommended amounts of sleep for children, grouped by age:
- The recommended amount of sleep for children ages 1-3 is 12-14 hours each night (take into account whether your child naps).
- Ages 3 to 6: 10 to 12 hours of sleep every day.
- Ten to eleven hours of sleep each day is recommended for children between the ages of seven and 12.
If your child has trouble falling asleep or keeps waking up in the middle of the night, he or she may have a sleep disorder. Your child’s pediatrician is the best source of information. Some doctors specialize in sleep disorders, while others focus on the ears, nose, and throat (ENT).
For a week, keep a log of your child’s sleeping habits to see how much and when they sleep. There is no need to discuss snoring or other breathing irregularities that may indicate a problem with breathing. Observations on your child’s behavior from the previous day can be helpful in this situation. Your child’s doctor and any other specialists involved in treatment can see this journal.
Tips for Improving Your Autistic Child’s Sleep
For autistic children, there are a few things to keep in mind when it comes to enhancing their sleep. Researchers believe the following strategies to be the most effective:
- A cold, dark, and quiet bedroom are essential to avoiding sensory difficulties. Do your best to reduce outside noise to a minimum by using blackout curtains and other noise-blocking measures.
- A good rule of thumb is to begin your child’s bedtime ritual at least one hour early. The best way to help your child wind down at night is to turn off all electronic devices and establish a consistent routine that involves everything from brushing teeth to reading bedtime stories together (and you). A warm bath and a light supper before night work wonder for some children. The inclusion of stuffed animals or other items that children with autism are particularly fond of can help them feel more secure in their daily routines. If at all feasible, try to stick to your regular schedule during vacations and weekends.
- Predictable waking to sleeping times is essential for a healthy lifestyle. 15 minutes, 10 minutes, and 5 minutes prior to the commencement of the nighttime routine give cautions. Turning off the television and going to the bathroom is an example of a process that can be practiced. If visual clocks or aural alarms work better for your child, you can use them.
- Help your child learn to sleep without your presence in the room by working with him one-on-one. If the problem persists, you may need to start slowly by sitting on the other side of the room and gradually moving farther away until you’re outside the door.
Children with autism may also benefit from extra attention to sensory and physical concerns in addition to these fundamental strategies. As an illustration, consider the following:
- You may wish to keep a log of how your child reacts to certain foods and exercise at bedtime. Is it more difficult for her to fall asleep if she eats her dinner early or if she consumes certain foods? Before going to sleep, does he feel more relaxed or energized after exercising? Using your results, alter your daily routine.
- You might want to have a look at goods designed for folks who have sensitivities. This could be done with the use of an electronic white noise machine or a weighted blanket 9which can be used to help your youngster relax down.
- People with autism may benefit from taking low amounts of melatonin supplements 30 minutes before bedtime.
If none of these tried-and-true methods work for your autistic child (which is likely if he or she has significant sleep troubles), then what? There are numerous ways to make your search for assistance to the next level in this case:
- Your child’s sleep cycle may be the subject of a sleep study, which must be ordered by a doctor. Sleep apnea, restless legs syndrome, and periodic limb movement disorder (PLMD) can all be discovered with a sleep study.
- As a result of Autism Speaks’ online “toolkit” for parents, parents can identify specific sleep issues and brainstorm ways to solve them.
- An appointment with a sleep program at a local medical facility or clinic could be beneficial. In order to help you better understand how to help your child sleep, pediatric sleep specialists may have tools and ideas at their fingertips.
What causes sleep disorders in children with autism?
Many hypotheses have been put out to explain why autistic children have difficulty sleeping. The first relates to social cues. Light and dark cycles and the body’s circadian rhythms tell us when it’s time to go to sleep at night. However, they also make use of nonverbal clues. Children, for example, may witness their siblings preparing for bedtime. Some of these signs may be misunderstood or misinterpreted by autistic children, who typically have difficulties speaking.
Melatonin, a hormone that helps regulate sleep-wake cycles, is another possibility. Tryptophan, an amino acid necessary for the production of melatonin, has been reported to be elevated or depleted in autistic children, depending on the study. Melatonin levels typically rise when it’s dark and fall when it’s light. Some children with autism do not produce melatonin at the optimal times of day, according to research. Melatonin levels are higher during the day and lower at night in these individuals. Increased sensitivity to external stimuli, such as touch or sound, maybe a contributing factor in children with autism’s difficulty sleeping or waking up throughout the night. A child with ASD may wake up suddenly if their mother opens the door to the bedroom or tucks the blankets in. It’s also likely that anxiety can interfere with a person’s ability to sleep. Autism-afflicted children are more likely to show signs of anxiousness than their peers.