Many children with autism spectrum disorder experience sleep issues. Most commonly, children with autism have difficulty falling asleep and experience disturbed sleep once they do.
Unfortunately, these sleep problems exacerbate other issues characteristic of the disorder. For instance, lack of sleep often results in hyperactivity, inattentiveness, and aggression.
According to studies, children with autism who get a better night’s sleep tend to have fewer behavioral problems and better social interactions.
Fortunately, many sleep issues can be resolved or alleviated by implementing some behavioral changes. The following tips have been helpful for many parents.
Keep the Bedroom Cool, Dark & Quiet
Children with ASD have heightened sensitivity and can be more sensitive to their environment than other children, so you may want to invest in blackout curtains and remove any stimulating electronics. Limit television time in the hours before bed as it can overstimulate their already sensitive brains. Instead, focus your child’s attention on quiet activities like drawing, puzzles, or reading.
Diet & Exercise
Watch your child’s diet and take care to remove any foods that they have sensitivity to as an upset stomach can disturb sleep. Children with autism are more likely to have gastrointestinal problems and food allergies or sensitivities, which if ignored, can cause disrupted sleep.
Limit liquid intake before bed to prevent bedwetting. Avoid foods and drinks with caffeine like tea, coffee, chocolate, and soda.
Provide regular exercise earlier in the day so your child can fall asleep better at night.
Bedtime Routine & Good Sleep Hygiene
Bedtime routines can help children fall asleep faster. Repeat the same activities in the same order each night 30 minutes before bedtime, including when your child brushes their teeth and if you read a bedtime story together. Have your child go to sleep and wake up at the same time, regardless of whether it’s a weekday or weekend.
Children with autism can show strong favoritism towards objects. Lean into this by using the same pajamas and objects in the bedtime routine. Find a way to include multiple objects (such as two stuffed animals) so your child can still sleep if one item becomes unavailable.
Prepare your child for bedtime by reminding them that it’s coming up, so they don’t get irritated by a sudden transition. Use something consistently, whether it’s a verbal reminder or a clock that signals the time.
Because children with autism are highly sensitive, you might consider using relaxation techniques in the bedroom routine, such as a gentle massage or lavender oils during bath time.
Coach Your Child to Fall Asleep Without You in the Room
Children with autism can have an even harder time falling asleep without their parents than their typically developing peers. Slowly coach your child to fall asleep without you in the room. In the event they wake up during the night, this will also help them fall back asleep on their own.
You can also establish a sense of normalcy around falling asleep alone by showing your child a picture of them asleep in their room while you are doing another activity, or limiting any sleep or nap time to take place solely in their bedroom. Then, go through each of these steps until your child falls asleep, doing one step for a few nights at a time before moving on to the next one:
- Lie next to your child in bed
- Lie near the bed
- Sit on a chair inside the bedroom with the door open
- Sit outside the bedroom but remain visible to your child
- Sit outside but out of sight, with the door open
- Sit outside with the door closed
- Go to your room and sleep
Helpful Sleep Products
There are many sleep products designed to help individuals with sensory and developmental disabilities fall asleep better.
Waterproof Mattresses & Bedding
Children with autism who regularly wet the bed may benefit from waterproof mattresses and bedding. These are made from polyurethane and other materials that are easy to clean and do not develop an odor or stain from repeated incontinence.
White Noise Machine
A white noise machine or smartphone app can help calm children to sleep using soothing music, white noises, and nature sounds. It also helps drown out other noise in the house they may be sensitive to.
Autistic children who snore may find relief from anti-snoring mouthpieces. These are fitted by a dentist to move the lower jaw forward and free up airways during sleep. Less extreme options include anti-snoring nasal plugs or pillows. Alternately, more extreme options for cases of sleep apnea include continuous positive air pressure (CPAP) machines, which fit an oxygen mask over the face during sleep.
Melatonin has been shown to help children with ASD fall asleep 28 minutes faster and sleep longer for 21 minutes. Ask your doctor about giving your child a melatonin supplement. Low doses of 1 to 3 mgs 30 minutes before bedtime can be effective.
Bed Rails & Floor Pads
Bed rails prevent falls from individuals who move a lot during sleep from rhythmic movement disorder, night terrors, or epilepsy. Bed rail pads provide a comfortable surface should your child come into contact with the rails during sleep, and floor pads around the sides of the bed can provide further protection against a fall.
Weighted blankets soothe the uncomfortable sensations from restless leg syndrome. Choose a blanket that weighs 10 percent of your child’s body weight plus 1 pound. Even an autistic child without RLS may prefer a sleeping bag in their bed, finding comfort in the warm, cocoon-like feeling.
Some individuals may have RLS due to an iron deficiency, in which case taking an iron supplement can relieve symptoms.
If your child suffers from hypersomnia or excessive daytime sleepiness, using light therapy boxes in the morning may help them adjust better to being awake during the day.