Many people have sleep issues. But for those on the autism spectrum, sleeping well may be particularly difficult. Here we look at strategies that can be used to help autistic people to sleep better.

Sleep disorders

How do you define a sleep disorder?

Many people on the autism spectrum are likely to suffer from disturbed sleep patterns at some point in their lives.

Reasons for this could include:

  • having difficulty settling, winding down and going to sleep.
  • waking repeatedly during the night, or having difficulty getting back to sleep after waking up to go to the toilet.
  • increased anxiety or an inability to relax causing insomnia.
  • social cueing problems, where an autistic person doesn’t make the connection between others in the house going to bed and their own need to sleep.
  • Irregular secretion of the sleep hormone melatonin, which regulates sleep patterns, or having atypical circadian rhythms (body clock).
  • Neurological conditions such as epilepsy.
  • sensory differences, such as increased sensitivity to blue light from smart phones, laptops and other screens, or sensitivity to certain sounds or white noise, which may be upsetting or distracting and keep them awake.
  • problems caused by food allergies, which could cause gastrointestinal issues and discomfort, or increased sensitivity to caffeine or other stimulants, which can disturb sleep.
  • hypersomnia - sleeping too much. Increased exhaustion could be caused by the additional stress autistic people experience in social situations.

Find out more about sleep disorders and read Research Autism's Essential Guide to Sleep Problems and Autism.

Strategies for dealing with sleep disorders

Keep a sleep diary

Sleep diaries can be used to establish any unusual patterns of sleep and identify factors which may be influencing the person’s ability to sleep. If you are using other strategies to aid sleep, you will be able to track how effective they are. Sleep diaries are also useful because you can show them to professionals such as teachers, GPs or social workers, to give them a clearer idea of the impact sleep issues are having on your lives. Certain benefit application forms, for example Disability Living Allowance (DLA), ask you how often you have to get up in the night to help your child. You can send in a copy of the sleep diary to support your application. A sleep diary can show the person themselves what their sleep patterns are like. They can then be used to establish incentives for staying in bed and trying to sleep.

Establish a reassuring routine

Establish a basic, ordered routine for the evening, which can be followed anywhere. Use visual timetables to make it easier to follow. If possible, limit the person’s screen time (TV, computer, tablet, smart phone) or exposure to bright lights an hour or two before bedtime, as these can inhibit the production of the sleep hormone Melatonin. Some children may find the transition from sleeping in their parent’s room to their own room by themselves difficult. This can be related to difficulty with change but also the need for reassurance around bedtime and sleeping. Coping with waking problems may require consistent reassurance on your part and a creative approach to your child’s needs.

Make the bedroom more comfortable

Autistic people can have sensory differences , which make it harder for them to relax and go to sleep, as well as stay asleep. Their environment and surroundings can also play a role. It may help to:

  • Block out light using dark curtains or black-out blinds.
  • Reduce noise using thick carpet, shutting doors fully, turning off appliances, and moving your child’s bed away from a wall with activity going on on the other side.
  • Block out noises by letting the person use ear plugs or listen to music through headphones.
  • Remove labels from bedding and night clothes, or try bedding and nightclothes made from other materials.
  • Reduce smells coming into the room by closing the door fully, or by using scented oils that the person finds relaxing.
  • Remove distractions, such as toys on the bed and pictures on the wall (unless the person finds these relaxing), and consider a different colour on the walls.
  • Use relaxation techniques such as having a bath, massage, quiet time or gentle exercise such as yoga, to help the person wind down before bedtime.

Explain sleep

Children can have difficulty understanding the need for sleep. A social story™ (developed by Carol Gray) could be used to explain this. They can also be used to reassure your child that they are safe when sleeping/alone.

Visual supports such as flow charts could also be used to explain sleep or children’s books that provide the biological explanation for sleep.

Diet

If food sensitivity/stomach discomfort is a problem, visit your GP or a dietitian for advice. We also suggest that you visit a dietitian before introducing any major dietary changes to check that the person still has a balanced diet.  Limit caffeine and other stimulants, especially near bedtime. 

Medication

According to The Sleep Council, Melatonin is a naturally occurring hormone which our bodies produce when it gets dark to help us sleep. Synthetic Melatonin supplements are only available on prescription in the UK. For further information you should consult your GP. Some foods are rich in melatonin, but current research is not clear whether a melatonin-rich diet could be effective in helping people sleep.  Some parents/carers have found that using medication in tandem with a behavioural or sensory approach can help to restore a good sleep pattern. The combination is crucial as without the behavioural intervention when the medical treatment ends the child is likely to return to their old sleep patterns. 

Natural remedies

Health food stores offer "natural" remedies which claim to treat insomnia and other sleep disorders. It’s important to consider how such products might interact with any other medication the person may be taking. If you are thinking of trying a “natural” or “alternative” remedy, you should discuss this with your GP first.

Getting some sleep yourself

Getting a proper night’s sleep is hugely important. It may have been suggested that you sleep when your child sleeps, but this won’t necessarily be convenient, especially if you have other people to care for and it can also be difficult to ‘switch off’ on demand. By the time you have got your child to sleep, particularly if they needed calming down, you may feel too wound up to sleep yourself.

  • Safety proof the person’s room so you can relax knowing that they cannot harm themselves while you are asleep.
  • Find out more about community care and respite services. All parents of children with disabilities are entitled to be assessed to see if they’re eligible.
  • If you are struggling with long term lack of sleep, implementing strategies such as those above can be impractical. Seek support outside the family such as your GP, social worker or your child’s school, for help and advice.  

Further information and support

Autism Helpline 

Autism Services Directory – for details of local support groups, NAS branches 

Cerebra Sleep Service

ISIS: Infant Sleep Information Source

Parent to Parent

Scope Sleep Solutions

Sleep Scotland

The Children's Sleep Charity

Managing sleep problems - University of Leicester video in English (also in Urdu, Hindi, Punjabi and Bengali).

Mind - how to cope with sleep problems

 

Last updated 18 October 2017

Quick link to this page: www.autism.org.uk/sleep