Lots of people have problems with sleep at some point in their life.  But for autistic adults and children, sleeping can be particularly difficult.  

If you’re a parent or carer of an autistic child, it can be difficult to know how to help your child with this issue.  

In this guide we look at the reasons why autistic children can have difficulty sleeping and suggest what you can do to help.
 

Why might my child struggle to sleep?  

Some autistic children will struggle with disturbed sleep. 

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. 

How can I help? 

Here are some strategies to help. You will need to adapt them to suit your child’s needs and level of understanding. 

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. 

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. 

Keep a sleep diary 

Sleep diaries can be used to establish any unusual patterns of sleep and identify factors which may be influencing your child’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. For older children, a sleep diary could be useful to show them 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. There is some research to suggest exposure to bright lights from screens (TVs, computer, tablet, smart phone etc) can inhibit the production of the sleep hormone Melatonin. You might, therefore want to reduce your child’s screen time before bed.  

Make the bedroom more comfortable 

Autistic people can have sensory differences, which make it harder 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 your child 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 your child finds relaxing 
• remove distractions, such as electronic devices near 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 your child wind down before bedtime. 

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 your child still has a balanced diet. Limit sugary foods and fizzy drinks 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. Some people are prescribed synthetic melatonin for sleep problems, for more information, you should speak to your child’s GP. 

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 your child’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.
   

Next steps 

Further information and support 

• Find out more about what help and support is available
• Autism Services Directory – for details of local support groups and National Autistic Society branches  
• Cerebra sleep advice service 
• Scope Sleep Solutions 
• Scope Keeping a sleep diary 
• Sleep Scotland 
• Mind - how to cope with sleep problems