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Getting enough sleep is a crucial part of human life, it’s vital for physical and mental well-being, and contributes to our overall health. Many autistic children have difficulties with their sleep which can be extremely stressful, not only for the individual child but also their family. It is recommended that children generally need between 8 and 12 hours of sleep every night depending upon their age.
There is a correlation between screen time and sleeping difficulties, and research suggests that exposure to bright lights from screens such as TVs, computers, tablets and smart phones can inhibit or delay the production of the sleep hormone Melatonin. Furthermore, this may have a greater impact upon autistic children as research suggests they may have lower melatonin levels than neurotypical children [1].
Research also suggests that 40-80% of autistic children experience sleep problems, compared to 25-40% of neurotypical children [2]. Also, there are significant reports to suggest that autistic children may experience greater difficulty winding down and falling asleep and have more nighttime awakenings than neurotypical children [3].
Why autistic children may have greater difficulty sleeping
Reasons autistic children may have greater difficulty sleeping can vary but could include:
- increased anxiety leading to greater difficulty relaxing and falling to sleep
- sensory processing differences interrupting sleep, such as increased sensitivity to light or sounds which can be upsetting or distracting, or may lead to nighttime waking
- lower or irregular levels of the sleep hormone melatonin which regulates sleep patterns
- difficulties engaging in calm, quiet, settling and winding down activities
- not always recognising the typical social cues that others going to bed, or perhaps noticing their own signs of tiredness
Research suggests a lack of sleep can impact negatively upon daily functioning, concentration, memory, learning and cognition. It can also heighten emotional responses, increase irritability and hyperactivity, and have an impact upon communication and relationships.
There’s also a close correlation between sleep and mental health. Living with a mental health difficulty can affect how well a person sleeps, and poor sleep can have a negative impact on mental health. Research suggests that anxiety is also associated with sleep disturbance in autistic children [4]. In addition, children’s difficulties sleeping can also impact upon family members, as their own sleep quality may be affected along with stress caused by the impact of reduced sleep on their child’s daily functioning, emotions and behaviour [5.]
Top tips for supporting children who experience difficulties with their sleep
- Create a quiet and safe space for children to sleep in. The bedroom should be a comfortable temperature for the child, not too hot or too cold. The room should be dark, but if a child prefers some light, a dim night light can be used and left on until morning. If light from streetlights or sunlight in the morning enters the room, consider using heavier curtains or blackout blinds. Consider smells in the room, and reduce unwanted smells coming into the room by closing the door full, or by using scented oils depending on a child’s preferences. Lavender scents can be helpful for calming and sleep, but remember each child is different and it is important to create the right calming sensory environment for them.
- Autistic children may be more aware of noises at night such as running water or sounds of traffic. Options to reduce noise include using thick carpet, shutting doors fully, turning off appliances and moving the bed away from walls. Alternatively, block out noises by using ear plugs, letting a child listen to music, white noise or sleep stories through headphones.
- Autistic children may have particular sensitivities to textures of bedding or their pyjamas. Consider asking whether the child prefers loose or tight pyjamas or whether they prefer light or heavier covers. Removing labels from bedding and night clothes may also help.
- Gentle and calming activities such as having a bath, massage, quiet time, reading, relaxation or gentle exercise such as yoga can help children wind down before bedtime.
- Establish a consistent bedtime routine, which can help children’s bodies learn the cues for bedtime and support the process of relaxing and getting ready for sleep. The routine should consist of soothing activities, whilst any more stimulating and exciting activities such as physical activity, TV, video games, loud music or bright lights should be kept to earlier in the day where possible and avoided before bedtime.
- Involve your child in choosing the elements or order of their bedtime routine – empower them to have choice in setting this so bedtime becomes less of a demand placed on them by adults. Having a visual representation of the routine can help remind them of each step and enable them to follow this clearly themselves. The schedule could consist of pictures, words or both, and could be created or personalised by the child. Where possible follow this each night to encourage consistency.
- Consider if there are any foods that your child may have sensitivities to, and be aware that these may impact on their sleeping habits. Food and drink high in sugar, and also fizzy drinks can have a stimulating effect on the body, so it is also helpful to avoid any of these foods or drinks before bedtime. A warm drink (such as warm milk) can often be soothing however and may be a helpful part of the bedtime routine.
Remember every child is different, so with all of these tips it is important to find what works and is calming and relaxing for you and your child. For more information about Caudwell Children’s Workshops, please click here.
References
[1]. J Melke et al. (2008). Abnormal melatonin synthesis in Autism Spectrum Disorders. Mol Psychiatry, 13 (1), 90–98. Doi: 10.1038/sj.mp.4002016
[2]. Reynolds, A., & Malow, B. A. (2011). Sleep and autism spectrum disorders. Pediatric Clinics of North America, 58(3), 685–698. https://doi.org/10.1016/j.pcl.2011.03.009
[3]. Buckley, A., Rodríguez, A. W., Jennison, K., Buckley, J., Thurm, A., Satô, S., & Swedo, S. E. (2010). Rapid eye movement sleep percentage in children with autism compared with children with developmental delay and typical development. Archives of Pediatrics & Adolescent Medicine, 164(11). https://doi.org/10.1001/archpediatrics.2010.202
[4]. Mazurek, M. O., & Petroski, G. F. (2015). Sleep problems in children with autism spectrum disorder: examining the contributions of sensory over-responsivity and anxiety. Sleep Medicine, 16(2), 270–279. https://doi.org/10.1016/j.sleep.2014.11.006
[5]. Galli, J., Loi, E., Visconti, L. M., Mattei, P., Eusebi, A., Calza, S., & Fazzi, E. (2022). Sleep disturbances in children affected by autism spectrum disorder. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.736696