If you or your child are autistic, you likely know that autism can affect sleep.
Good sleep can be as elusive as it is essential, and countless people experience insomnia at some point in their lives. But for autistic people and their families, restorative sleep can seem a little farther out of reach.
Considering its impact on critical areas such as emotional processing, learning abilities, and social interactions, improving sleep is a priority. This is true for everyone, but particularly for autistic people, whose strengths exist outside the social arena.
Even though disrupted sleep is often part of autism, it’s possible to improve the situation and wake up well-rested.
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Sleep differences in autism present before 2 years of age and are one of the first indicators of this neurotype. By comparison, only about half of typically developing children and adolescents experience disrupted sleep.
Genetic and neurological differences combined with environment make it harder for autistic people to sleep well. The result is:
- more time needed to fall asleep
- increased nighttime awakenings
- sleep cycle changes
Sleep testing (polysomnography)
- less time in rapid eye movement (REM) sleep — an essential sleep stage that processes learning and long-term memory
- more undifferentiated sleep
- differences in eye movement bursts
- less time in bed
- decreased total sleep time
- less time from sleep onset to the start of REM sleep — a timeframe that should take about
- longer period of stage 1 sleep — the short transition from wakefulness to sleep
Autistic people differ in how they produce melatonin, a hormone that regulates sleep-wake cycles. Usually, melatonin production responds to changes in daylight and increases as night falls to help with sleep. But some autistic children produce more melatonin during the day and less at night.
Sensory differences can impact sleep. It’s estimated that about 69% to 95% of autistic children have sensory issues, compared to only 3% to 14% of typically developing children.
Because one of the sensory differences relates to sensitivity, or detection thresholds, it’s easy to understand why autistic children wake up more often.
Conditions that accompany autism can make it harder to sleep well. Examples include:
- gastrointestinal issues
Medications can also play a role in sleep disturbances, like stimulants to treat attention differences.
Though less common, obstructive sleep apnea (OSA) is sleep-disordered breathing, making it harder for autistic children to focus and regulate their emotions.
OSA interferes with sleep by interrupting oxygen intake, causing heart rhythm irregularities, and disrupting sound sleep. A 2018 study that included 6,794 autistic children 2 to 18 years old determined that 8% had OSA.
Sleep disruption can be frustrating, particularly if you’ve already tried to fix the situation. But good sleep is important enough to continue looking for solutions.
Sleep tips for autistic adults
Sleep data can offer insight into potential disruptive factors you hadn’t considered. Collecting data is as simple as keeping a diary to log any changes to your routine or factors you think might be necessary.
If anxiety is interfering with your sleep, a weighted blanket may help. The constant pressure can be calming and help reduce anxiety for autistic people.
Psychotherapy, like cognitive behavioral therapy (CBT), can also help you regulate anxiety interfering with sleep.
Mindfulness training is another tool you can try to manage anxiety and stress.
If you haven’t assessed your sleep hygiene, now is an excellent time to start. Sleep hygiene is a collection of healthy sleep habits that can help you get a better night’s rest. They include:
- keeping a consistent schedule and routine
- screen cut-off times
- regular exercise
- keeping to a caffeine limit
- optimal bedroom conditions (cool, dark, and quiet)
- stress management
Helping your autistic child sleep better
Some sleep strategies for autistic children are the same as for their typically developing peers:
- having a consistent bedtime routine that includes relaxing activities like a bath and story time
- avoiding high energy activities, caffeine, or sugary snacks before bedtime
- turning off electronic screens at least an hour before bedtime
Your autistic child will likely have more need for sleep support, but there are other approaches you can try:
- A dark window blind, quiet carpet, and door that doesn’t creak can reduce sensory disruptions.
- Your child’s pediatrician can recommend a melatonin supplement.
- A sleep psychologist can offer more suggestions like bright light therapy, which helps to regulate melatonin release.
Sleep disruptions in autism are common. If you feel as if no one understands what you’re experiencing, know that many people do. If you haven’t already, it might be helpful to reach out to others in the autistic community for support and advice.
You can also try the American Psychological Association psychologist locator tool if you’re interested in trying therapy.
Sleep impacts so many aspects of daily life. Once you’ve found the sleep strategies that work for you, so many other things will improve, too.