All children may occasionally have trouble falling and staying asleep, but kids with autism often deal with significant sleep problems.
Read this article to learn more about autism-related sleep disorders, what causes them, and how lifestyle changes and medication can improve your child’s sleep.
Sleep Disorders and Autistic Children
Sleep disorders are common among children with autism. Research shows that up to 80% of autistic children have some type of sleep issues, for example:
- Resistance to bedtime
- Trouble falling asleep (sleep-onset insomnia)
- Restlessness and discomfort while sleeping
- Poor sleep quality
- Sleep apnea or breathing interruptions during sleep
- Sleeping much less than recommended for their age
- Waking through the night and staying awake for more than an hour
- Waking too early and daytime sleepiness.
Researchers aren’t sure why sleep issues occur more commonly in children with autism than in their neurotypical peers. Some theories include sensitivities to stimuli, biological brain differences, high rates of anxiety, and other factors. Read on to learn more.
What Causes Sleep Disorders in Autistic Children?
Sleep problems in children with autism can be related to their daytime and bedtime habits, as well as a range of other environmental and biological factors. Once you understand what’s causing your child’s sleep problems, it will be easier to find the appropriate solution.
- If your child does not have a consistent bedtime routine, there are no predictable cues indicating that it’s time to sleep.
- Your child’s sleep environment may be too hot, cold, or noisy. These conditions can make it challenging to fall asleep, and even more so if your child has sensory sensitivities.
- If your child is very active in the evening, it will be harder to feel calm and sleepy before bed.
- Unhealthy eating habits, such as eating foods low in fiber and high in saturated fat and sugar can lead to lighter and less restorative sleep.
- Lack of physical activity and exercise during the day may cause sleep-related problems.
- Long or late daytime naps can negatively impact sleep quality and the duration of sleep at night.
Social communication difficulties
Sleep problems in autistic children may be a result of their social communication difficulties. Many children with autism have difficulty reading social cues and may not understand that it’s time to get ready for bed.
Children with autism who have heightened sensitivity can find it challenging to calm down and fall asleep. They are also more prone to be awakened by noise during the night.
Health conditions and medications
Children with comorbid medical conditions, such as asthma, epilepsy, gastrointestinal disorders, and anxiety may develop sleep problems. Some medications like ADHD drugs may also affect sleep and lead to insomnia.
Abnormal melatonin production
Many autistic children have abnormal levels of tryptophan, an amino acid involved in the production of the sleep-regulating hormone melatonin. They also tend to have atypical circadian rhythms that cause them to produce more melatonin during the day than at night.
Researchers have identified a gene associated with sleep latency and poor sleep quality that is often missing in people with autism.
Sleep Disorder Effects on Autistic Children
Studies show that children with autism who have sleep problems display more severe behavioral and learning issues, for example:
- Increased social communication challenges
- More compulsive rituals and obsessive behaviors
- More frequent occurrences of challenging behavior
- More instances of hyperactivity and attention deficit disorder
- Higher levels of irritability and aggression
- Higher rates of behavioral issues, depression, and anxiety
- More frequent concentration problems
- More frequent instances of obsessive-compulsive disorder
- Decreased learning and cognitive performance
- Decreased ability to develop peer relationships.
Many parents believe that there’s nothing they can do about the sleep issues of their children with autism. However, it is possible to improve your child’s sleep quality by making some lifestyle adjustments.
Ways to Help a Child with Autism Sleep Better
All children need good quality sleep to grow and stay healthy and children with autism are no exception. Here’s what you can do to help your child sleep better:
- Establish a nighttime routine to make it easier for your child to understand that it’s bedtime.
- Add bedtime to your child’s daily schedule to help them know when it’s time to go to bed.
- Remind your child it’s bedtime a few minutes in advance by using a cue, like a clock or a picture.
- You can use social stories to explain the importance of sleep to your child.
- Help your child relax before bed. Give them a bath and a back massage, read a story together, and turn on relaxing music.
- Avoid giving your child stimulants, such as caffeinated drinks and sugar before bed.
- Make sure your child is physically active during the day.
- Use stress-relieving techniques and breathing exercises throughout the day to help your child relax.
- Switch off the television and electronic devices at least an hour before bedtime.
- Keep your child’s bedroom dark, quiet, and cool in order to minimize any sensory issues.
- Consider purchasing products designed for children with sensory issues, for example, weighted blankets, soothing pillows, sensory sheets, and white noise machines.
With enough practice and consistency, many children with autism will highly benefit from these steps and start sleeping better, however, others will still need a bit more help. In the following section, we take a look at sleep medication for autistic children.
Sleep Medication for Children with Autism
Your child’s doctor may prescribe medication to improve sleep quality. The most commonly prescribed sleep medication for children with autism include:
Clonidine is a prescription medication used to treat a variety of conditions from high blood pressure to anxiety. It has also been found to induce sleepiness and reduce nighttime waking in children with autism. Clonidine may help your child fall asleep and have fewer awakenings at night.
Antidepressants like Mirtazapine are sometimes prescribed for sleep problems in children with autism due to their sedative properties. However, like all medications, antidepressants come with side effects, including sleepiness, dizziness, headaches, and increased appetite.
Motrin and other antihistamines have sleep-inducing side effects, but can cause daytime drowsiness which might affect your child’s ability to learn during the day. Antihistamines can also cause some children to become hyperactive, which can make their sleep problems even worse.
Some doctors recommend Benadryl to induce drowsiness. This antihistamine is often given in addition to another prescription medication.
Some children with autism are given hypnotic sleep aids such as zolpidem, zopiclone, and zaleplon—commonly referred to as the z-drugs—that work by slowing activity in the brain. These medications are generally well tolerated, but they may have adverse effects in some children, including drowsiness and gastrointestinal issues.
Risperidone and clonazepam
Risperidone and anti-seizure medication like clonazepam are usually given to older children and teenagers with autism when other medications are not effective.
Melatonin is a dietary supplement commonly used to treat sleep disorders. Melatonin might help some autistic children fall asleep faster, sleep for longer, and wake up less frequently during the night. It has relatively few and mild side effects, but keep in mind that taking too much melatonin can make your child’s insomnia worse.