Autism and Bedtime

Many of us experience a poor night’s sleep occasionally – or even go through periods of disrupted sleep during stressful times, early parenthood and more.

For autistic people, getting regular, deep sleep can be even more challenging. And this can be especially true for children with Autistic Spectrum Disorder (ASD), who may struggle with adjusting to bedtime routines and can be more sensitive to environmental changes that might not disrupt other sleepers.

In this guide, clinical psychologist Dr Lisa Williams explores how ASD can affect bedtime and suggests how parents can make small changes to help autistic children to sleep more soundly at night.

What causes a child with autism to struggle with sleep?

While not all autistic children present the same traits, it can be common for those with ASD to struggle with sleep.

Whether it’s difficulty winding down and drifting off, disrupted sleep or more distressing symptoms like nightmares and bedwetting, autistic children may experience several challenges when it comes to bedtime.

There isn’t a single cause or trigger for poor sleep among autistic children, but many potential challenges can make it difficult to maintain deep sleep. These may include one or a few of the following:

• Changes to routines and habits

  – the predictability of a routine can be comforting for autistic people, relieving the anxiety that often comes with change or uncertainty. So, it can be important to develop a nightly ritual that is calming and comforting before bed. However, when small changes occur to these routines – for example, a child’s favourite duvet cover is in the wash – it can have the opposite effect, causing anxiety or distress.

• Difficulty navigating social cues

  – ‘unwinding before bed’ is common in many homes. You might change into pyjamas, read a book or make a cup of tea – any activity that makes you feel calm, relaxed and ready to sleep. And when you see those around you preparing themselves for bed, it may make you start to feel sleepy, too. But for autistic people, these cues can sometimes be more difficult to read – and it can be harder for them to get into the relaxed state that makes sleep so much easier.

• Heightened sensitivity

  – for many people with ASD, it is common to experience a heightened sensitivity to noise, light, temperature and more. And, unfortunately, a noisy, loud or uncomfortable environment is almost impossible to sleep in. A new or unusual noise – such as people walking by outside – light creeping through a crack in the bedroom door or excessive summer heat could all make it difficult to reach the calm and relaxed state needed for sleep.

• Melatonin

  – melatonin is the hormone that regulates the sleep-wake cycle, designed to help our bodies feel alert during daylight hours and sleepy when it’s dark. However, melatonin synthesis can often be impaired in those with ASD – meaning they’re less likely to experience a natural feeling of sleepiness at night. Some autistic people may even feel more alert at night as their circadian rhythm is disrupted.

What negative effects can sleep problems cause?

Long periods of poor or little sleep can make anyone feel tired and irritable or have difficulty concentrating. In more severe cases, it can even contribute to a weakened immune system and increased risk of physical injury.

This is no different for people with ASD – who, in some cases, may even find it more difficult to cope with these negative effects of poor sleep.

The heightened feelings of stress and anxiety that can come with prolonged lack of sleep can exacerbate some traits in autistic people, such as meltdowns, difficulty focusing and challenges regulating their emotions.

Unfortunately, this can even start to impact sleep for the rest of the family – with potentially stressful evenings leading to difficulty nodding off, or parents waking up throughout the night to comfort distressed children.

If you’re noticing signs of impacted sleep in your child, a Child Autism Assessment is designed to identify autism in children so that they get the support they need to thrive.

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How much sleep should my child get?

The amount of sleep recommended for your child will depend on their age. Infants can spend up to 16 hours a day sleeping and toddlers may still need up to 14 hours of sleep, between nighttime and naps.

Children aged three to five are recommended to get between ten and 13 hours of sleep per day, while those aged six to 12 are still encouraged to get between nine and 12 hours of sleep.

However, it’s important to remember that autistic children can often experience difficulty sleeping – which can lead to tiredness, irritability and other symptoms that can lead people to believe they need more sleep than other children.

But the reality is, children with ASD don’t need more sleep. They just need to make sure they’re able to get enough quality sleep to avoid the potentially negative effects of poor or interrupted sleep.

So, how can you support your child to get more sleep?

How to get an autistic child to sleep

Helping a child with autism to get regular high-quality sleep can be challenging, due to the need to try and control many environmental factors, such as light, noise and bedtime routines.

But it is possible to put some support structures in place to help your child know it’s bedtime – and drift off more easily. This may include:

• Sticking to a bedtime routine

  – the stability and familiarity of a routine can be calming for children with ASD, helping them unwind before sleep. Creating a routine they can predict and follow every night can help ease them into bedtime. This might include having a bath at the same time every night, before moving into the bedroom and getting into pyjamas, reading a book then sleeping.

• Minimising sensory distractions

  – while it’s impossible to control every noise or light, you can make some small changes to your child’s bedroom and bedtime routine to minimise the impact of these sensory distractions. This might include hanging blackout curtains and even playing white noise at night. Where possible, regulating the temperature of the room to avoid extremes of hot and cold can also create a comfortable environment for your child.

• Associating bedtime with sleeping

  – some autistic people can have difficulty understanding the social cues associated with winding down for bed. So, it can be helpful to find ways to associate bedtime with sleeping, for example, avoiding letting their bed be a place of play during the day.

• Creating a calming environment

  – attempting to sleep while stimulated can be near impossible. This includes being anxious or nervous, excited or just the feeling you get after exercise or play. So, calming your autistic child before bedtime can help ease them into a good night’s sleep. This may include reading a story to them before bed or even playing gentle, relaxing music to drown out unusual or unpredictable background noise.

Some parents of autistic children may be tempted to seek support in the form of medication – specifically, melatonin – to help their child get a better night’s sleep. However, while melatonin can be appropriate and effective for some people, it must be prescribed to the individual by a medical professional – and never bought online or through any other method.

If your child is having difficulty sleeping, our Child ASD & ADHD Assessment can identify signs of autism and ADHD, helping them to get the support that’s right for them.

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Frequently Asked Questions (FAQs)

• What calms an autistic child?

  There is no single routine or behaviour that can calm all people with ASD, and what someone finds calming will depend on the individual child. However, creating a calming environment for a child before bedtime often means avoiding significant changes to routines or highly sensory activities, such as those that are especially noisy, bright or physical.

• Do autistic children need more sleep?

  Autistic children do not need more sleep than other children. However, many people with ASD experience difficulty sleeping, which can lead to prolonged periods of poor or interrupted sleep. As a result, these people may present as tired and irritable or have difficulty concentrating – leading many people to think they need more sleep, when they’re really just getting less sleep than others.

• What is the best bedtime routine for an autistic child?

  There is no single ‘best’ bedtime routine for autistic children, and an effective routine will depend on the individual child. However, successful bedtime routines are often those that take place at the same time each night, with activities in the same order and with minimal deviations or distractions. This predictability creates a calming and stress-free environment to help the child unwind before sleep.