Children with autism usually have some sleep pattern problems. Some “go till they drop,” then sleep very soundly all night, and are difficult to get started in the morning. Others have great difficulty getting to sleep and may wake often, or be very restless, winding themselves up in the covers, or even ending up on the floor.
The child who gets a restful night of sleep will be less hyper-irritable in the morning. The “go till you drop” child will be easier to awaken in the morning and is likely to be in a better mood if he can get to bed and to sleep before the stage of complete exhaustion.
No single suggestion will work for all children, but here are some strategies that have proven effective in many cases.
It is wise to eliminate television (and computers) for one to two hours before bedtime, as the programs children like are often over-stimulating. If the family has a video player, this may be made more palatable by showing the “essential” program for viewing at another time.
Rough or rowdy play should be eliminated for one to two hours before bedtime; no tickling, wrestling, etc.
Quiet activities such as drawing, looking at books, or playing with puzzles or construction sets are more suitable activities for a period before bed.
If a bath or shower is an evening activity, follow with five minutes of a towel “rub-down,” being sure to use downward strokes in the direction the hair grows. A rub-down with lotion may be used to add to the length of this activity. Pressure touch is calming.
After the child is in bed, a back-rub may also be soothing. Again, be sure to start with the neck and go down to the base of the spine. Use slow, rhythmic strokes; when one hand is at the base on the spine, start at the back of the neck with the other hand.
Using a soft musical background may help some children to relax and drift off to sleep. It is important to choose the music carefully. It should have a definite predictable rhythm (not too much syncopation). Orchestral music is preferred to singing, in general.
Reading to the child once he is in bed may be calming. Reading poetry with strong rhythm and rhyme is usually more effective than stories.
Because pressure touch and neutral warmth (the body’s heat retained) are both calming, a sleeping bag may promote calm, restful sleep. A “mummy bag” which fits closely around the body is preferable to a loose one. These are easily constructed. If the parent “sells” this as “the way cowboys sleep” or “the way astronauts sleep,” it will probably be accepted.
Remember, the child on the autism spectrum uses tremendous amounts of energy and needs more sleep than the quiet child. Many seven- and eight-year-olds will operate better on 10 to 12 hours of sleep than on lesser amounts.
Parents, remember, the time you invest in promoting sleep now will save you many, many hours in the long run and you won’t have to do it forever. Once the patterns are established, you will be able to reclaim a large part of your evening for yourselves.
Autism speaks had some similar ideas but also had more environment and day time ideas to help:
Many potential reasons exist for poor sleep in children with ASD, including neurological, behavioral, and medical issues. Some early research studies indicate possible abnormalities in brain systems that regulate sleep. Studies are underway in children with ASD evaluating levels of hormones such as melatonin and other chemicals released by the brain known to affect sleep. Behavioral issues such as poor sleep hygiene and limit-setting problems can contribute to insomnia. In addition, medical issues more common in children with ASD such as epilepsy or gastroesophageal reflux can disrupt sleep. Sometimes medications your child might be taking can be alerting and contribute to difficulty falling asleep. Psychiatric issues frequently associated with ASD such as anxiety and/or depression can interfere with sleep. Finally sleep disorders common in the general population such as sleep apnea, sleepwalking, nightmares, restless legs syndrome may impact sleep.
Fortunately, there are several ways parents can improve a child’s sleep. First discuss your child’s sleep with your health care professional. It can be helpful to know the amount of sleep your child needs. For example the National Sleep Foundation recommends for preschool children (11-13 hrs), school age children (10 -11 hrs) and for adolescents (9 ¼ hrs). (sleepfoundation.org)
Establishing good sleep hygiene by addressing the following domains is a good first step.
Sleep environment: the bedroom should be dark, quiet and cool. As children with ASD might be particularly sensitive to noises and/or have sensory issues, the environment should be adapted to make sure your child is as comfortable as possible.
Bedtime routine: the routine should be predictable, relatively short (20 – 30 minutes) and include relaxing activities such as reading or listening to quiet music. Avoid the use of electronics close to bedtime such as TV, computer, video games etc. that can be stimulating making it difficult for your child to fall asleep.
Sleep\wake schedule: the schedule should be regular with not much of a difference between the weekday and weekend schedule.
Teach your child to fall asleep alone: It is important that your child learn the skill of falling asleep without a parent present. All children and adults wake briefly during the night but quickly put themselves back to sleep by reestablishing associations used at bedtime. So if your child needs a parent present to fall asleep at bedtime, he might need a parent to help him fall back asleep during the normal awakenings.
Exercise: Daytime exercise can make it easier to fall asleep and children who exercise tend to have deeper sleep. Avoid allowing your child to exercise too close to bedtime as it can make it difficult for him to fall asleep.
Avoid caffeine particularly close to bedtime, which can be alerting making it difficult for your child to fall asleep. Caffeine is found not only in coffee, but also in tea, chocolate and some sodas.
Naps are helpful for preschool children, but should not be taken late in the afternoon as they can interfere with bedtime.
WebMD has some body cellular ideas:
Melatonin, which normally helps regulate sleep-wake cycles. To make melatonin, the body needs an amino acid called tryptophan, which research has found to be either higher or lower than normal in children with autism. Typically, melatonin levels rise in response to darkness (at night) and dip during the daylight hours. Studies have shown that some children with autism don't release melatonin at the correct times of day. Instead, they have high levels of melatonin during the daytime and lower levels at night.
Another reason children with autism may have trouble falling asleep or awaken in the middle of the night could be an increased sensitivity to outside stimuli, such as touch or sound. While most kids continue to sleep soundly while their mother opens the bedroom door or tucks in the covers, a child with ASD might wake up abruptly.
That being said:
For us it is the same routine: We stop our iPad time we go potty, take a shower or a bath, brush teeth/floss then swing while I read then lights out and cuddles for 20 then I go and he goes to sleep. That's not always but more often he goes to sleep than the not. 😊