Why do children with Autism have a hard time sleeping? What can be done?

Sleep problems are very common, reportedly as high as 80% in children with ASD. In typically developing children sleep problems and insufficient sleep can result in daytime sleepiness, learning problems and behavioral issues such as hyperactivity, inattentiveness and aggression.

Do you struggle with putting your child to sleep? It is not uncommon for one with autism to have sleep problems as well, since these are co-morbidity. Until today, researchers have not identified the underlying cause, but the strongest evidence seems to point at their heightened sensory perception. With that in mind, we hope to share more about the more common causes, consequences of these sleep problems, and solutions to mitigate these problems.

Firstly, one theory suggests that sleep problems are caused by the hormone melatonin, as children with autism may not release melatonin at the correct times of the day to regulate the circadian rhythm. Melatonin controls your body’s internal clock, responsible for signaling the time of the day. This is why, as some of you may know, melatonin is a common sleep supplement for insomnia. To make melatonin, the body needs an amino acid called tryptophan, which happens to be either too much or too little in children with autism. Melatonin levels rise in response to darkness to help us feel sleepy, while decreasing in the daytime, but this may not be so for children with autism, which is why they have trouble sleeping at night.

Another reason why they may have difficulty sleeping or staying asleep could be because they are more sensitive to external stimuli, such as light or sound. Just like how some people may be able to fall asleep even with the lights on, others may find it impossible to. A child may wake up abruptly even from a very slight noise that others will sleep through due to their sensitive nervous system. Anxiety could also be another cause; children with autism tend to face greater levels of anxiety. If you notice your child picking the skin on his fingers (known as excoriation disorder), it might indicate anxiety as well. Excoriation disorder does not only occur among children with autism, but is also common among neurotypicals and functioning adults.

Consequences of these sleep problems include impacts on quality of life, learning and overall health. Research has found a correlation between lack of sleep and aggression, hyperactivity, slower learning and increased behavioral problems.

Fortunately, there are ways to help your child if he is struggling with sleep!

First and foremost, establish a good sleep hygiene in terms of the sleep environment, regular bedtime routine and fixed sleep and wake timing.

Your child’s sleep environment should be dark, quiet and cool as light keeps the brain awake and the body sleeps better in a cool temperature. Try to make whatever changes necessary to create a more comfortable environment that is both relaxing and conducive for sleep, and you never know what little changes might help your child significantly.

In addition, as most parents might already be doing, a bedtime routine is a good way to settle the mind down in preparation for sleep. Pointers to note are 1. Keeping the routine about 20-30 minutes, and include relaxing activities such as reading or listening to soothing music. Avoid the use of electronics during this timing because firstly, TV or games are very stimulating and secondly, blue light from screens actually suppresses the hormone melatonin, as above mentioned, which induces sleepiness. As for the sleep and wake timings of your child, it is important to keep it consistent, and wake up timings on the weekends should not differ too much with weekdays.

Another effective way is to increase the amount of exercise your child does on a daily or weekly basis. Exercising in the day makes it a lot easier for your child to fall asleep, and also allows them to fall into a deeper sleep. Take note that exercising too close to bedtime might be counter-effective and make it harder to fall asleep, so try to schedule the exercise in the afternoon or before dinnertime. Avoid sugar or caffeine close to bedtime as the effects of food sensitivity is often very prominent and take a while to fade.

In short, the changes you can make to help your child sleep better are as follows: making the bedroom more comfortable, cutting down on screen time or sugary foods before sleep, establishing a consistent bedtime routine and also getting them involved in daytime exercise.

Written by Claudie