ASD Sleep Help Guide

Autism spectrum disorder (ASD) has been diagnosed in around 2 million people in the United States. It is indeed a spectrum, and people with an ASD diagnosis can have wildly different issues and challenges.

However, around half of all children diagnosed with ASD also experience sleep issues. Typically, they have issues falling asleep and don’t experience restful sleep, which can cause their other issues to worsen. This is also true of adults with ASD.

Common Sleep Disorders Affecting Children and Adults With Autism

Children diagnosed with ASD sleep an average of almost 33 minutes less each night than same-aged children without this diagnosis. They also take more than ten minutes longer to fall asleep.

Along with sleep issues, people living with ASD are more likely to be diagnosed with gastrointestinal issues and epilepsy. Both of these issues also can cause problems with sleep.

Commonly occurring sleep issues include:

Resistance to going to bed
Recurrent insomnia (not enough sleep) or hypersomnia (too much sleep)
Parasomnias including night terrors and sleepwalking
Breathing issues such as sleep apnea
Problems waking up in the morning
Recurring daytime sleepiness
Movement issues like rhythmic movement disorder and restless leg syndrome
Bed-wetting

Not only are children with ASD more likely to have these sleep issues, but they are more likely to experience them more intensely than neurotypical children do.

Of particular concern is that not getting enough sleep has been proven to cause social issues, and maintaining social relationships is already an issue for many people diagnosed with ASD. Lack of sleep can also aggravate other behavioral issues and worsen existing depression and anxiety symptoms.

Why Are Children With Autism More Prone to Sleep Problems?

Scientists have yet to answer why children (and adults) with ASD are more likely to have sleep issues. However, some theories are currently being investigated.

Abnormal Melatonin Production

One known scientific fact is that people with ASD typically have unusual levels of the amino acid tryptophan, which helps the body produce melatonin. Bodies make melatonin to regulate sleep. People with ASD don’t make melatonin on the same schedule that other people’s bodies do.

Most people make high levels of melatonin at night and less during the day, which aids in sleep. People with ASD are more likely to produce melatonin on an opposite schedule, with the sleep-producing hormone released at high levels during the day.

Difficulty Reading Social Cues

One well-known aspect of ASD is that people diagnosed with it often have problems deciphering social cues. Social cues help people realize when their family members and housemates are preparing for bed.

Young children especially need the reinforcement of social cues to help them develop good sleep habits.

Heightened Sensitivity

People with ASD are more likely to be disturbed by external stimuli like noise or light. This makes it more difficult for them to calm their brains enough to go to sleep.

Developmental Issues

Neurotypical babies typically sleep a lot, waking mostly to eat. As babies become toddlers, they continue taking daytime naps but begin sleeping more at night and being awake more during the day. Children with ASD don’t naturally develop these sleeping patterns like their neurotypical peers.

Genetic Abnormalities

Scientists believe that people with autism get about ten percent less REM sleep than their neurotypical peers. There are two current theories about why this might be. One is that a genetic mutation that leads to autism also causes insomnia.

The other theory is that people with autism have neurotransmitter differences that interfere with REM sleep. REM sleep is the part of the sleep cycle when people dream their brains process experiences and things learned during the day. Missing out on REM sleep impacts cognitive ability and success in school.

How Do Sleep Issues Change as My Autistic Child Ages?

Some issues children with ASD have do go away as they age. For example, night terrors tend to stop around age 7. Most people also outgrow sleepwalking.

However, adults with autism still are twice as likely to have sleep issues as adults without an autism diagnosis. Around one fifth of adults diagnosed with ASD are also diagnosed with a sleep disorder such as insomnia or sleep apnea.

How Can I Help My Autistic Child Sleep Better?

Children who get enough sleep typically do better in school and in their social lives. This is just as true for children with ASD. Parents should keep an eye on their children and watch for issues like unusual movements, snoring, or breathing issues.

Any of these symptoms should be reported to the child’s pediatrician. Making sure children with ASD get enough sleep also helps their parents and caregivers, who have a greater chance than the general population of having sleep disorders themselves.

Behavior Changes

Some sleep issues can be addressed through changes to behavior or routine.

1. Keep the Bedroom Cool, Dark, and Quiet

The heightened levels of sensitivity typically associated with ASD mean that light and sound are much more of an issue for people with autism. Blackout curtains can help create a dark bedroom an autistic person can sleep in. Electronics should also be limited in the bedroom and in the hours before bed.

2. Practice Good Sleep Hygiene and Establish a Bedtime Routine

Consistent bedtime routines help children fall asleep more quickly. The same activities should be repeated in the exact same order each night leading up to bedtime. This includes activities like taking a bath, brushing teeth, and reading stories.

3. Adjust Your Child’s Diet and Exercise

Since ASD and gastrointestinal issues are often linked, parents should watch for sensitivities to foods. Anything that causes stomach upset should be avoided going forward.

Liquids should also be limited right before bed, especially if bed-wetting is an issue. Regular exercise during the day also helps kids fall asleep at night. However, the hours before bed should be calm to help kids begin to wind down.

4. Coach Your Child to Fall Asleep Without You in the Room

It’s hard for many children to fall asleep on their own, but it’s especially challenging for children with ASD. It’s a vital skill, though, since it will help children soothe themselves back to sleep if they wake up during the night.

The following steps can help kids get used to sleeping on their own. Each step should be done for a few nights before moving on to the next.

Lie down with the child until they fall asleep.
Lie on the floor near the bed.
Sit in a chair inside the bedroom with the door open.
Move the chair outside the room but within sight of the child’s bed.
Leaving the bedroom door open, move the chair so the child can’t see it from the bed.
Close the door but sit outside it.
Say goodnight, leave the room, and close the door.

Sleep Products

Many products are designed to help people with sleep issues fall and stay asleep. They can be especially useful for both children and adults with ASD.

Waterproof Mattresses and Bedding

People who wet the bed need waterproof bedding and mattresses that resist odor and are easy to clean.

Bed Rails and Floor Pads

Children who move around a lot while they sleep due to rhythmic movement disorder or night terrors can benefit from bed rails that keep them from falling off the bed. Bed rail pads cushion the rails so the child won’t be injured if they come into contact with the rails.

White Noise Machine

White noise, produced by either an app or a machine, helps children sleep by drowning out other noise in the home. Used consistently, it can also become a key part of a child’s routine as they begin to associate the noise with sleep.

Anti-Snoring Devices

Anti-snoring mouthpieces are fitted by the child’s dentist. The devices move the lower jaw forward in order to open up the airway while the person sleeps and offer relief from snoring. Extreme cases of sleep apnea typically require the use of continuous positive air pressure (CPAP) machines.

Weighted Blankets

Weighted blankets are of immense help for people dealing with restless leg syndrome. The weight of the blanket soothes the feeling of needing to move.

Light Therapy

People with ASD dealing with extreme daytime drowsiness are often helped by using a light therapy box when they wake up in the morning.

Melatonin Supplements

Melatonin has been scientifically proven to help kids with autism get to sleep faster and stay asleep longer than kids who don’t take melatonin supplements.

Sleep Resources

Additional Resources

About Derek Hales

Derek Hales is the Founder and Editor-in-Chief of NapLab.com. He has been featured in Fast Company, Reader's Digest, Business Insider, Realtor.com, Huffington Post, Washington Post, AskMen, and She Knows. Derek has personally tested over 320+ mattresses and hundreds of pillows, sheets, beds, and other sleep products.