Does it take your child hours to fall asleep? Does your child wake up multiple times throughout the day? Does your child wake up at the crack of dawn? Many parents feel alone when it comes to their child’s poor sleeping habits, but 80% of children with autism experience sleep problems. The Standford home sleep study data revealed that children with autism took about 160 minutes to enter REM sleep compared to 10 minutes by the control group. They also found that children with autism spent 15.5% of their time in REM sleep, while their counterparts spent 25% of their sleep in REM. Improving sleep can improve cognition, mood, and behavior. We answer frequently asked questions about sleep issues of children with autism and at-home tips to improve sleep.
What are the causes of sleep issues?
There is not a consistent etiology for sleep problems in children with autism. Sleep disturbances may be due to neurological, behavioral, and/or medical issues. Research is being conducted to evaluate the levels of hormones such as melatonin and other chemicals released by the brain that may contribute to sleeping issues in children with autism.
What should I do if I suspect my child has sleeping issues?
First, keep a sleep diary for a week to track your child’s sleeping patterns and behaviors. Calculate how much sleep your child is getting including naps. Typical amount of sleep include:
Also, be sure to note any disturbances, snoring, breathing patterns, unusual movements, or difficulty breathing. Once you have a detailed sleep diary, contact your child’s pediatrician for an appointment. Your child’s doctor can help determine contributing factors to your child’s sleeping issues. Factors may include but are not limited to:
• Sleep apnea
• Low melatonin levels
• Environmental issues or sleep routines
Once your child’s doctor completes an evaluation, they may refer to a sleep specialist. An overnight sleep-monitoring procedure, polysomnography, is recommended for a thorough assessment. The procedure assesses behaviors during sleep and evaluates for signs of sleep apnea, periodic leg cramps, or restless leg syndrome. Once the full evaluation is competed, an individualized treatment plan will be created including behavioral therapies, medication, and/or other treatment approaches.
What are some at-home strategies I can implement?
A team of professionals will develop the best treatment approach for your child regarding his/her sleep issues. In juncture with therapy, medication, and other techniques, these at-home changes can help your child get a better night sleep.
• Avoid stimulants before bed. Limit the amount of caffeine and sugar your child consumes close to bedtime.
• Increase exercise and movement. During the day, encourage your child to be active and exercise. Children who exercise during the day tend to have better sleep than children who do not. Exercise should be throughout the day but not too close to bedtime.
• Consistent nighttime routine. Bedtime routine needs to be relatively short (20-30 minutes) and predicable. Click on the provided link to learn more about establishing a great bedtime routine for your child.
• Shut down electronics. An hour before bedtime, all stimulating activities such as television, video games, tablets, and cellphones should be turned off.
• Relax before bed. Teach your child ways to relax before going to bed. Taking a bath, reading a book, gentle back massages, or soft music are all great ways to rewind and calm-down.
• Create a positive sleep environment. Many children with autism have sensory sensitivities. Sensory problems may negatively affect a child’s sleep. Occupational therapist may suggest weighted blankets or tight clothing while sleeping. Other suggestions include heavy or dark curtains on windows, white noise machine, humidifier, and fans or AC unit if too warm in the bedroom.
• Steady Sleep schedule. Bedtime and wake-up time should stay consistent between weekdays and weekends. Although this may be challenging for some families, going to bed later and sleeping in on weekends can negatively impact your child’s sleep patterns.
• Do not sleep with your child. Parents often get into the routine of sleeping with their children until they fall asleep. If your child is use to falling asleep with a parent present, they may not be able to self-sooth in order to fall back asleep if they wake up in the middle of the night. Children and adults often wake up in the middle of the night, but they are able to fall back asleep by using the same strategies used at bedtime.It may be an adjustment for your child not to have you sleep next to him/her. For the first three nights, lie next to child in bed. For the next three nights, transition to sleeping on the floor or another mattress next to them. Then, sit on a chair with the door open. The last two steps involve sitting outside the room but still visible to your child and finally sitting outside the room with the door closed.
If you are concerned about your child’s sleeping pattern, contact Lumiere Children’s therapy for a consultation with one of our occupational therapists.
Chen, I. (2015, October 09). Wide awake: Why children with autism struggle with sleep. Retrieved June 13, 2017, from https://spectrumnews.org/features/deep-dive/wide-awake-why-children-with-autism-struggle-with-sleep/
Helping Your Child With Autism Get a Good Night's Sleep. (n.d.). Retrieved June 15, 2017, from http://www.webmd.com/brain/autism/helping-your-child-with-autism-get-a-good-nights-sleep#2
Lamm, C. (2012, July 24). Sleep. Retrieved June 15, 2017, from https://www.autismspeaks.org/family-services/health-and-wellness/sleep
Sleep and autism: helping your child. (n.d.). Retrieved June 15, 2017, from http://www.autism.org.uk/about/health/child-sleep.aspx