Sleep disorders tend to go hand in hand with Autism. It is estimated that between 60% and 80% of Autistic children have difficulty sleeping. This can include trouble falling asleep, restlessness and poor sleep quality, thrashing about, and early rising. It continually baffles me that my child will have no noticeable changes in behavior whether he sleeps ten hours or four and three-eighths hours. In fact, a lack of a good night’s rest can sometimes affect everyone else in the family more than the child!

No known cause

There is no solid research on what causes sleep disorders in children with Autism. The two strongest theories are misinterpreted social cues and the irregular release of  the hormone melatonin.

People typically use their body’s circadian rhythms, the light and dark cycles, and social cues to know when it’s time to retire for the evening. We may see others getting ready for bed or have a sense of the next day’s schedule, which helps dictate the start of our bedtime ritual.

Children with Autism fail to understand social cues and the big picture. Even after clearly repeating my expectations to my son (e.g., ten more minutes of this card game and then you must brush your teeth), he will still start a new game when the timer goes off. He’s not stalling or manipulating me for a later bedtime. Boy do I spin myself in circles when I take the approach of uttering a long litany of my evening tasks and why I have to be on time the next day for a meeting! Yep. It’s like talking to a dashboard : ) It’s a good reminder for me to speak in clear and concise phrases and leave the rest to my silent mental gymnastics.

Additionally, the body uses melatonin to regulate sleep/wake cycles. It creates melatonin with the amino acid tryptophan, which has been found to be either higher or lower than normal in Autistic children. In a normal functioning system, the melatonin levels will rise at night and dip during the day, in response to the dark and light. Children with Autism don’t release this hormone at the correct times.

This coupled with sensitivity to outside stimuli can definitely play a large role in sleep disorders. Children with Autism also tend to wake abruptly to any light noise or movement once asleep. In my own house, I can vacuum next to my daughter’s head and she would continue sawing wood, whereas if I simply look at the bedroom door, contemplating checking on my son, he will sense it and pop up like a Whack-a-Mole carnival game. It’s always been like that, even when he was an infant.

Tips to get a better night’s rest

I find the best way to combat the sleep issue is by establishing a solid nighttime routine. In a perfect world, this would include a bath, reading stories, soft music, and consistent bedtimes. I do my best, but sometimes he just needs to wind down with a limited block of his favorite TV show.

Our absolute favorite nighttime ritual is “hot dog”: rolling him up in a blanket and using a yoga ball for deep compression on his back. We use different patterns as “toppings”, like circles are called onions, vertical rolling is called ketchup, etc. This is an instant calming tool that never disappoints. Finishing the routine with a recap of positive behavior for the day and a short EFT session is a surefire recipe for sleep success.

On that note, it’s almost 1 a.m. I should probably get some sleep!