Sleep problems are extremely common for those children with Autism Spectrum Disorder. There are many theories behind sleep disturbances in these children, like sensory sensitivities, extra stress, gastrointestinal issues, decreased melatonin levels, and decreased physical activity. Other causes might include night terrors, sleep apnea and seizures, for those with more severe cases. Or a combination of factors might be involved – writes David Fawcett, dad of two autistic sons.
For Dylan, our five-year old Autistic son, he has had sleep problems since birth. It took about six months for Dylan to first sleep mostly through the night, when most children accomplish that within several weeks to a few months. That was short lived though as after a few more months he would start having a very erratic sleep, with either having severe difficulty falling asleep, taking up to two hours to do such, or with many awakenings at night, or one prolonged few hour awakening about four hours after first falling asleep.
With regards to sensory difficulties that affect sleep, for Dylan, and for many others with ASD, the sensitivity often involves sound, touch, light and temperature. For instance, Dylan wakes up extremely easy to very minor sounds, as he is very sensitive to even the slightest of noise. He could wake up to the sound of someone rolling over in bed next to his bed, or awaken easily by the sound of wind outside the window, or to the sound of the refrigerator or heater clicking on at night in another room. As soon as Dylan was old enough, we had to get Dylan his own bedroom, and make sure that room was the one furthest away from those items. Dylan also needs it totally dark in his room, and so moonlight shining through the blinds disturbs his sleep, as does a glow from a clock seem to want to keep him up at night.
As parents, we had to resort to replacing the standard blinds in his bedroom with honeycomb blinds, and that filtered out much of the light, and we would make sure our outdoor house light was off too, as it was not far from his window and could shine in. We also resorted to putting dark drapes over his new blinds, to make sure it was extra dark in his room, as when any light came in the room at night he wanted to get up out of bed and run to the living room.
As well, Dylan is extra texture, touch and temperature sensitive, so this means the items he wears and that are on or involve his bed, and the temperature in his room during sleep, has to be just right for him. If Dylan is too hot or too cold, we noticed that kept him up more. The blanket he uses at night has to have the right feel, and be soft and comforting, and without dust allergens, or he will throw it off his bed at night, and the night pajamas or night shirt needs to not aggravate his skin, as Dylan loves scratching at night if things are not proper there. Also, Dylan will cry in bed if he does not wear socks at night, and if they become untucked from his pajama pants.
Each child with Autism will not necessarily have the same sleep sensory issues or level of sleep difficulties, as each Autistic child is different and may have other sleep patterns, too. As Autism Spectrum Disorder severity can range from mild to severe, and as those with that condition can be either over sensitive or under sensitive to things, this means there may be Autistic children thus who have more regular sleep patterns, but others at the extreme end perhaps staying awake most of the night and needing to sleep much during the day.
Dylan was diagnosed with Circadian Rhythm Disorder after having a sleep study done, and that can be a cause of sleep problems for those with ASD, too. This just means those afflicted with such condition have shown that their natural sleep and wake cycle patterns are adversely affected. One theory is that this disturbance is because of the inability of the body to produce enough melatonin, as adequate melatonin is needed to lower body temperature which promotes drowsiness. As Dylan’s organic testing results showed a low melatonin level we tried a melatonin supplement nightly with delayed release and that helped his sleep, too.
A lack of sleep in children could also lead to chronic sleep deprivation. Often the caregivers and other family members will have severe sleep problems too because of the Autistic child’s sleep difficulties, and even insomnia could result as well. This could mean increased anxiety and stress for one or all involved, which could result in increased irritability and behavioral issues throughout the day, which further affects sleep. My wife and I were often only getting a few hours of sleep per night because of Dylan’s sleep problems.
But, the efforts and changes we as parents made to help Dylan’s sleep have seemed to be working, as Dylan now sleeps on average nine hours a night, instead of the usual six. Other things we tried to help him at night include trying to get him into a calming pattern an hour before bed, like a bath, dimming the lights, and gentle music. As children with Autism often love routines, we also try to put Dylan to bed at the same time each night, and to get up at the same time too. For Dylan’s one daytime nap, we make sure it is not too late, as that could delay when he goes to bed at night. And throughout the day, we try to reduce his anxiety to promote better sleep.