SLEEPING ISSUES: STRATEGIES TO CHANGE SLEEPING PATTERNS



AUTISM & SLEEP

Just like any other child, children with Autism Spectrum Disorder (ASD) sometimes have difficulty going to sleep and staying asleep. However, children with ASD often have sleep difficulties that we don’t see as often in other children. Studies show that the prevalence of sleep disturbance in children with ASD is 40-80%, compared to 20-40% in typically developing children (Margaret et al., 2009).


Several sleep problems that are commonly seen in children with autism include the following:

  • Irregular sleep and wake patterns (e.g., lying awake until very late or waking very early in the morning)

  • Sleeping much less than expected for their age

  • Being awake for more than an hour during the night

  • Getting up and playing or making noise for one or more hours during the night

  • Excessive sleepiness during the day

It has been found that sleep disturbances can have detrimental effects on children’s cognitive development and daily functioning in various areas, including attention, learning, memory, mood, and behavior (Margaret et al., 2009). Additionally, poor sleep in children with ASD has been shown to, in turn, diminish parents’ sleep quality (Margaret et al., 2009). Thus, it is very important that our kiddos (and their caregivers!) get the proper amount of sleep so they can function at their highest potential every day.


It has been found that sleep disturbances can have detrimental effects on children’s cognitive development and daily functioning in various areas, including attention, learning, memory, mood, and behavior.

AVERAGE SLEEP REQUIREMENTS, BY AGE

You might be wondering, “How much sleep is my child even supposed to get?!”


Every child needs a slightly different amount of sleep. However, in general, these are the average sleep requirements for children, by age (Shroff, 2018):

  • Newborn–1 year old: 14 to 16 hours per day

  • 1–3 years old: 12 to 14 hours per day

  • 3–6 years old: 10 to 12 hours per day

  • 7–12 years old: 10 to 11 hours per day

So, if your child is not getting the appropriate amount of sleep for their age, consider utilizing some of the tips outlined below in order to improve their sleep quality.




TIPS FOR MANAGING SLEEP DIFFICULTIES

DEVELOPING SLEEP ROUTINES & HABITS

  1. Develop a consistent bedtime routine that involves your child participating in a few enjoyable, low energy activities in the 20-30 minutes before bedtime. Some examples include taking a bath (if your child likes bath time), doing puzzles, or story time.

  2. Try to limit screen time and try to avoid giving your child stimulants, such as caffeine and sugar, right before bed.

  3. Set a consistent, age-appropriate bedtime for your child. An appropriate bedtime is when your child is sleepy, but not overtired. Furthermore, set a consistent wake time, so your child can get used to going to sleep and waking up at the same time every day.

  4. Give your child plenty of warning that bedtime is approaching. You can use a timer, verbally warn your child (e.g., “10 more minutes until bedtime!”), use a visual to show your child that it’s almost bedtime, or you could even use all three strategies together! Some families also turn on relaxing music to signal an upcoming bedtime. Feel free to get creative, while also remaining consistent with the approaches that you use. Choose something that you can use or do whenever and wherever you are.

  5. Teach your child to fall asleep alone. All children and adults wake up briefly throughout the night, but quickly put themselves back to sleep by practicing what they typically do at bedtime. So, if your child needs a parent present to fall asleep at bedtime, it is likely that he/she might need a parent to help him/her fall back asleep in the middle of the night.

  6. If your child gets out of bed after you’ve put him/her to sleep and needs your help to fall back asleep, quietly and calmly put your child back to bed. Try to give your child minimal attention during this process. You may need to do this many times––especially if you’re just beginning to implement a new bedtime routine.


Set a consistent, age-appropriate bedtime for your child. An appropriate bedtime is when your child is sleepy, but not overtired.

CREATING A HEALTHY SLEEP ENVIRONMENT

  1. Your child’s bedroom should be dark, quiet, and cool. If the room is too dark, add a dim nightlight. If light shines into the room, put heavy curtains on your child's windows.

  2. The bedroom should be quiet at night. Try to limit noise from other siblings or from TV, computers, video games, or music in rooms nearby. Some children may find white noise or a low, quiet, consistent background sound (e.g., ceiling fan) soothing.

  3. Make sure that the temperature of the room and choice of bedding feel comfortable to your child and fit with his/her sensory needs. Additionally, it’s important to think about things such as the weight, fit, and fabric of your child’s pajamas.

In summary, sleep difficulties are very common in children with ASD. If you feel that your child has inconsistent sleep patterns or displays poor quality sleep, try implementing some of the strategies listed above.


Here’s to a good night’s sleep – don’t let the bedbugs bite!


About the Author

Lindsay R. – BCBA

Lindsay was born and raised in South Florida. She went to Duke University to obtain her undergraduate degree in Psychology, and then went on to earn her Master's Degree in Clinical Psychology from the University of Georgia. She became a BCBA in June of 2019 and has been working with InBloom since February of 2020. Lindsay loves to travel and spent 2 months volunteering in India!




References

Margaret, S. C., PhD, CRNP, Mason, T. B., MD, PhD, MSCE, Valladares, O., MS, Bucan, M., PhD, Levy, S. E., PhD, Mandell, D. S., ScD, . . . Pinto-Martin, J., PhD, MPH. (2009). Sleep Behaviors and Sleep Quality in Children with Autism Spectrum Disorders. Sleep, 32(12). doi:10.1093/sleep/32.12.1556


Shroff, A. (2018, June 18). Child Sleep: Recommended Hours For Every Age. Retrieved July 05, 2020, from https://www.webmd.com/parenting/guide/sleep-children


Sleep problems: Children with autism spectrum disorder. (2020, May 06). Retrieved July 05,

2020, from https://raisingchildren.net.au/autism/health-daily-care/sleep/sleep-problems-children-with-asd


Weiss, S. K., MD, FRCPC, & Malow, B. A., MD, MS. (n.d.). Strategies to Improve Sleep in Children with Autism Spectrum Disorders: A Parent's Guide.

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