The connection and relationship between autism and improper sleepfor The Sleep AdvisorsJana

 Sarno, Hopebridge Chief Clinical Officer

What are sleep challenges commonly experienced by those on the spectrum?

And what makes them more or less likely to experience these challenges? Individuals with autism spectrum disorder can experience a number of sleep challenges, but in my experience at Hopebridge Autism Therapy Centers, they typically fall into one of two buckets: trouble falling asleep or frequent night awakenings.

Some studies suggest that individuals with autism may experience differences in their sleepwake cycles or may be more likely to be affected by insomnia than their neurotypical peers. Other underlying reasons may include sensory sensitivities, restlessness, inconsistent sleep routines, or night terrors, in which they may have trouble distinguishing from reality.

Night awakenings can turn dangerous if individuals struggle with elopement. Families whose children are known to wander at night may have to worry about their safety within the house, as well as the risks posed from nearby roads, swimming pools and other bodies of water, among other things.

What strategies can individuals on the spectrum employ in order to better their sleep?

Sleep interventions are not one-size-fits-all. What may be calming for one person may excite another. When approaching sleep with our pediatric patients during ABA therapy, we first work to determine the underlying reasons behind their sleep challenges. In our Hopebridge centers, our behavior analysts are trained to use special sleep-related assessments, but families can sometimes determine the root causes by simply asking themselves questions like, “Is there light shining in the room?” “Are sensory sensitivities affecting sleep?” and “Are they distracted by something in their bedroom?” All in all, I think it’s important to stress healthy sleep routines. These should be predictable routines that signal to the child that sleep is near.

If there do not seem to be any environmental barriers for sleep, caregivers should think about what the child is drawn to once they wake. For instance, are they looking for a parent’s attention, snacks or access to a tablet? In these instances, I recommend making bedtime routine and sleep situations predictable.

To do this, limit vigorous activities before bedtime, as well as the number of “fun” toys in the bed, though one comfort item is fine as it is safe for their age. I also recommend restricting non-bedtime routine activities from occurring in bed to help children understand the bed is for sleeping.

If late-night or early morning awakenings are the challenge, caregivers should limit the attention they give their kids—keep it boring! If screen time plays a role in these moments, families can place tablets in an area where children cannot reach them during nighttime hours, or install apps on the TV that require passcodes.

If a child tends to wake around the same time every night, parents can plan scheduled awakenings by going into their room just before it would typically occur, then gently and calmly waking their child before leaving the room. These planned awakenings disrupt REM sleep, allowing them to more quickly go back to sleep through the usual awakening.

Elopement challenges are some of the more dangerous sleep-related challenges and should be treated seriously. High-tech monitors like The Nest Cam can come in handy, as they alert users through the phone when picking up movement or sound. For some families, locks on bedroom doors may be necessary, and it can be a good idea to connect with local first responders in advance to prepare for potential emergencies.