Managing Sleep Disorders in Children with Autism

Parents of children with autism are acutely aware of the struggle of getting them to sleep every night. Sleep issues in those with autism spectrum disorder are one of the most major concerns of parents, because it affects not only the child but also the entire household. Children with autism have a wide range of issues that pose challenges for parents, teachers, and healthcare practitioners. But sleep problems can leave the child tired and irritable and disrupt the sleep of every other person in the house.

Much like the other issues presented by autism spectrum disorder, the sleep issues also range from mild to severe. In some children, it is more manageable, while in others, the help of healthcare practitioners may be required. By understanding the cause of sleep disorders, parents can help children with autism settle down and get a good night’s rest.

What Is Autism Spectrum Disorder?

Autism is defined as a developmental disorder characterized by difficulties in communication and social interaction, varying in severity. Not all children with autism spectrum disorder have the same symptoms, although most of them are related to social skills and communication. Symptoms of autism spectrum disorder appear within the ages of 1 and 2. Children with autism may also have symptoms of hyperactivity, difficulty learning, and inability to make friends.

Some of the most important symptoms of autism spectrum disorder include:

• Lack of response when called by name
• Resistance to being held or cuddled
• Not showing emotions or making eye contact
• Difficulty speaking or delayed speech
• Inability to start a conversation or hold one
• Difficulty following instructions or nonverbal cues like facial expressions
• Passive, aggressive or disruptive behavior in social situations
• Problem with coordination
• Repetitive movements like spinning or rocking
• Indulging in self-harm, like biting or head-banging
• Affinity to specific routines and inability to adapt to change

Autism spectrum disorder has no cure but if intervened early the right treatment and therapy can make a big difference. People have to live with autism forever, and in many cases, their social and professional lives are impaired, including making friends, forming relationships, or holding a job. In some people, symptoms of autism are very visible while others may not appear as autistic at first glance.

Sleep Disorders in Autism

All children have a problem with sleep in the early years. They may either refuse to adhere to a certain bed time, or fall asleep before it’s time for bed, or have difficulty waking up in the morning. Some children me also experience insomnia, but it usually goes away on its own and is not a cause for concern.

But when it comes to children with autism, sleep disorders add to the challenges already faced by parents on a daily basis. Children with autism also exhibit certain sleep disorders not usually seen in other children, such as:

• Irregular sleep and wake patterns, such as staying awake till very late or waking up too early in the morning
• Sleeping too little for their age or being awake till late in the night
• Getting up and playing or making noise in the middle of the night when they are supposed to sleep
• Excessive sleepiness during the day
• Falling asleep in weird places and refusing to budge

As with other problems experienced by children with autism, sleep disorders can also be hard to manage. The worst part is when it begins to take a toll on the parents and other members of the household. Children with autism can be excessively needy and seek reassurance all the time. They may wake up in the middle of the night or too early in the morning and also wake up the entire household because they cannot settle and need reassurance. Such behavior can lead to excessive parental stress.

In children with mild to moderate autism, these sleep disorders get better with age. But in children with severe autism spectrum disorder, sleep issues can last for years and may never completely go away. If a child with severe autism experiences sleep disorders on a daily basis, parents should seek the help of a professional to try and make things better before the child grows older. Once the child grows up, these issues can be almost impossible to eradicate.

Causes Behind Sleep Disorders in Children with Autism

Sleep disorders in children with autism result from a number of factors. It helps to note that sleep disorder itself is not the issue; there is an underlying cause that needs to be treated first. Some of the causes behind autism related sleep disorders are:

Difficulty in Communication

Children with autism usually have difficulties communicating their needs and wants to others. They are not able to adjust in a social setting or make friends. This is often one of the reasons why your child might be kept awake at night. Inability to communicate clearly with others causes stress to the child and prevents normal sleep. Because of these communication problems, children with autism are often unable to pick up on cues. All these stress can cause sleep disorders in children with autism.

Sticking to Routine

Children with autism are extremely particular about routine. They find it easy to fall asleep if a specific bedtime is followed every day. Even the slightest deviation from routine can upset them and cause mental disturbances. Besides, they also have weird habits, such as falling asleep in a particular place and refusing to sleep in bed. They may have favorite objects like a toy or a set of clothes without which they refuse to go to bed. They may even throw tantrums if they do not find their favorite objects. Children with autism can be stubborn and these habits can be very hard to break, escalating sleep disorders.

Hyperactivity

One of the biggest symptoms of autism spectrum disorder is hyperactivity. Children with autism refuse to settle and have excessive energy and alertness, make it hard for them to fall asleep. They may have difficulty sitting or lying in one place for long time, and make repetitive movements like spinning, jumping or flapping their arms and legs. Because of such hyperactivity, it can be hard to get children with autism to settle or sleep. If social settings cause anxiety to the child, it can snowball into a sleep disorder.

Side Effects of Medications

If your child takes medications for autism, they can have certain side effects. Sleep issues are often side effects of medications. In that case, you should consult the healthcare practitioner to change the medication.

Managing Sleep Disorders

Sleep problems in children with autism aren’t always because of the condition. Some of them can also be behavior issues that can be easily managed by strategies used for any other child.

However, children with autism can have difficulty understanding instructions or cues, so you need a lot of time and patience.

The following are a few strategies for managing sleep problems in children with autism.

Develop and Stick to Sleep Routines

As with any other child, you need to establish a positive routine during bedtime. This involves engaging your child in relaxing and calming activities for 20 or 30 minutes before bed. The routine should be age-appropriate bedtime for your child. Regular bedtimes and wake times have been found to help children with autism spectrum disorder with their sleep problems.

Warning for Approaching Bed Time

Children with autism get upset if they are suddenly asked to change activities. For instance, if your child is busy with his favorite toy when you suddenly announce it’s time for bed, they may get upset and throw a tantrum. Therefore, you should give plenty of warnings in advance that bedtime is approaching. Also make sure to stick to the routine every single day, even when you are on a holiday or at someone else’s house.

Be Patient and Consistent

Children with autism can get upset at being put to bed and keep getting out. Parents need to put the child gently back to bed, as many times as they get out. Returning the child to bed helps establish the fact that it’s bedtime and they need to sleep.

Sleep Environment

Pay careful attention to the sleep environment of the child. If the child won’t sleep without a certain toy or pillow, it’s important to gradually phase out the item to decrease their reliance on it. It’s also necessary to teach the child to sleep in their own bed and to fall asleep on their own. This can be done with the help of cues, like drawing pictures or telling them stories. If your child suffers from anxiety, playing music, keeping a night light on, or telling them bedtime stories can help bring about relaxation.

Although certain autism-related problems exist even in adulthood, sleep problems can be managed with lots of patience and consistence from the parents, and help from professionals.