The ‘sleep profile’ of an autistic person can be quite different from that of a neurotypical person. It’s estimated that between 40 and 80% of children on the autistic spectrum have sleep difficulties, compared with 25 to 40% in the general population. This may include issues such as taking longer to fall asleep, more fragmented sleep, shorter total sleep times, and sleeping at unusual times of the day. This means that autistic people may get significantly less sleep overall, which can in turn take its toll on parents and carers who may have their sleep broken in order to support those they’re looking after.
There are some common signs of insufficient sleep that you can look out for, including:
Sleep deprivation can also lead to difficulties with thinking, reduced ability to pay attention, memory lapses, and physical health difficulties in the long term. It’s really important to try to optimise children’s sleep, as well as for yourself as their parent or carer.
The essential foundations of sleep are having a consistent sleep schedule, an appropriate bedtime, and a regular routine, which will be slightly different for everyone as we all have different preferences. You might find that putting together a visual timetable of how bedtime is supposed to run can help make it as predictable as possible. This could be with photos, cartoons, or even the actual items themselves stuck onto the planner with Velcro or Blu Tack.
One of the great things about this sort of approach is that it allows your child to negotiate and plan out the order of activities, giving them some ownership of the process, which can help them to be prepared to engage with it.
Any sensory sensitivities also need to be taken into account. This can be related to textures, the type of laundry detergents you use, the temperature of the room, and also the level of light in the room. If children are especially sensitive to sound, it can be helpful to use a white/pink noise-making device (or a radio tuned to static) to provide a sound blanket throughout the night to help mask short-lived disturbing sounds.
When it comes to smart devices, the blue light they emit and the stimulation they provide can be detrimental to sleep, which is why they should be avoided in the hour before bedtime. Rather than taking them away abruptly, it can be helpful to provide an advanced warning that it’s nearly time for the device to turn off. There are even apps that automatically switch devices off, removing that source of conflict between caregivers and children. Try to make turning phones and devices off something everyone in the family does so that your child doesn’t feel singled out. Perhaps you can set up a designated family charging area in a non-sleep related room.
If your child gets out of bed at night, try to be as robotically boring as possible and encourage them to go back to bed with minimal fuss. Bedtime passes can also be helpful for some children. The idea is that you give your child a pass or several passes and they can choose whether to exchange them for parental contact or something they want in the night. But if they keep hold of them till morning, they can get a better reward.
Autistic children may experience heightened levels of anxiety in general, especially when things become unpredictable, so clear communication is key. You might find anxiety management strategies helpful, including talking about their anxieties, breathing exercises, and mindfulness. In some cases, psychological therapy can help children to learn new ways to manage their worries.
Some children also benefit from using "worry eaters”, which are small bedtime toys that help children deal with their fears, troubles and anxieties. The child will write or draw whatever their troubles are on a piece of paper and feed it into the mouth of the worry eater, locking it away and calming unhelpful thoughts.
Before adopting any new strategies to help your child sleep, we always recommend checking in with your child's therapist or GP to see if they can recommend any adaptations that might be helpful for autistic people.