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Calling the Sandman: Autism Sleep Problems

Unfortunately, the Sandman is a mythical character, and sleep problems are very real. Sleep disturbances are a common concern expressed by many parents and caregivers of people with an Autism Spectrum Disorder (ASD) diagnosis. More than 80% of people with ASD have experienced sleep difficulties in their lifetime. Sleep deprivation can affect many aspects of a person’s life, from health, to mood, to behavior. If children aren’t sleeping, their parents aren’t sleeping either. Addressing sleep issues with your child is important for the overall functioning of the family.

When dealing with sleep problems, first ensure there isn’t a medical condition that may be affecting your child’s sleep. Illness, enlarged adenoids and tonsils, gastrointestinal discomfort, for example, can impede sleep. Always consult your child’s primary physician about sleep difficulties first. Your child’s physician can also tell you the appropriate amount of sleep per night depending on your child’s age. Remember, each person is an individual, and your child may need a little more or a little less sleep.

While there may be underlying physiological causes to sleep problems, environmental sources can promote or hinder a good night’s sleep. If your child is healthy but continues to have trouble going to sleep, staying asleep, or waking too early, there are strategies you can start using right now to encourage good sleep hygiene.

 

Sleep strategies

Routine: Don’t underestimate the power of routine! Routines provide predictability, promote independence, and signal it’s time to wind down. A bedtime routine might include a bath, massage, story or song, and tuck into bed. Bedtime routines should be relaxing and soothing for your child, so choose activities that calm your child. A visual schedule can be developed to show your child the steps of the routine.

Bedtime: Your child should have a consistent bedtime each night, during the week, on weekends, and holidays. Just as importantly, your child should have a consistent wakeup time. It may be tempting to let your child sleep in, especially if they were up frequently during the night, but resist the urge.

Electronics: Limit screen time 1-2 hours before bed. Instead, use this time to go for a leisurely walk, play a quiet game, read a book, or put together a puzzle. Use of electronics before bed can result in difficulty falling asleep and staying asleep so be sure to power down a while before bedtime. (This goes for parents, too!) Consider keeping televisions out of bedrooms, because they also disrupt sleep.

Environment: The best sleeping environments are comfortable and typically dark, cool, and quiet. Blackout shades and curtains can help to keep the room dark, and noise machines can drown out background noise in the home. Be sure that your child is comfortable and that their sensory preferences are considered.

Food and drinks: Heavy meals should be discouraged right before bedtime to avoid possible gastrointestinal discomfort, but a light snack can often be consumed without problems. Caffeine is a stimulant and should be avoided hours before bed, if not totally eliminated from the diet. It takes the average adult about five hours to metabolize caffeine, and children take even longer. Avoid soda, coffee, tea, and even chocolate in the hours before bedtime. While we don’t want to restrict liquids at night, be mindful of how much your child is drinking. Getting up to use the bathroom many times a night can certainly disrupt sleep!

Daytime behavior: Naps during the day should be avoided, except for very young children. Unless your child is ill or has a medical condition (for example, following a seizure), try not to allow any daytime sleep, as it will affect the quality and quantity of night sleep. Ensure that your child is exposed to sunlight and has the opportunity to be physically active every day.

Night waking: If your child is waking during the night and getting out of bed, calmly direct your child back to bed. Do not allow electronics use, watching television, or any other stimulating or highly preferred activity during overnight hours. Similarly, do not engage in long conversations or engaging activities with your child. You want the child to learn that nighttime is for sleeping and not for fun activities and undivided attention from mom or dad.

What do you do if you practice good sleep hygiene and your child still has sleep problems? The above strategies will work for many people, but other people may need more specialized interventions. If your child continues to display sleep difficulties, contact your child’s primary physician to explore further medical conditions that may be affecting sleep and request a referral to a professional who is experienced in treating children with sleep problems, such as a psychologist or Board Certified Behavior Analyst.

Jessica B. LeBoeuf, PhD, LP, BCBA, is a member of ASNC’s Clinical Department and can be reached at jleboeuf@autismsociety-nc.org.

ASNC’s Clinical Department staff is composed of PhD and master’s-level licensed psychologists, Board Certified Behavior Analysts, and former special education teachers. We provide individualized intensive consultation using evidence-based practices to support children and adults across the spectrum in home, school, employment, residential and other community-based contexts. We also deliver workshops to professionals on a wide range of topics including but not limited to, strategies to prevent and respond to challenging behaviors, best practices in early intervention, functional communication training, and evidence-based practices in instruction for K-12 students with autism.

To find out more, contact us at 919-390-7242 or clinical@autismsociety-nc.org.

 

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