The Ultimate Guide to Improving Sleep in Children with Autism

Updated: Oct 19, 2018

originally written for and published on

We all need sleep. Our bodies go through a period of rebooting when we sleep each night. Any given night, once we fall asleep, we alternate between the restorative Rapid Eye Movement (REM) stage and Non-REM stages of a sleep cycle every 90-110 minutes. It is during this normal sleep cycle that our bodies and brains process the events of the day and refresh for a new day!

If you’ve ever suffered through a sleepless night, you can testify to the irritability, daytime sleepiness, difficulty concentrating, poor planning, and disorganization that resulted. In fact, research has drawn correlations between learning issues and sleep disturbances. While the occasional poor night’s sleep will inevitably affect us all at some point or another, more frequent difficulties with sleep can be problematic and warrant professional help.

Sleep deprivation

The National Sleep Foundation recommends that preschool children receive 11-13 hours of sleep each night, school age children (10 -11 hours) and for teenagers (8 - 10 hours). Because the recommended sleep time decreases with age, the recommendation for adults is 7-9 hours of sleep per night.

If your child is not getting the recommended amount of sleep, the effects can compound and sleep deprivation can result.

Side effects of sleep deprivation can include:

  • Irritability, mood changes

  • Daytime drowsiness

  • Behavioral issues: hyperactivity, aggression, inattentiveness

  • Difficulties with organization, planning, judgement

  • Difficulties with new learning & retention of learned skills (memory)

  • Decreased safety awareness

Common Sleep disorders

The National Sleep Foundation reports that only 35% of American adults qualify their night’s sleep as “good.” When sleep issues manifest for a sustained period of time, a more clinically diagnosed sleep disorder may be to blame. While the most common sleep issues reported are related to falling and staying asleep, there are a number of ways to characterize a sleep problem:

  • Insomnias: difficulty falling asleep and/or difficulty staying asleep

  • Hypersomnia: excessive sleepiness

  • Sleep-Related Breathing Disorders: apnea, snoring, groaning

  • Circadian Rhythm Sleep-Wake Cycle Disorders

  • Parasomnia - excessive movement during sleep cycles

Unfortunately, for children with autism, these sleep problems occur more frequently are compounded by some of the stressors that are commonly associated with autism spectrum disorder.

Sleep Problems, Sleep Patterns, and Autism

Autism Speaks estimates that over 80% of children with autism have sleep problems. Researchers are working hard to uncover exactly why the incidence of sleep disorders is so high in autistic children: Does the neurological and genetic makeup of the autistic brain and body contribute to sleep issues? Or, are issues with sleep contributing to commonly observed symptoms, behaviors, and learning difficulties associated with autism?

In a study published in the Archives of Disease Control, it was reported that children with autism, aged 30 months to 11 years old, slept for 17-43 minutes less per day than their peers. The shortened sleep times were attributed to later bedtimes, earlier wake times, and night awakening (3+ times per night). As the age of the research participants increased, the problems with night awakening increased as well (11% of children with ASD versus .5% of children aged 6.75 years). Sleep deprivation is thought to exacerbate some of the social, behavioral, and cognitive skill issues associated with autism.

Research has also indicated that children with autism spend less time in the critically-important REM sleep cycle than other peers (15% compared with 23%). Since this is the restorative phase of sleep where the day’s information, experiences, and memories are consolidated, researchers are examining the role this lack of REM-sleep plays in the learning difficulties associated with autism.

Another common sleep problem with children with autism is difficulty falling asleep. Each of our bodies has a 24-hour sleep-wake pattern called a circadian rhythm. These circadian rhythms are controlled by the hypothalamus of your brain and are essential to falling asleep and waking in a regular timeframe. The hypothalamus controls the brain’s release of melatonin, which helps your body become tired. Research has found that people with autism have elevated melatonin levels during the day, and lower levels of melatonin at night - this is the opposite of what should be the case. This dysregulation of melatonin levels can contribute to a disruption of the body’s circadian rhythm, meaning parents have to work extra hard to make a non-drowsy child ready for bed!

Additionally, researchers are examining the role that genetics plays in the autism-sleep relationship. Recent research has found more than twice the genetic mutations of circadian genes in people with autism. Scientists continue to explore what mutations are indicators of sleep disorders and whether or not these specific mutations are unique to autism or found in other neurotypical sleep-disordered people.

If you haven’t realized by now, there is no easy answer for figuring out the origination and/or solutions for sleep disorders! To further complicate the issue, children with autism have additional considerations when looking at what could contribute to sleep disturbances:

  • Comorbid diagnoses like anxiety, restless leg syndrome, epilepsy

  • Side effects of medication(s)

  • Neurological diagnoses

  • Sensory dysregulation