Developing Good Sleep Habits in Autistic Children

It is not unusual for children with autism to also have sleep issues.  In many cases, this compounds the challenges the child faces in attention span and development, and adds stress and fatigue for the rest of the family.  It is not clear why children with autism also tend to have sleep disorders.  Possibilities include their increased response to outside stimuli, inability to read social cues (i.e., not being able to tell from others’ behavior that it is night time), irregular melatonin levels, and other theories.

Regardless of the cause, there are steps you can take to help establish good sleep patterns in your autistic child.  Let me first state that I am not a psychologist or a physician, and if sleep issues present a major challenge for your child, you should seek professional help.  We have worked with a psychologist and behavioral therapist in overcoming our son’s sleep issues, and he now uses a sleep medication to help him get to sleep. This medication helps some with sleeping through the night as well, but we are convinced that our improved efforts to establish good sleep habits are more responsible for these gains.

Before discussing what you should do, let me share some of the mistakes that we made through the years (our son is now seven).  Perhaps you will gain from the comedy of our errors and avoid repeating them.  In most cases, we tried to give our son what he asked for in order to calm him down and allow him to go back to sleep. Of course, since communication is a major challenge for autistic children, our son didn’t really want what he was asking for, he was only applying what limited vocabulary he had.

• Reading the same story over and over to him until he fell back asleep (after having read it to him over and over to get him to sleep in the first place)
• Putting a TV in his room so he could watch Sprout^® at night and stay in his bed (as if he would stay in his bed)
• Allowing him to come into our room to watch Sprout (I can’t tell you how greatly the middle-of-the-night shows on Sprout now irritate us.)
• Allowing him to come into our room to go back to sleep (which may or may not eventually happen after 2 hours or so of tossing, turning, and occasional jumping)
• Sitting next to his bed until he fell back to sleep (often with one arm on him to hold him in his bed)

I’m sure there are a few other errors I have blocked from my mind.  Let’s move on to what we should have done (and now do) when he woke in the middle of the night.  The concept is that the actions you should take to help the autistic child develop good sleep habits are the same you should use for any other child.  These may be more challenging for autistic children due to the social and communication hurdles, but when followed, they should yield improved behaviors.

Establish a consistent bedtime routine. This routine should start the same time every night, with consistent reminders that night time is approaching and that is the time for sleep.

Practice good habits on getting the child to sleep. This includes maintaining a routine as mentioned above and allowing the child to fall asleep on his or her own. If you usually stay in their room until they fall asleep, gradually remove your presence from their room.  Minimize your interaction with them should they continually get out of bed (put them back to bed with no talking). If you need help on this, simply watch almost any episode of Supernanny.

Keep the child in their own bed. Like with any child, allowing them to sleep with the parents just provides an attractive alternative to learning to fall back asleep on their own, thus encouraging them to repeat the behavior.

Remove as many stimuli as possible. No toys should be allowed in the bed (except for comforting items like stuffed animals), and there should be no TV or extraneous light in the room (again, other than a comforting night light if needed).

Work to gradually remove yourself from the room. Depending on how significant the sleep problems are, you may need to start with sitting in the child’s room, but over time (either that night or the next time) move closer to the door, then outside the door with the door open, and eventually outside the door with the door closed.

Be persistent. Correcting sleep behaviors can be very stressful, but any backwards step and set back weeks of effort.  This adjustment may have a negative effect on your family in the short term (such as waking up other children due to the noise) but will have an incredibly positive effect in the long run.

Again, should sleep issues be a major barrier in your child’s development or well-being, seek professional help.  It is my hope that our experiences will help you address occasional sleep issues in your autistic child, or at least serve as the starting point for discussions with such a professional.  Our child now sleeps through the night at least 95% of the time, and on the nights he doesn’t he typically just plays (if loudly) in his room with no intervention from us. If you have any tips that have helped your child sleep better, I’d be happy to learn of them in the comments.

Authors Note: As I post this early on a weekday morning, our son has been awake since at least 3:30, but playing contentedly in his room for over two hours.  This is the first night he has been up so early in over three weeks, and we have to at least take satisfaction that he has needed no intervention this morning to keep him in his room.

Sprout is a registered trademark of Children’s Network, LLC

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