Sleep Challenges & Autism

Carers and autistic people/people with autism often talk about the difficulties they experience with sleep; whether that be in terms of not getting enough sleep, finding it hard to fall asleep or finding it hard to stay asleep [1] [2]. We have worked with many carers and autistic people who talk about the emotional and financial burden of lack of sleep [3] [4].  This page is all about giving you a bit of peace of mind, to reassure you that you are not alone, and to offer some helpful strategies.  To ensure that you are armed with all the information, we have included research to support some of the stuff that we talk about, which can be found at the end of this page.  So, read on for detailed information about why sleep difficulties are so common in the autistic community and some strategies to help.
Or, if you are short of time (or sleep!) and need some easy reading, take a look at our handy poster or leaflet.

WHY Are Sleep Challenges Common in Autism?

It is still unclear why autistic people/people with autism struggle with sleep. There are argued to be three underlying factors that may relate to these sleep challenges: [5]
1) Some researchers talk about the impact of our hormones (e.g., melatonin) and our brains, which have an impact on when our body feels like it should/needs sleep.
2) Other research suggests the impact of psychological factors, such as anxiety or impulsivity (for example, if also diagnosed as ADHD).
3) Sleep may also be impacted by social factors, as difficult sleep has been associated with behavioural difficulties and poorer family functioning.
However, it is important to remember that lack of sleep can also cause some of these challenges. In essence, sleep and autism is a complex one, but what do we do if we/our family are struggling with a lack of sleep?

What Has Been Shown to Help?

The impact of sleep on the autistic community has been heavily talked about- in terms of how a lack of sleep impacts carers and autistic peoples day-to-day functioning, and ability to work [4] [6] [7]. Carers have also talked about how lack of sleep can exasperate sensory challenges and increase risky behaviours [8].

In Northamptonshire, Sleep Right  offer sleep support for families of children with special educational needs and/or disabilities aged 2-18.  They will talk you through the available options including a 1:1, 6 week parent support programme and/or potential medical treatments (such as Melatonin). For information on this referral pathway, click here.

However, by the point of referral many families are already severely sleep deprived, and therefore requiring more immediate support.

What can we do in the meantime?  

We reached out to autistic carers asking for their tips on ensuring the best night's sleep.

All of the carers that we spoke to mention the importance of creating a sleep environment that helped with getting to sleep or maintaining sleep.

There are several techniques that carers used for this:
• One tip for this was to create white noise [8] to drown out external noise by using fans or binaural beats to prevent outside disturbance (particularly if the person is very sensitive to noise).
• As well as this, blackout curtains were reported to be useful as a way of preventing early waking due to external light [9].
• Use of certain smells, such as in lavender oil [10], could also be used as aromatherapy to aid in sleep.
• Finally, decompression/weighted blankets [11] were mentioned by many carers as they helped with sensory difficulties – however, it is important to check the suited weight requirement for the user to ensure safety. You can find some information about this weight here.

Carers also talked about the need for good pre-sleep practices:
• Carers emphasised the importance of developing a regular sleep routine structured around your own needs [12]. For example, you can adapt our visual sleep schedule to what works for you. Remember, dependent on the age of the autistic person, it’s helpful to create this schedule together, easing anxiety around sleep and giving them a sense of ownership/control[13].  
• Other carers also talked about stimulating activities before bedtime to become mentally or physically tired, although it was mentioned that avoidance of blue light (such as tablets or phones) was best. Some useful fine motor skill tasks are suggested here.

Use of sleep conducive foods and medicine was also mentioned:
• Carers, Sleep Right and the research talked about the importance of eating ‘sleepy foods’ before bedtime [14].
Here are a list of some useful foods, and some fun recipes!
• Being prescribed melatonin [15] or certain supplements [16, 17] was also mentioned as beneficial.
However, it is important that the use of prescriptions/change in the autistic person's diet is done in consultation with Sleep Right and/or a medically trained professional.

Autistic people also talked about the benefit of pets, distraction (e.g., reading, not placing too much focus on getting to sleep) and co-sleeping [13].  
However, remember what works for one person, will not work with another! This is just about arming you with the tools to make your own decisions as a family/autistic individual.

For more information on Melatonin, click here.

For more information on Behavioural Support, please click here.