Improving sleep for children with autism spectrum disorder

Many children with autism have trouble sleeping, whether it is not being able to fall asleep, waking up many times during the night, rising early, or simply feeling less need to sleep.

Children who are not well-rested have difficulty sustaining attention and participating in intervention. They may have greater behavioural difficulties, including increased tantrums.

Here are some ways to help your child sleep:

• Set and honour a consistent daily bedtime and wake-up schedule, including weekends. If your child has trouble falling asleep or gets a “second wind,” try delaying bedtime for 30 minutes or so.
• A dark sleep environment with blackout curtains supports sleep by enabling melatonin production. Night lights are fine if needed.
• Room temperature and bedding impact sleep. They can be adjusted to your child’s sensory comfort.
• Remove electronics — television, tablets, smartphones, gaming consoles — and other highly preferred items from your child’s room.
• For some children with autism, visual schedules with pictures, words, or both can help. Visual schedules help your child learn a bedtime routine and develop consistency.
• Offer your child calming activities starting two hours before bed. Consider reading a book together, having a light snack, taking a bath, a massage, listening to music, and some cuddle time. Avoid new or stimulating activities or engaging with electronics.
• Melatonin before bed helps regulate their sleep-wake schedule.
• Consider other changes during the day. Children who exercise regularly may doze off more easily at night and sleep better. Avoid caffeine for at least three hours before bedtime. (This includes soda, chocolate, and tea or coffee.) Noise, however subtle, can be more pronounced and affecting for children with autism.
• If these strategies don’t help improve your child’s sleep quality, consult with your paediatrician, behaviour consultant, or psychologist to explore other options.

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