Research demonstrates that sleep problems are common in children diagnosed with Autism Spectrum Disorder (ASD). These sleep problems often include difficulty in falling asleep, frequent night time awakenings and not falling asleep in their own bed. Sleep problems can have negative consequences for the child’s neurological development, learning and his or her daytime functioning as well as for the family as a whole. Several studies have shown positive outcomes for behavioral interventions aimed at improving a child’s sleep hygiene and reducing associated negative sleep behaviors. Below are five ways you can start improving your child’s sleep and helping everyone in the family get a good night’s rest.
Begin a Sleep Diary
· For two weeks, track when your child goes to bed, when they wake up, and the number of wake ups. This will help you begin to figure out the pattern of the problem
Create a Peaceful Sleep Environment
· Dim all the lights throughout the house and in the child’s bedroom at least 1-2 hours before the beginning of bedtime
· Bedtime should be the same every night
· The bedroom environment should be associated with sleep as much as possible
· A cool, quiet and dark environment is best
· Do not have computers nearby or bright screen lights or sounds
· Do not use the bedroom as a time-out location in order to avoid introducing a negative association with a place that should be associated with comfort and sleep
Create a Positive Bedtime Routine
· Present a visual schedule in the form of a checklist and/or picture board of a routine that starts at least 30-60 minutes before bedtime
· Activities to include: taking a bath, brushing teeth, changing into pajamas, reading and singing a song
· Using relaxation techniques can be useful in helping your child unwind and relax
· Include small variations in the routine each night so that it does not become a ritual that cannot be changed
· Provide positive reinforcement to help increase motivation and promote successful completion of the routine
· Watching TV or other screens (or at least decrease the intensity of the brightness of the screens)
· Engaging in other overly stimulating activities and discussing topics that can be distressing to you and/or your child (e.g., homework completion)
· Getting into the bed or rocking the child to sleep
Create a Regular Nap Schedule
· A regular nap schedule for children 3 and under helps improve night time sleep
· At least 3 hours should have elapsed between last nap and bedtime so that the child can be ready for his or her regular bedtime
Exercise and Diet
· Ensure your child gets plenty of exercise during the day
· In consultation with your prescribing physician, consider reducing medication use that impacts sleep (e.g., stimulants), especially before bedtime, or change the timing of when the medication is given
· Reduce foods and fluids that can negatively affect sleep (i.e., any food containing caffeine and sugar, such as chocolate, soda etc.)
The Child Study Center’s expert team of clinicians in the Autism Spectrum Disorder Clinical and Research Program are available to evaluate and treat sleep difficulties and other challenging behaviors. Our Child and Adolescent Sleep Program (CASP) can also provide further information regarding the evaluation and treatment of sleep behaviors and disorders.
References and Related Research
Goldman, R.E., Clemons, T. & Malow, B.A. (2012). Parental Sleep Concerns in Autism Spectrum Disorders: Variations from Childhood to Adolescence. Journal of Autism and Developmental Disorders, 42(4), 531-538.
Malow, B.A., Marzec, M.L., McGrew, S.G., Wang, L., Henderson, L.M. & Stone, W.L. (2006). Characterizing Sleep in Children with Autism Spectrum Disorders. SLEEP, 29(12), 1563-1571.Turner, K.S. & Johnson, C.R. (2012). Behavioral Interventions to Address Sleep Disturbances in Children with Autism Spectrum Disorders: A Review. Topics in Early Childhood Special Education, 33(3), 144-152.