Autism and Sleep

Understanding the links between autism and sleep ›

Tips for improving sleep for children with autism ›

Seeking help from a healthcare professional

Frequently asked questions ›

Seeking help from a healthcare professional if you have concerns about your autistic child’s sleep

Before seeking help from a healthcare professional there are some things you can do to help your child sleep better. These include creating a reassuring bedtime routine, encouraging and establishing good sleep habits and keeping a sleep nap diary.

Tips for improving sleep for children with autism →

If, despite having tried good sleep-wake habits, your child’s sleep problems haven’t improved enough, it is advisable to talk to your child’s doctor who may be able to help you or who may decide to refer you to another specialist professional. If you would like to understand more about the main measures of good quality sleep and why it is important to treat insomnia in autistic children read our frequently asked questions.

As a parent or carer you have an essential role to play in helping healthcare professionals understand your child’s sleep problems. Providing accurate information to the medical team about the problems, and their impact on your child and your family, will help the medical team to:
• Decide what course of action and/ or treatment to start
• Assess the effectiveness of the course of action and/ or treatment and adjust if necessary

Sometimes underlying conditions, such as anxiety, gastrointestinal (tummy) problems or pain, might be contributing to your child’s sleep problems and it might also be necessary to treat these conditions. It is important then that you tell your child’s doctor if you suspect another condition.

Preparing for the first consultation to discuss your child’s sleep problems1

Preparing for your first appointment to discuss your child’s sleep problems with a healthcare professional will help you receive support more quickly. Remember that the medical team are not there to judge you, but to support and help you and your child.

How do I prepare? Begin by capturing relevant information in the days leading up to the appointment. This information might include:

 

1. DESCRIBING YOUR CHILD’S SLEEPING ENVIRONMENT

  • Does your child sleep alone in a bed that they can or cannot get out of?
  • Does your child use a comforter e.g. a particular blanket or toy to sleep with?
  • Is the bedroom environment consistent i.e. the same space each night?
  • Have bedtime routines been put in place?

2. DESCRIBING THE SPECIFIC ISSUES OR CHALLENGES THAT AFFECT YOUR CHILD’S SLEEP

  • Does your child have difficulty falling asleep, experience nocturnal awakenings (with or without nightmares), have difficulty waking up?
  • Do your child’s sleep problems impact their general behaviour, learning ability or their autistic symptoms? If you remember particularly striking examples, write them down so as not to forget to mention them in the consultation.
  • Do your child’s sleep problems impact family life?

3. SHARING YOUR EXPERIENCE AND DIFFICULTIES

  • Have there been certain situations where you have noted that specific events have had a negative effect on your child’s sleep e.g. illness, or events that delayed bedtime or created anger? There may also have been events that positively impacted your child’s sleep which you should also note.
  • Have you tried different solutions to help improve your child’s sleep e.g. co-sleeping, introducing a reward system? Let the doctor know if other things have worked such as letting your child play a game in the evening or fall asleep in front of the television.

All details can be important. If you have the feeling that certain harmless events soothe or, on the contrary, aggravate your child’s sleep difficulties, say so. Be open and honest. If your doctor gives you information about setting up a particular bedtime routine or suggests specific behavioural techniques that you will find difficult to put in place, do speak up and let them know.

4. ASSESSING YOUR CHILDS SLEEP PROBLEMS

To understand the nature, and severity, of your child’s sleep problems, healthcare professionals generally recommend that parents/carers fill out a sleep diary. This can be done using a paper diary or an electronic tool such as SNappD®, which is a free, simple-to-use sleep and nap diary app that allows sleep statistics, and the impact of poor sleep to be recorded and if you wish, shared with a healthcare professional.

Treatment of sleep disorders in autistic children1

For some children, “the fix” may be as straightforward as establishing a routine, such as an order of activities at bedtime or changing the temperature or lighting  in a bedroom. Sticking with regular bed and wake times can put the brain and body on a schedule that makes sleep more reliable.

You might also want to read Tips for improving children’s sleep →

Your child’s healthcare professional may decide that medication could help but it is always best to try other strategies, such as good sleep-wake habits, first. If these strategies do not improve your child’s sleep sufficiently on their own, it is still advisable to continue with them if your child is prescribed medication.

Evaluation of response to treatment

To decide if a treatment, or an intervention, has been successful in improving your child’s sleep problems it is important to evaluate not only their sleep but also whether there have been improvements in your child during the day. For instance are they less tired, less irritable or more attentive? Finally, the evaluation involves assessing your satisfaction with your child’s sleep and your own sleep and well-being.

You can download and complete this questionnaire to determine if a treatment has been effective.

Evaluating your autistic child’s response to insomnia treatment →

REFERENCES:
  1. Lecture by Prof. Carmen M. Schröder: Sleep disorders in ASD and their behavioural management – ​​February 27, 2020.

UK/FLY/2023/2389 March 2023