Sleep in Children with Autism

Sleep in children with autism is often disturbed and affects them and their families. Find out why it happens and what to do about it.
Sleep in Children with Autism
Elena Sanz Martín

Reviewed and approved by the psychologist Elena Sanz Martín.

Last update: 27 December, 2022

Raising a child with autism is a challenge. Understanding their social and communication difficulties, inflexibility, and behavior patterns and helping them manage them is almost a full-time job. Therefore, being rested and in a good frame of mind is essential for families to cope with the day-to-day. However, this is greatly hindered by the common sleep problems in children with autism.

Poor rest affects and aggravates the symptoms of autism and adds a number of additional complications. For this reason, we’ll now address the causes of sleep problems and suggest some solutions.

Sleep problems in children with autism

Sleep problems are common in children with autism spectrum disorder (ASD). In fact, it’s estimated that 70-80% of infants with this diagnosis don’t sleep well. In some cases, the difficulties improve over the years, but in others, they remain or worsen even into adulthood.

The reasons for poor sleep can vary widely:

  • Resistance to bedtime: Many children with ASD refuse to go to bed at bedtime and may react with anger, rage, and frustration when parents put them to bed.
  • Increased sleep latency: That is, they may take a long time to fall asleep.
  • Frequent awakenings: These are of a longer duration than in the case of neurotypical children. In general, children with ASD tend to seek the presence and attention of their parents, which also affects the rest of their caretakers.
  • Less restful sleep: In this case, we’re not only talking about a fragmented sleep pattern but also about the fact that these children spend less time in the REM phase (which is essential for the body’s nocturnal recovery).
A child resting his head on his desk during class.
Children with autism may be tired and cranky during the day due to sleep disturbances.

How does poor rest affect daily performance?

Lack of rest can cause poor work performance in parents, higher rates of absenteeism, and health and mood problems (such as irritability, anxiety, and exhaustion). Even siblings can be affected by the nighttime dynamics of children with ASD and suffer repercussions in their personal and school activities.

But, first and foremost, it’s the children with ASD themselves who suffer from being tired and cranky. This increases their challenges in terms of socialization and learning. In addition, studies have shown that, in the long term, poor sleep can lead to somatic complaints and the development of ADHD symptoms.

Why is sleep disturbed in children with autism?

There’s no single reason for sleep disturbances in children with ASD. In fact, there may be a confluence of several factors, some of which are modifiable and others not. These are some of the main ones:

  • Genetic alterations or mutations that affect some point of the wake-sleep cycle, especially the natural production of melatonin.
  • Sensory processing problems. Ambient light, background noise, the unpleasant feeling of pajamas or bedding can make it difficult for these children to relax and fall asleep.
  • Anxious behaviors or anxiety disorders. These characteristics generate a permanent restlessness that prevents children with autism from falling asleep. In turn, it leads to a vicious circle that’s difficult to break.
  • Bad habits, lack of routine, and neglect of sleep hygiene. All these can also aggravate the difficulties. Therefore, it’s important to have an orderly sleep schedule and tend to certain aspects prior to going to sleep.

Keys to dealing with sleep problems in children with autism

If your child has autism and has difficulty resting, it’s very important that you go to a professional who can perform an individualized study and suggest adjusted guidelines. In any case, here are some of the measures that can be taken to promote sleep in your child.

Take care of the environment at bedtime

Make sure the bedroom is dark and quiet and that the textiles are pleasant for the child. If there’s a fear of the dark, it’s possible to turn on a dim, indirect light. Also, make sure that the room temperature is between 65 and 70 degrees Fahrenheit.

Establish a proper bedtime routine

A girl taking notes during a video call.
It’s important to avoid the use of screens before bedtime. Ideally, your child should do relaxing activities such as taking a bath and reading or listening to a story.

During the hours prior to sleep, screens and stimulating games shouldn’t be used. Instead, these hours should be devoted to quiet and relaxing activities. It’s possible to bathe your child before bedtime and read a story or sing a soft song to help them relax.

Take care of your child’s sleep hygiene

To do this, avoid stimulating foods or medications before bedtime, make sure they don’t exercise or nap in the late afternoon, and, above all, keep regular bedtime and wake-up times.

Use visual schedules

You can use certain tools to establish and reward proper sleep habits. Visual schedules help the child understand a sequence of actions to be performed, such as brushing teeth, going to bed, reading a story, and going to sleep.

Behavior modification charts based on reinforcement help motivate and consolidate achievements. You can use them to reward nights of adequate sleep.

Sometimes the use of melatonin may be indicated to promote sleep in children, although it’s best to consult a doctor about this.

Consult with a specialist about the steps to follow

In short, it’s very common for children with autism spectrum disorder to have difficulty sleeping. For this reason, the best measure is always to consult with a specialist, as they’ll be able to indicate or modify the appropriate medication and propose action guidelines to help improve the rest of the entire family.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Mazurek, M. O., Dovgan, K., Neumeyer, A. M., & Malow, B. A. (2019). Course and predictors of sleep and co-occurring problems in children with autism spectrum disorder. Journal of Autism and Developmental Disorders49(5), 2101-2115.
  • Reynolds, A. M., Soke, G. N., Sabourin, K. R., Hepburn, S., Katz, T., Wiggins, L. D., … & Levy, S. E. (2019). Sleep problems in 2-to 5-year-olds with autism spectrum disorder and other developmental delays. Pediatrics143(3).
  • Wang, L., Li, J., Ruan, Y., Lu, T., Liu, C., Jia, M., … & Zhang, D. (2013). Sequencing ASMT identifies rare mutations in Chinese Han patients with autism. PloS one8(1), e53727.

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.