Sleep is an area I have really struggled with. Any new parent learns very quickly why sleep deprivation is used as a form of torture. I remember silently screaming – help my autistic child won’t sleep many times.
Autism and sleep presents its own challenges. There are children and adults who sleep well and those who don’t. If your child is one who struggles with sleep then I feel your pain. Unfortunately there are no magic answers to getting your child to sleep. Having said that consistency and routine will help enormously along with lots of patience too.
My eldest son has autism and this may explain some of the sleep issues we have had. Sleep problems are common in young children with autism but they are also common in all young children (just in varying degrees of intensity).
Sleep is an essential part of our lives. You need deep sleep as this is when your body renews itself (tissue repair, hormone production, growth) and energy is restored. There are three main stages of sleep:
- Stage one is usually brief (maybe 5-10 minutes) when you are drowsy with your eyes closed. At this point it is easy to wake you up, useful to remember with toddlers who fall asleep late afternoon (known by parents as an illegal nap).
- Stage two is light sleep. Your body begins to get ready for deep sleep, the heart rate slows down and the body temperature begins to drop.
- Stage three is deep sleep. It is hard to wake someone up in a deep sleep. Particularly in the 1st hour, if you are woken up during this stage you may initially feel disorientated. As you enter a deep sleep this is the stage people can experience sleepwalking, talking in your sleep, bedwetting and night terrors. These behaviours tend to happen as you move from non-REM to REM sleep.
REM (rapid eye movement) sleep is sometimes referred to as dream sleep- this is when the brain is busy and your muscles switch off, it is at this point most of your learning takes place.
This full sleep cycle usually lasts between 90-120 minutes, it is then normally repeated several times through the night. The length of these cycles throughout the night or day are different for infants, toddlers, children and adults hence the different recommended hours of sleep.
Sleep problems and Autism
It is very common for people with autism to have sleep issues. Our biggest issue with my son was / is a difficulty falling asleep.
Melatonin is a hormone that is released by the brain to control your daily sleep and wake cycle. It is thought that patterns of melatonin secretion may be irregular in children on the autistic spectrum and it can be produced at the wrong time of day.
Some common sleep issues related to autism:
- Difficulty falling asleep – my son would often lie in bed for several hours (at about 2 years old he would do this for about 3 hours) before he would actually fall asleep.
- Waking in the night – we had a long period of time during which my son would wake at about 2am and then not go back to sleep until 5am.
- Irregular sleep patterns
- Shorter sleep in total – My son can manage on 5 hours a night easily (thankfully this has got better and he can now sleep for 8 hrs regularly). I really struggle with less than 6.5.
- Sleeping at the wrong time of day– my son would often have lots of energy at bedtime and want to be running around, but would be exhausted mid-afternoon.
Sleep deprivation and autism
Everyone will want to give you advice on how to get your kids to sleep. For some people controlled crying works but for others it is hell. It is very hard to be objective and consistent when you are sleep deprived yourself. at 21 months old my son had slept through (and by this I mean 10pm-5am) four times. Most nights he was up several times or for long periods in the middle of the night.
Sleep when the baby / child sleeps is very good advice (not that I ever took it the first time round!). Then when I had my second child they never slept at the same time! Having sleep deprivation will affect you- your ability to be a good parent, friend or partner. Try to remember this, at least recognise you are exhausted and you can then at least explain your snappiness / forgetfulness etc.
For most people it will get better, consistency and routine really helped my son. He was around 3 years old when he started to sleep through consistently, he has good weeks and bad weeks but so do I. Frustratingly when the kids are asleep I spend my time watching TV rather than sleeping as it is my only chance to watch something other than Paw Patrol and Peppa Pig.
Helping your little ones wind down
There are lots of sleep techniques / aids that people use for example some people with autism may find using a smell such as lavender useful as it can be associated with sleep- lots of common baby bubble bath products have lavender in. Some children with autism may also find a weighted blanket useful. My son prefers not to use the duvet and has a light blanket instead.
I got a cheap fibre optic lamp, it is a great sensory item for the kids, it changes colour and is very soft to touch. Great for getting them to calm down just before bed.
There is lots of evidence that the blue light emitted from televisions, tablets and phones will affect your ability to fall asleep. Most advise not using these items for an hour before going to bed.
Ask for help
If you are struggling with sleep ask for help. Health visitors and other professionals can refer you to sleep specialists who may be able to help. You can ask family and friends to watch your kids while you sleep, I wish I had done this more.
I was advised to do a sleep diary to look at naps. Are they in a routine of sleeping for long periods in the day? How long are they up in the night? What time have you started the bedtime routine and What time did they go to sleep? This was helpful for me to see if there was triggers that made going to sleep worse (e.g. TV just before bed / daddy coming in and getting the baby all excited just as they were falling asleep). It also helped me to see what was the best time of day for naps for my son (not that I have much control over this).
I have found both my children different. My second child has generally slept well or at least consistently (except when teething or ill) whilst my eldest had terrible sleep for the first 3 years, made worse by a lack of predictability.
Our Sleep Routine
The only two things that have made a big difference for us is time and consistency. As my son gets older sleep has become better. Consistency and patience have been worth it, my son with autism is comfortable with a routine as he knows and understands what is expected. Although it did take a long time to get him into the routine. I had many nights sitting at the edge of his bed for hours just getting him to stay in bed as every two seconds he would want to jump out of bed to play.
I use the above visual aid for our bedtime routine, previously I had a similar visual but it was photos of my son, this was easier for him to understand at first.
Our current bedtime routine:
We watch Cbeebies bedtime hour, it is on from 6-7pm but we usually start about 6.20 and catch In the Night Garden followed by the bedtime story. It is part of our routine and helps them to wind down. At 7pm Cbeebies plays its goodnight song and then switches off and the kids know that means bedtime and are happy to come upstairs.
Then it is bath time, followed by brushing teeth and getting in their PJs.
Next is milk, for a while we also had a small snack (oat bar) which works well if kids wake up hungry in the night or haven’t eaten their dinner.
Then it is time for a bedtime story we have two books then it is time to get into bed.
The key is sticking to the rules. Keep the routine the same, and remember it takes a long time for some kids to catch onto the routine but you will get there eventually.
Things will change and you will need to adapt the routine accordingly. For about a month my son decided he had to go to sleep in his chair rather than his bed. After some stressful nights I let it go, we started to let him go to sleep in the chair then we moved him to the bed once he was asleep, he got over it and is now back to the bed.
Good luck and happy sleep to all.