Sleep Disorders and Autism Spectrum Disorder

Eileen Bailey Health Guide
  • "Sleep is very important for children and teens, not only for development, but also for behavior during the day. When children have autism spectrum disorder, sleep disturbances are a common problem." Allison Tsai, Health Central's Sleep Disorders Community


    Not getting a good night’s sleep can make anyone cranky and irritable. The lack of sleep can interfere with our ability to concentrate, learn and remember. We need sleep for a healthy immune system and for our bodies to properly grow. For children with an autism spectrum disorder (ASD), sleep can make daytime behavioral difficulties even worse. According to studies, anywhere from 40 to 80 percent of children with ASD have significant sleep disturbances.

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    Reasons for Sleep Disturbances in Children with ASD

    Some research suggests that children with ASD have below normal levels of melatonin, a substance naturally produced by the human body which regulates our wake/sleep cycle. Some children with ASD may have medical problems that interfere with sleep, for example, they may have allergies, reflux, sleep apnea or seizures.

    Sensory sensitivities may also interfere with sleep - they may not be able to sleep because sheets are too stiff or itchy, they may be sensitive to too much or too little light. Sounds, even normal house sounds, may keep them awake.

    Your child’s need for certain routines may also create problems at bedtime. If routines are not followed exactly or if a situation causes routines to be changed, your child may have a hard time falling asleep. For example, an emergency might arise where you can’t follow the bedtime routine of bath, story and then bed. In this case, your child may lie awake for hours.

    For some children with autism, getting back to sleep once they awake in the middle of the night is difficult. They associate certain routines with falling asleep and when those routines do not happen again, they can’t fall back asleep.

    Tips for Parents

    When your child can’t fall asleep or is awake for several hours during the night, it can interfere not only with their development and well-being, it can create problems for you and your other children. Everyone in the house can suffer from lack of sleep.

    The following are some tips to help your child, and everyone, get a good night’s sleep:

    Create a schedule for your child’s bedtime routine. You can use words or pictures to depict the order of the routine so your child can follow along and knows what to expect and when it is time to get into bed for the night. You can also create a routine for what your child should do if he or she awakes during the night. Once you establish a bedtime routine, stick to it.

    Create a sleep-friendly routine for the time leading up to bedtime. For example, plan activities such as reading or other quiet activities that will help him wind down rather than wind up. Begin turning off some lights and eliminating noise an hour or two before bedtime to start signaling that it is time to go to bed.

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    Create a different area for play. If your child uses his room for active play, he may have a hard time associating the same area with quiet time and sleep. If you don’t have room in your home to create a separate play area, you can try to divide the bedroom into an area to play and an area to sleep.

    Make sure your child is getting physical exercise during the day hours. Vigorous exercise during the daytime can help promote sleep. Make sure the exercise occurs at least 2 to 3 hours before bedtime.

    Eliminate or reduce caffeine from your child’s diet. Besides coffee and tea, sodas and chocolate contain caffeine. Limiting caffeine may help your child sleep better.

    If you have tried many of these suggestions and nothing seems to work, talk with your pediatrician about what other options are available. The FDA hasn’t approved any sleep-aid medications for children, however, melatonin supplements have been found to be effective in some studies. Before using a supplement, talk with your doctor about whether it will interfere with other medications your child is taking and about the proper dosage. You can also talk with your child’s behavioral specialist about creating a calming environment and routine for before bedtime. You can also ask for a referral to a childhood sleep specialist who may provide you with additional ideas.

    For more information on sleep disorders:

    Health Central’s Sleep Community

    Understanding Insomnia

    Quiz: How Much Do You Know About Sleep Disorders?


    “Characterizing Sleep Disorders in Autism Spectrum Disorder,” Date Unknown, Ruth O’Hara, Ph.D, Simons Foundation Autism Research Initiative

    “Melatonin Shows Promise for Improving Sleep Problems in Children with Autism,” 2008, Feb. 12, Michele Solis,

    “Promoting Sleep in Children with Autism Spectrum Disorders,” Date Unknown, Beth A. Malow M.D., M.S., Vanderbilt Sleep Disorders Center

    “Sleep Disorders-Beth Malow, M.D., M.S.” Date Unknown, Beth Malow,

    “Sleep Problems in Children with Autism Spectrum Disorders, Developmental Delays and Typical Development: A Population-Based Study,” 2012, P. Krakowski et al, Journal of Sleep Research

Published On: May 01, 2013