Sleep Issues and Autism: How to get some rest.

Parents of newborns often commiserate about sleep deprivation, later looking back with fond memories of those early sleep-deprived days when their infants awoke frequently for feedings during the night.  But what if the sleepless nights were to continue year after year with no break in sight?  This is exactly the scenario for many families impacted by autism.  A study last year from noted Vanderbilt ASD and sleep disturbances researcher Suzanne Goldman, Ph.D., found that, “…sleep problems persist through adolescence in ASD with differences in types of problems experienced and emphasize the need for clinicians to address sleep behaviors not only in young children with ASD but throughout the age span.” [i] Clearly, many families impacted by autism do not have sleep deprivation in the rear view mirror no matter the age of the ASD child.

Sleep disorders can impact many areas of day-to-day functioning including behavior, school performance, nutrition, physical fitness and overall health status. Additionally, earlier research by Dr. Goldman and her team found that some symptoms often associated with autism—hyperactivity, obsessive and ritualistic behaviors- worsened when sleep disturbance was a factor. [ii]

What options do families have in facilitating improved sleep habits in their children with autism? Many are understandably reluctant to implement steady doses of pharmaceuticals and instead go in search of alternate routes to encourage healthy sleep patterns.  There is a growing body of evidence to support that establishing a melatonin protocol may be a safe and effective means by which to improve sleep quality and duration in individuals with autism.

Melatonin is a hormone secreted by the pineal gland in the brain. Its functions include helping to regulate other hormones, and maintaining the body’s circadian rhythm, an important factor in determining when people fall asleep and when they wake up. A new study published last month concluded that melatonin, “…was effective in week 1 of treatment, maintained effects over several months, was well tolerated and safe, and showed improvement in sleep, behavior, and parenting stress.” [iii] As an added benefit to often financially-strapped families, melatonin is inexpensive and readily available at retail outlets and online. As with any medicine or supplement, parents should check with their child’s physician before implementing a melatonin protocol.

There are also several strategies for successful sleep habits that families can employ. As with so many other aspects of life once autism has become a factor, consistency is key. Here are some tips that may prove beneficial to the entire family in getting a good night’s sleep:

  • Develop a bedtime routine. Whether it’s reading a story, having a bath, or listening to soft music, develop a schedule and stick to the same order of pre-bedtime activities each night.
  • Avoid high-energy activities. Turn off the TV, video games, and avoid any other stimulating activities before bedtime.
  • Set a certain time for bed every night and stick to it.  Being consistent with bedtime can help train the body to get ready for sleep.
  • Prevent sensory distractions. You might consider heavy, dark draperies or shades, and tend to any squeaky doors or any other noises that might cause night-time waking.
  • Remove potential temptations. Put away any toys or games in your child’s room that might prompt him to get out of bed.
  • Establish a set wake-up time. Consistency in wake-up time is just as important as consistency in bedtime in helping to set the body’s internal clock.

Establishing good sleep habits can take considerable effort but the potential rewards are substantial.  For more information on sleep disorders and how you can help your child with autism, subscribe to the Autism File. Real Challenges.  Real Solutions.

[i] Goldman, Suzanne, et al. Parental Sleep Concerns in Autism Spectrum Disorders: Variations from Childhood to Adolescence. Journal of Autism and Developmental Disorders. Department of Neurology-Sleep Disorders Program, Vanderbilt University Medical Center.  May, 2011.

[ii] Goldman, Suzanne, et al. Defining the sleep phenotype in children with autism. Developmental Neuropsychology. Sleep Disorders Division, Department of Neurology and Kennedy Center, Vanderbilt University School of Medicine. 2009 Sep;34 (5):560-73.

[iii] Marlow, Beth et al. Melatonin for Sleep in Children with Autism: A Controlled Trial Examining Dose, Tolerability, and Outcomes. Journal of Autism and Developmental Disorders. Sleep Disorders Division, Department of Neurology and Kennedy Center, Vanderbilt University School of Medicine. December, 2011.


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