Written by Jill Zwarensteyn, Editor
Autism happens on a spectrum, and depending on where your child falls on that spectrum, they may experience certain difficulties in daily life. Unfortunately, some of those challenges extend into nighttime hours and can make it difficult for autistic children to fall and stay asleep.
As challenging as it can be for autistic children to get enough sleep, it’s also imperative that they do, since getting adequate sleep can help them function better in their daily lives. Additionally, this can help the child’s caregivers get better rest as well. In this article, we’ll share our tips on how to get an autistic child to sleep.
What Is Autism?
Autism spectrum disorder (or ASD) is a neurological and developmental disorder1. On the surface, it affects how people interact with others, including how they communicate, learn, and behave. Internally, it can affect how people process emotions and how sensitive they are to external sounds or sensations.
Autism is considered a developmental disorder because symptoms typically don’t appear until after two years old.1
If your child is over the age of two, though, and exhibits some of the following symptoms, they may fall somewhere on the autism spectrum:
- Difficulty communicating and interacting with people
- Restricted interests
- Repetitive behaviors
- Little or inconsistent eye contact
- Appearing not to listen or look at people who are speaking
- Not responding to their name
- Infrequently sharing their feelings, interests,
- Difficulty with back-and-forth conversations
- Displaying facial expressions or movements that don’t match what’s being said
- Having trouble understanding another person’s point of view
- Difficulty adjusting behaviors to social situations
- Difficulty in making friends
- Having a remarkable memory
- Strong visual or auditory learners
- Excelling in math, science, music, or art
While ASD can be diagnosed by the age of two, many children do not receive a final diagnosis until they’re older2.
If you think your child might be on the autism spectrum, talk to your doctor. There are several steps to formally diagnosing a child, including developmental monitoring, developmental screening, and developmental diagnosis.2
An early diagnosis3 can help equip you and your child with the tools they need to be happy and healthy.
Sleep and Autism
Sleep problems are more than twice as likely4 to occur in children with autism than those without, and evidence shows that the less sleep a child with autism gets, the more severe5 their symptoms can become. For example, they can show more severe, repetitive behaviors and be more hyperactive and distracted.
Unfortunately, some of the behaviors exhibited by autistic kids are the very things that prevent them from getting to bed. These behaviors6 can include:
- Hyperactivity
- Compulsions
- Inattention
- Obsessive rituals
- Physical aggressiveness
It isn’t just outward behaviors that can make sleep more complicated for autistic kids. Many people on the autism spectrum can have coinciding conditions, including gastrointestinal issues, ADHD, anxiety, or depression, all of which can also add to sleep issues.5
Some studies point to a deficiency or dysregulation of the “sleep hormone,” melatonin, in people with autism7. Others even suggest certain genetic mutations8 that are more common in children with autism directly impact sleep.
Finally, children with autism also tend to be more sensitive9 to things like sound, touch, and light, which can also make sleep difficult.
Learn More: Sleep and Autism
Tips to Get Autistic Kids to Sleep
Regular Bedtime Routine
An established bedtime routine is helpful for anyone. A routine helps signal the body that it’s time for bed, and it can be soothing for someone who’s trying to make sense of all the stimuli around them.
The important thing to remember with this tip is to have a set ritual that’s in a specific order. You can make a chart with pictures for your child to follow or create a checklist, so they feel a sense of accomplishment at the end of the day.
Be sure to stick to the routine, as children with autism have been shown to respond well to consistent routines10. Conversely, deviating from a routine may cause an autistic child anxiety or bedtime tantrums.
Eliminate Screen Time
There are two key reasons to eliminate screen time at night:
- The blue light from the screen disrupts the production of melatonin. This hormone is necessary for sleep, and as mentioned, there is some evidence that autistic people are already low in this hormone.7
- Exposure to a screen, whether it’s watching a video or playing a game, will keep their mind active and occupied when instead, it should be winding down for bed.
Make sure they have put away all screens at least one hour before bedtime. If an hour isn’t possible, 30 minutes is okay too.
Find Out More: The Link Between TV and Children’s Sleep Habits and Best Blue Light Blocking Glasses
Avoid Rowdy Play
Again, as bedtime approaches, an autistic child should be winding down, not getting riled up. Even though it may be fun and playful, ticking, wrestling, roughhousing, or any activities that get the heart rate up should be avoided for at least one hour11 before bedtime. Playful activities are still highly recommended, but for daytime only.
Instead of rowdy play, plan other activities that are quiet and peaceful. Perhaps coloring, cuddling the pet, or reading a bedtime story together can help prepare your little one for bed.
Quiet Activities
Planned quiet time should be part of the nightly ritual. This might include reading before bed, though we recommend avoiding any scary or stressful bedtime stories.
Some autistic children can get anxious12 with information or sensory overload, so be sure to keep this in mind when finding a relaxing, quiet activity. It may take some trial and error to see what works best for your child.
Bath or Shower
Baths and showers can be soothing for some children. Plus, quickly raising and then lowering the core body temperature can help induce drowsiness13.
That said, some children with autism and sensory issues do not enjoy bathing and this could be upsetting enough to delay sleep.12 For these kids, bathing or showering earlier in the day may be preferable.
Read more about showering before bed here.
Pressure Touch
Deep-pressure touch has been shown to help relax and calm14 children on the autism spectrum. You can do this15 by hugging, squeezing, or massaging your child, or for those who don’t like touch, let them wear something weighted like a weighted blanket or vest. You can also try placing a weighted beanbag or heating bag on their chest.
Pressure touch works by balancing a person’s proprioceptive sense, which means to know where they are in space.15
Soft Musical Background
Play some gentle, relaxing music in the background while your child is winding down for the night. Experts recommend16 something that has a predictable rhythm and preferably a tune that’s instrumental rather than someone singing. Both YouTube and Spotify have collections of calming music specifically for children with autism.
Try a Light Snack
It’s advised that you don’t give your child a heavy meal or large snack late at night. However, going to bed hungry can make sleep more difficult and lead to overeating and behavioral issues the next day.
If your child needs a late-night snack, a light snack made up of complex carbohydrates17, like oatmeal or whole wheat toast, can help your child fall asleep more easily since these serotonin levels.
Creating a Relaxing Sleep Environment
Everyone needs a relaxing sleep environment at night, but children who are very sensitive to their environment will especially need this. You should surround them with the things they love. A soft blanket, a favorite stuffed animal, and a glowing nightlight can all help an autistic child fall asleep and stay in bed all night.
Comfortable Bedding
As many as 90 percent18 of autistic people are sensitive to sounds, sights, tastes, smells, or touch. If your child is sensitive to touch, you’ll want to make sure their bedsheets, covers, and pillows are soft, cool, and clean. Look for sheets that are made of natural fabric, like cotton, eucalyptus, or bamboo.
Your child’s pillow should also be carefully considered, and it should be comfortable for their sleep position. For example, a child who’s a stomach sleeper should have a flat pillow, whereas back and side sleepers need a bit more support to remain comfortable. We typically recommend medium-loft pillows for back sleepers and higher-loft pillows for side sleepers.
Read More: Our list of Best Pillows for Back Sleepers and Best Pillows for Side Sleepers
Weighted Blanket
A weighted blanket is a good way to apply deep pressure, just like a hug or massage. In fact, a 2021 study19 found that weighted blankets improved morning mood and significantly decreased the time it took for autistic children to fall asleep.
When you’re shopping for a weighted blanket for your child, be sure to look for options with non-toxic filling and ones that can be washed. You’ll also want to factor in the right weight for your child. Typically, the formula is 10 percent of their body weight.
Night Lights
It’s not unusual for children to be afraid of the dark, and a nightlight could help, especially for children on the spectrum. We suggest finding one that is dim and emits a red or orange color. A light that’s too bright, or blue or white in tone, may keep your child awake.
See Our Guide: Best Night Lights for Toddlers
White Noise
Since so many people with autism are sensitive to sounds, any little noise at night might be enough to keep your child awake.18
A white noise machine can block out these distracting noises by combining all the sound frequencies into a soothing hum. There are also white noise machines available that have relaxing nature soundscapes, calming music, or guided meditations.
Comfortable Mattress
Take a look at your child’s existing mattress and check for wear and tear, sagging, and odors. If your child’s mattress is uncomfortable, it will certainly affect their ability to get a peaceful night of rest.
More: Best Kids Mattress
Bedtime Clothing
Scratchy and tight clothing can be a major trigger for people with sensory issues.12 Make sure your child’s pajamas are not too tight or too warm, and preferably, they should be made from something soft and breathable like cotton or bamboo. You may also want to get clothing that doesn’t have noticeable seams, has no bows or tags, or if they do, remove the tags from the clothing yourself.
Also, notice if your child seems to be removing their pajamas during the night; this is a good indicator that their bedtime clothing is too warm.
Frequently Asked Questions
How can I get my autistic child to sleep in their own bed?
An autistic child often wants to be near their parent(s) or guardian(s), and that can include at night while sleeping. Unfortunately, this may set into motion a pattern that can be hard to break. Plus, it negatively impacts the caregivers’ sleep as well.
Instead, we recommend the following tips:
- Institute a reward system. You may need to incentivize your little one to resist the urge to crawl into bed with you. Let them know that if they express their independence by sleeping in their own bed, they’ll get a reward in return. Reward systems are used often with autistic children, both by parents and educators. Children with autism seem to feel less rewarded by social things20, so you might implement some sort of token reward system21 that culminates in a new gift or experience.
- Provide a safety net. This tip is closely linked to the reward system. Sometimes an autistic child will need a parent or guardian close by. You can give your child a number of “free passes” that they can use when they really need to be close. Once the free passes are up, though, be sure to enforce the boundary. Autistic children need boundaries22, even if they might have trouble understanding them.
- The vanishing chair. Instead of your child coming into your bed to fall asleep, have them lie in their bed but place a chair right next to them23. Sit with them until they fall asleep or until they feel comfortable with you leaving (this time should be no more than 20 minutes). Every night, gradually move the chair further away until you are at the door. The final step is to not be in the room at all but to promise to check in after a set amount of time.
Are there sleep medications for children?
Yes, there are prescription medications. However, parents may instead opt for a more natural route like magnesium or melatonin. If you are interested in sleep medication or supplements, you should speak with a trusted pediatrician before giving your child any.
Is melatonin recommended for kids with autism?
Melatonin is a hormone produced in the body that helps to regulate the sleep-wake cycle, and many people take melatonin supplements to help improve their sleeping habits.
For people with autism, though, supplementing with melatonin may have benefits beyond sleep. Research is still ongoing, but preliminary studies suggest there is a correlation between a lack of melatonin and autism symptoms24. This could mean that supplementing with melatonin may help some of the day-to-day symptoms of autism, in addition to helping autistic kids get to sleep.
There have been many more studies looking specifically at melatonin for sleep in autistic children. One double-blind study25 involving 125 children with autism investigated the use of a slow-release formulation. The kids assigned to the melatonin supplement group slept nearly an hour longer and fell asleep 40 minutes faster than the placebo group.
If you’re wondering if melatonin may be right for your child, speak to your pediatrician.
Conclusion
Getting a child to fall asleep, regardless of whether they’re autistic or not, is a nightly challenge that could last for years. While most children respond well to behavioral training and modifications, this isn’t always the case for a child who is on the autism spectrum.
We hope that this list of tips provides you and your child with some guidance, and ultimately, a better night’s sleep for everyone. Feel free to use one or several of these tips in combination, and if you have specific questions or concerns about your child, be sure to talk to your pediatrician.
Jill Zwarensteyn
Editor
About Author
Jill Zwarensteyn is the Editor for Sleep Advisor and a Certified Sleep Science Coach. She is enthusiastic about providing helpful and engaging information on all things sleep and wellness.
Combination Sleeper
References:
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- “Screening and Diagnosis of Autism Spectrum Disorder”. Centers for Disease Control and Prevention. Last modified March 31, 2022.
- Jullien, Sophie. “Screening for autistic spectrum disorder in early childhood”. BMC Pediatrics. 2021.
- Reynolds MD, Anne M., et al. “Sleep Problems in 2- to 5-Year-Olds With Autism Spectrum Disorder and Other Developmental Delays”. American Academy of Pediatrics. 2019.
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- Maruani, Anna., et al. “Morning Plasma Melatonin Differences in Autism: Beyond the Impact of Pineal Gland Volume”. Frontiers in Psychiatry. 2019.
- Wright, Jessica. “Sleep struggles in autistic people may have genetic basis”. Spectrum News. 2019.
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- Harding, Edward C., Franks, Nicholas P., Wisden, William. “The Temperature Dependence of Sleep”. Frontiers in Neuroscience. 2019.
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- Aylward, Luke. “How and when to use deep pressure”. Bristol Autism Support. Webpage accessed June 28, 2023.
- Herbers, Kelsey. “Autism study tracks musical rhythm as possible treatment”. VUMC Reporter. 2019.
- “Better Sleep: 3 Simple Diet Tweaks”. Johns Hopkins Medicine. Webpage accessed June 28, 2023.
- Zeliadt, Nicholette. “Sensory sensitivity may share genetic roots with autism”. Spectrum News. 2018.
- Gee, Bryan M., et al. “Weighted Blankets and Sleep Quality in Children with Autism Spectrum Disorders: A Single-Subject Design”. National Library of Medicine. National Library of Medicine. 2020.
- Deweerdt, Sarah. “Reward-system differences may underlie multiple autism features”. Spectrum News. 2018.
- Liu, Michelle. “What is a Token Economy System?”. Pacific Autism Center for Education. 2022.
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- “Disappearing Chair Technique”. National Health Service. Last modified November 2021.
- Wu, Zhou-yue., et al. “Autism spectrum disorder (ASD): Disturbance of the melatonin system and its implications”. ScienceDirect. 2020.
- Gringras, Paul., et al. “Efficacy and Safety of Pediatric Prolonged-Release Melatonin for Insomnia in Children With Autism Spectrum Disorder”. Journal of the American Academy of Child & Adolescent Psychiatry. 2017.