Here’s the good news: once your household is better at getting a child with autism to sleep, the entire family simultaneously learns how to establish healthy sleep habits. This is almost an imperative skill set in an era where both children and adults are chronically sleep-deprived. A healthy circadian rhythm, which includes regular wake/sleep times, exercise, and a balanced diet, benefits everyone in the family.
We understand what a crisis it is when a child struggles to go to sleep or stay asleep because the parent(s) and siblings bear the brunt. As sleep-deprived children with ASD are more prone to meltdowns, so are their parents and guardians. Stop that cycle by focusing on these eight tips for establishing healthy sleep habits.
Children with ASD are often very touch-sensitive, which means they’re particular about their pajamas, pillows, sheets, blankets, etc. Do all you can to create a safe and comfortable sleep environment. As they get older, enlist their help in “designing and testing” (within reason, of course!), their ideal “cozy zone.” While PJs and other textiles should honor their preferences, the bedroom should also be:
Feeling safe and comfortable is the foundation of getting a good night’s sleep. It also makes your child more likely to fall back to sleep without needing your assistance in the middle of the night.
This is a key component of any sleep routine, whether or not an individual has ASD. Keeping consistent sleep and wake times programs that circadian rhythm and is something your child can anchor into (see #6 below).
Because children with autism crave routine more deeply than their non-ASD counterparts, it could be that your bedtime routine must be phased into a different version that gets you out of the room sooner. Again, give your child lots of warning about how a change is coming and begin planning it.
Create a schedule together and use a timer that gradually phases you from the bed after reading time, to a chair in the room as s/he settles into bed, and then out of the room. This may take up to a couple of weeks or more, but the phase-out “phase” can be instrumental in creating an independent sleeper.
Other things that assist this step include:
Caffeine can last for as long as 12 hours in a sensitive child’s system. For this reason, we recommend completely avoiding caffeine altogether. Even “decaf” products are often slightly caffeinated so use herbal teas and non-caffeinated drinks.
We’ve learned so much about the role of diet and nutrition when it comes to healthy behavioral support for those with ASD. Make sure your child is eating as healthy as possible, and time dinner so that there is at least an hour or two (three is even better) between the end of dinner and sleep time. Eating right before bed can make it harder for children to fall asleep and is more likely to cause unsettling dreams or nightmares.
As with food, it’s best for physical exertion to cease at least a couple of hours before bedtime to help the child wind down. A physically tired body is more likely to “feel tired,” and this makes bedtime and sleep, an easier proposition.
Exercise rules of thumb are that preschool and younger children should have at least three hours of physical activity per day, and one of those hours should be spent in more vigorous play such as running, jumping, or pedaling. School-age children and teens should spend several physically active hours per day with at least one hour spent in moderate to vigorous activity.
Once you’ve established the appropriate bedtime (figure out what time the child needs to get up to be ready and leave on time, and then count the hours back by how many hours of sleep they need), it’s time to create a soothing and relaxing pre-bedtime routine.
So, let’s say you need to leave the house by 7:45 each morning, and it takes your child about one hour to be up and ready. This is a 6:45 wake-up time. If the child needs 11 hours of sleep on average, bedtime should be at 7:45 each evening.
With that in mind, here is an example:
This timetable and list of activities is completely different from house to house and based on the family’s preferences and needs. But establishing a repeatable wind-down/bedtime routine cuts out pre-bedtime stimulants and creates a soothing rhythm.
Nap times are a precious lifeline for parents, but they begin to hinder bedtime and sleep habits as children get older. If your child hits four or five years old and naps are still a part of the daytime routine, it’s time to phase them out. Catnaps of 20 minutes or so in the early afternoon are fine, but try to replace naptime with an active “quiet time” (puzzles, Rubik’s cube, reading, word games, etc.), which may positively support nighttime sleep patterns.
Are these ideas not working? Don’t give up hope. It’s time to seek support from behavioral specialists who can work with your family to create personalized bedtime solutions. Contact the Autism Response Team to schedule a consultation. Our agency requires family involvement to ensure that we are able to see the greatest success in the least amount of time.