A GUIDE TO AUTISM (ASD) AND SLEEP PROBLEMS
It is important for everyone to get a good night’s rest. However, children and adults with autism have trouble falling asleep and staying asleep throughout the night. Sleep problems are very common amongst individuals with ASD and other developmental conditions.
People with autism tend to take much longer to fall asleep. They do not sleep peacefully because they wake up frequently during the night. Sleep deprivation affects mood and contributes to medical conditions such as diabetes, high blood pressure, heart disease, and obesity.
How Common Are Sleep Problems with Autism?
Sleep problems are quite common because many of these people have other conditions that are known to disrupt sleep. Some of these conditions include; depression, sensory sensitivities to sound, light, or touch, anxiety, attention deficit hyperactivity or gastrointestinal problems.
Some people with autism take medications that can cause insomnia. For instance, people on the spectrum take stimulants that are known to disrupt sleep.
Also, some studies suggest that people with autism carry mutations, which affect levels of melatonin. Melatonin is a natural hormone that controls sleep. Reducing the level of melatonin makes it difficult to fall asleep.
What are some of the types of Sleep Problems?
Insomnia is when it is difficult to fall asleep or stay asleep. Insomnia usually leads to lethargy, daytime sleepiness, and a general feeling of being unwell, both physically and mentally. Insomnia is a more common occurrence for people with autism and also for people with other conditions. A few factors that could impact healthy sleep patterns are certain biological factors, specific substances or unhealthy sleeping habits.
- Sleep Apnea
This is the most common and serious sleep disorder among people with autism. It causes breathing to become shallow during the sleep cycle. Also, breathing can stop completely for up to 10 seconds during sleep. Obstructive sleep apnea, which occurs when there is a complete or partial obstruction of the airway, is the most common form of sleep apnea.
- Night Terrors and Nightmares
Night terrors and nightmares can make people with autism wake up crying or screaming. Children between 18 months to 6 years tend to suffer from this the most. Unfortunately, night terrors and bad dreams can make it hard for children to get back to sleep because they are afraid.
- Restless Sleep
Children with autism usually have restless sleep more often than children that aren’t on the spectrum. These children may be prone to head-banging, head-rolling, and body-rocking. Restless sleep may also be a sign of other less common sleep disorders among children. Using the right settling strategies can help the child get a good night’s rest.
Many children with autism snore when they are sleeping. This is because snoring is usually a clear sign of sleep apnea a condition known to be as issue. It is important to consult your child’s health care provider for a proper diagnosis.
- Bedwetting and Toileting
Difficulties with toilet training and bedwetting are a common issue. If a child wets the bed at night, the child will likely wake up and may have problems getting back to sleep. Even if the child wakes up to go to the toilet, they might still be unable to go back to sleep.
- Difficulty Falling Asleep
Difficulty falling asleep is the most common sleep problem for people with autism. Some people find it difficult to switch their minds off and close their eyes even in the presence of a calming and consistent bedtime routine. Also, some people with autism are hypersensitive to sounds and light when trying to sleep.
Why Do People with Autism have Trouble Sleeping?
There are genetic causes of autism, which can have an impact on the ability of people with autism to get a good night’s rest. It makes it hard for the person to fall asleep and stay asleep.
Many people with autism have a hard time falling asleep because they are hyper-responsive to sensory input. That is why they cannot block out sensations and noises that are disturbing their rest.
Lack of Melatonin
Melatonin is a sleep-rated hormone. So, some studies suggest people with autism lack melatonin because they produce less melatonin than neurotypical people.
Physical or Mental Illness
Individuals on the spectrum may have a physical or mental illness that can make it difficult to fall asleep. Also, they can have ADHD, anxiety, acid reflux, sleep apnea, seizures disorders, and obsessive-compulsive disorder that make it harder to sleep.
What are the Consequences of Poor Sleep?
Neurologic Effects on the Brain and Pain
Poor sleep makes people with autism experience uncontrolled reflexive movements of the eye known as nystagmus. They also can have slurred speech or develop a tremor (slight shakiness in their hands).
Sleep deprivation may reduce the threshold for seizures and can cause other neurological reflexes such as hyperactive deep tendon reflexes, hyperactive gag reflex, and sluggish corneal reflexes.
Affects Blood Pressure
Poor sleep can cause subtle changes in vital signs such as breathing rate, heart rate, blood pressure, and body temperature. Poor sleep can cause a decrease in body temperature and it can lead to longer and more frequent pauses in breathing known as sleep apnea.
Impact on Growth and Thyroid Function
Poor sleep can impact weight and growth in children with autism. Sleep deprivation compromises the amount of growth hormone released, that is why some children with autism do not reach their full growth potential. Basically, they are shorter than they would otherwise have been.
Chronic sleep deprivation impacts metabolism. Hence, it leads to impaired glucose tolerance and weight gain. People who do not get enough sleep every night, often end up overweight. Getting enough rest can help maintain a healthy weight.
Alertness and Concentration
Sleep deprivation slows down thought processes. Studies show that poor sleep can lead to lower alertness and concentration. Most people with autism, who do not get enough sleep, are always confused because they find it difficult to focus and pay attention. This makes it difficult to perform tasks, which require complex thought and logical reasoning.
Sleep deprivation impairs memory. Getting a good night's sleep helps to strengthen the nerve connections that make memories. That means not getting enough sleep weakens the memory making it easy to forget stuff and misplace things.
Learning is difficult when you are tired. Poor sleep makes it hard to learn efficiently, to focus and pick up new information. Additionally, poor sleep affects memory, which is important when learning.
Mood and Mental Health
Poor sleep alters mood significantly. That makes it difficult for people to cope with stress often making them angry and irritable. People on the spectrum may be affected to a higher degree. Unfortunately, this may negatively affect a person’s job or relationships.
It is very common for people who do not get enough sleep to be depressed. Chronic sleep deprivation puts people with autism at greater risk of depression than average.
How to Treat Sleep Problems in People with Autism?
Cognitive-Behavioral Therapy (CBT)
CBT is a form of psychotherapy used for treating sleeping problems in people with autism. Sometimes people with autism do not fall asleep because of fears. Therefore, CBT involves talking through the fears that cause sleep problems and alternative ways of coping are discussed. Some studies have shown that CBT is effective in treating sleep problems in people with autism.
Natural Light Therapy
Natural Light Therapy stimulates the production of hormones serotonin and melatonin. It helps to stimulate the brain to produce serotonin and makes a person feel more awake in the morning. Exposing people to natural light or light machines that help stimulate natural light are both effective treatments.
Melatonin alerts the body that it is time to sleep. It is important to reduce natural light exposure in the evening to stimulate the production of melatonin. Natural Light Therapy helps regulate these hormones.
People with autism should sleep in a dark, quiet, and cool bedroom. This is because most people with autism are sensitive to noises and light. Creating the perfect sleeping environment makes it easier to fall asleep. If the person is comfortable in their bedroom they will sleep peacefully.
Regular Bedtime Routine
Establishing a regular bedtime routine can help the person with autism fall asleep easily. It is important to have a predictable bedtime routine. Brushing your teeth, putting on pajamas, reading, or doing something that the person finds relaxing are great examples of what to include in your routine.
Learn to Fall Asleep
People with autism need to learn the skill of falling asleep alone. Parents teach very young children how to fall asleep alone to help them establish a good sleep pattern. Learning how to fall asleep alone makes it easier for the person to put themselves back to sleep when they wake up in the middle of the night.
People, who exercise during the day, tend to fall asleep quick and they always have a deep sleep. People with autism can exercise during the day, but they should never exercise too close to bedtime. This is because exercising close to bedtime can make it difficult to fall asleep.
To fall asleep easily avoid certain stimulants that contain caffeine, such as tea, coffee, soda and chocolate. It is most important to avoid caffeine close to bedtime. Caffeine makes the person more alert, which makes it difficult to fall asleep.
Picking the right diet can help people with autism fall asleep. If stomach discomfort or food sensitivity is the issue, the person should visit a dietitian for advice. People with autism should not introduce major dietary changes before visiting a dietitian. The dietitian will help them pick a balanced diet that will improve the quality of their sleep. It is important to eat foods rich in melatonin.
Valerian is an herbal home remedy. It is taken as a supplement or brewed as the tea. It reduces anxiety and improves sleep quality. Taking valerian improves sleep quality. How? It affects the level of gamma-aminobutyric acid (GABA), which is the calming neurotransmitters in the body.
Lemon Balm also known as Melissa officinalis. It is a tea and herbal supplement. It calms the nerves and relieves anxiety. It is usually found in supplements.
Magnesium makes it easier to fall asleep by quieting the mind and body. It has a relaxing effect because it regulates the production of melatonin and increases the levels of GABA. Increasing the levels of magnesium and GABA in the body improves the quality of sleep.
Lavender The soothing fragrance of lavender enhances sleep. In fact, a lot of studies have shown that smelling lavender oil for around 30 minutes can help improve the quality of sleep. This effect is strong for people suffering from mild insomnia. Lavender aromatherapy is perfect for improving the quality and duration of sleep.
Glycine is an amino acid. It plays a crucial in the nervous system. It helps improves sleep. How? It lowers body temperature at bedtime, which signals that it is time to sleep. It can improve sleep quality. Glycine can be found in foods rich in nutrients such as cabbage, bone broth, kale, meat, spinach, eggs, beans, poultry, fish, and many more.
People with autism should aim to improve the quality of their sleep; it will help reduce their frustration levels and improve their quality of life. Why? Getting a good night rest reduces stress, improves memory, lowers blood pressures, helps maintain weight and puts the person in a better mood. For someone living on the spectrum lack of sleep poses a large problem as these individuals can experience the effects of sleep deprivation more deeply and have a harder time vocalizing what the problem is.