Autism & Sleep

We’ve all heard about sleep hygiene right? You know – good routine before bed, hot drink, bath, regular bed time, reduce or eliminate screen time for an hour (at least) before attempting to go to sleep. Let’s call that level one. Level two or a combination of both, is trying out various calming or sleeping apps, audio books in addition to the first remedies and you can even flirt with ASMR (autonomous, sensory meridian response). Very interesting piece about that in New York Times. And if that fails, try melatonin medication – a supplement of a naturally occurring hormone, that helps to regulate your sleep patterns by creating ‘sleep pressure’ of the desire to fall asleep.

But what if sleep hygiene doesn’t work for autistic teens? It certainly doesn’t for most of the autistic teens I treat or for my own autistic teen.

Initial findings from an original research article published by Dr. Georgia Pavlopoulou, hints at just that – sleep hygiene isn’t cutting it for autistic teens. You can read the article on this link:

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.583868/full

So what are parents supposed to do?

When they fall into a deep sleep a few hours before dawn

According to Dr. Pavlopoulou’s research, sleep hygiene practice could be highly adapted to be more effective in autistic youngsters especially teenagers. Habits such as:

– “sleep should be treated individually and in relation to the personal factors that affect each autistic person.

-“engaging in a range of physical activities during daytime”

-“personal time for intense engagement with favourite activities and hobbies”

As the research was done directly with autistic teenagers, rather than via questionnaires or being presented by clinicians who haven’t engaged autistic adolescents directly, it is worth noting that this is an innovative study for this reason, ie using the direct experiences of the study group. One of the conclusions drawn by Dr. Pavlopoulou is that “researchers and professionals may benefit from working collaboratively with autistic adolescents.”

In my experience, sleep is a highly emotive issue in families and is sometimes a difficult issue to address as it can be tied up in so many associated issues, such as anxiety, bullying, exam stress, social isolation as well as a host of family and environmental factors. Definitely one size doesn’t fit all, but undeniably there is a prevalence of sleep disturbance in this community and its sister community – teens with ADHD.

As a family we have talked about this extensively and came up with some lose ideas that may be useful to you (these were agreed only after considerable dialogue and information sharing and boundary setting on all sides!) Good luck.

  1. phone out of room overnight until aged 16
  2. screens out of room overnight until aged 15 (once they’re in, they’re in forever)
  3. flexibility on lights out and screens at weekends, and holidays
  4. encourage as much physical activity as possible during daytime (not including to and from school or college)
  5. monitor behaviour and anxiety levels, gently address these if you see there is no other cause apart from sleep deprivation
  6. if you feel there is another cause for difficulty in getting to sleep, endeavour to open a dialogue with the YP about the causes
  7. talk about sleep, why it’s important for the body and the brain, discuss any fears (dark, nightmares)
  8. use a weighted blanket (do lots of research, there are some pricy ones on the market)
  9. use black out blinds we found reasonable ones here 
  10. ensure your child isn’t hungry at bedtime
  11. if you are concerned about your child’s persistent sleep issues, speak to your GP.

© Suzy Rowland

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