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Consistent Routines and Persistence are Key to Sleep Challenges in Children with Autism

sleep disorders in autism, autism spectrum disorders, children

Many children with autism spectrum disorders (ASD) have difficulty with sleep which is stressful for both the children and their parents. Sleep experts with The Vanderbilt Kennedy Center have created a resource for families struggling with this issue for the Autism Speaks Autism Treatment Network (ATN), a network of hospitals, physicians, researchers and families across the United States and Canada.

Sleep disorders affect between 40 and 80 percent of children with autism. The biggest sleep issues include difficulty falling asleep, restlessness or poor sleep quality, and waking early. Researchers do not exactly know why this occurs, but do have some theories.

First, normally developing children often know when it is time to go to sleep because of the normal “light and dark” cycles and the body’s circadian rhythms. But they also use social clues, which children with autism may fail to understand or misinterpret.

Second, melatonin is a hormone that normally regulates the sleep-wake cycle. To make melatonin, the body needs tryptophan, an amino acid found to out of sync in children with autism. These children do not release melatonin at the correct times of the day. Normally, melatonin levels rise in response to darkness and dip in daylight hours. In children with autism, melatonin is often high during the day and lower at night.

A third theory suggests that children with autism have difficulty staying asleep due to an increased sensitivity to outside stimuli, such as touch or sound. Anxiety or hyperactivity, common in autistic children, could also affect sleep.

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“Strategies to Improve Sleep in Children with Autism Spectrum Disorders” is an 8-page informational booklet available for free download at AutismSpeaks.org. It contains information on how to provide a comfortable sleep setting, establish a regular bedtime routine, keep a regular schedule, teaches your child to fall asleep alone, and promotes daytime behaviors conducive to nighttime sleep.

Overall, the guide suggests implementing a plan that works well with your family’s lifestyle. Try one small change at first, and then slowly incorporate others into the regimen. But be patient! It can take as much as 2 weeks of persistence and consistent routines to see a change.

One thing parents should keep in mind, though. Typically developing school-age children often need 10-11 hours of sleep, but a child with autism may need less. Find what works best for your child so that he or she is performing optimally during the day without excessive tiredness or irritability from a lack of sleep.

The toolkit was co-developed by Beth Malow MD MS, Burry Chair in Cognitive Childhood Development and a professor of Neurology and Pediatrics at The Vanderbilt Kennedy Center’ Sleep Division, and Kim Frank MEd, an educational consultant for the Treatment and Research Institute for Autism Spectrum Disorders (TRIAD).

The Vanderbilt Kennedy Center has developed other toolkits with Autism Speaks, including “Taking the Work Out of Blood Work” and “Visual Supports and Autism Spectrum Disorder.” These are also available on the Autism Speaks website.

Additional Resource:
WebMD - Helping Your Child with Autism Get a Good Night's Sleep



It was so eye opening to read this article. Our daughter was diagnosed with AS just a few months before she passed away at age 33. After reading this and other articles now I understand what she was experiencing. She was the love of our lives, but we didn't know how to deal with her. At times it was with great frustration, other times with anger. I had alot of guilt after her death, but after seeing this and other stories I knew we did the best we could with what we knew at the time. Thank you.