Autism & Sleep Issues: Connections & How to Cope

How Common Are Sleep Issues in Autism?

Sleep issues are common for autistic individuals. Research suggests that both children and adults may experience decreased sleep onset latency.¹ Additionally, they are more likely to be easily aroused from sleep, which can be stressful for an individual. These disturbances can lead to chronic fatigue and affect the quality of life for autistic people.¹

Which Types of Sleep Problems Are Most Common?

Autistic people who experience sleep problems may be awakened throughout the night by background noise, uncomfortable temperatures, or a variety of other stimuli. Some research suggests that autistic children may spend less time in REM sleep compared to neurotypical kids.¹ This means they are not able to reap the restorative benefits that come with getting enough sleep. Further studies show a strong link between autism and insomnia. However, researchers do not yet understand the contributing factors to this connection.

What Causes Sleep Issues in Autism?

Environmental factors, genetics, and external factors can all play a role in sleep issues with autism. For example, various types of light and noise pollution, along with stress, could possibly result in these problems.^2,3 Sleep quality can be further impacted by co-occurring mental health conditions, such as attention deficit hyperactivity disorder (ADHD) or psychological conditions.

Sleep disruptions can result in significant problems, such as an increased risk for anxiety, depression, and self-injury.

Possible causes of sleep issues for autistic individuals include:

• Sensory issues: Sensory overload can result in difficulties falling asleep and maintaining sleep, as autistic people are unable to focus on sleeping until the stimuli causing discomfort is removed.
• Genetic factors: Autistic individuals have biological differences that may contribute to poor sleep quality. Researchers believe that neurobiological mechanisms associated with autism may be connected to insomnia in some way.³
• Lack of melatonin: People with autism are more likely to experience a lack of melatonin which can negatively impact sleep patterns.
• Comorbid conditions: It is common for autistic people to experience an anxiety disorder, ADHD, or another mental health condition. Certain symptoms of these disorders can contribute to disrupted sleep patterns.
• Gastrointestinal Issues: Irritable bowel syndrome (IBS), gastroesophageal reflux disease (GERD), and inflammatory bowel disease (IBD) can wreak havoc on an autistic person’s sleep patterns.^1,4

How Are Sleep Issues Assessed in Autistic Individuals?

Evaluating sleep disturbances in autistic individuals is often performed through questionnaires and interviews. A thorough review of the patient’s sleep environment is also important in this process. Several tests—such as a sleep study (i.e., polysomnography)—may be performed to assess sleep quality. This test records brain wave activity over a period of about eight hours. Depending on what is causing one’s disturbances, treatment can include behavioral interventions, medical treatment or a combination of both.

7 Tips for Coping With Sleep Issues in Autism

If one’s sleep quality is causing problems in their daily life, it is important to consider ways to address the source of this problem. However, there are steps an autistic person can take in the meantime to cope with these difficulties.

The following are seven tips for coping with sleep issues:⁵

1. Set a Bedtime Routine

Sleep greatly impacts one’s mental health and well-being. For parents of autistic children, one way to help improve your child’s sleep quality and prevent bedtime procrastination is to establish a sleep routine. For example, try dimming the lights and playing music before they go to bed. Remember, it’s okay if your child doesn’t fall asleep at their set bedtime! There will always be another night with new opportunities for establishing peaceful sleep time routines.

Routine is equally as important for autistic adults, as it allows them to unwind and decompress. Create separation from your daily stressors and focus on establishing a routine that works well for you. You could also try a meditation practice, natural remedies, or light stretching before bed.

2. Make Healthy Diet Changes

What you eat may impact your overall sleep quality. A lack of nutrients–such as calcium, magnesium, and vitamins A, C, D, E, and K–are associated with sleep problems. By making some healthy changes, such as introducing more fresh fruits and vegetables, you can boost your chances of getting a good night’s rest.

3. Stay Physically Active

Staying active can significantly help when dealing with sleep problems. If you’re looking for some ideas, consider trying yoga or pilates. These are both full-body, non-strenuous activities that combine stretching and strengthening exercises. Additionally, jogging can be beneficial as well. Even a brisk walk is also effective as it can boost endorphins, helping to promote happiness and overall well-being. Consider taking long walks through a park, along a seaside, or just in your neighborhood before bedtime.

4. Limit Sensory Stimulation Before Bed

Autistic individuals often experience sensory disturbances at night. To reduce the risk of sensory overload, try using a weighted blanket, showering before bed, buying blackout curtains, or listening to meditative music. Progressive muscle relaxation may also be helpful.

5. Keep a Sleep Diary

Maintaining a sleep diary can help you monitor your sleep patterns and disturbances. It also encourages you to look at how your sleep schedules are affecting your ability to fall and stay asleep.

6. Meditation

Meditation has been shown to significantly improve sleep quality and have positive effects on anxiety, depression, pain sensitivity and quality of life in autistic people. Many meditations can include progressive muscle relaxation strategies in order to slow down your body and get it ready for rest.

7. Seek Professional Support

When one’s sleep quality improves, so does their mood and ability to function in all areas of life. While there are many different methods for addressing sleep issues, these are not always effective or acceptable on an ongoing basis. However, finding a neurodiversity-affirming therapist who understands your individual needs can help you explore various treatment options until you begin experiencing relief.

Treatment options for autistic individuals that can help with sleep issues include:

• Cognitive behavioral therapy (CBT): CBT for insomnia is designed to help people identify and change negative sleep-related thoughts and behaviors. It encourages clients to develop a healthy sleep routine. 
• Hypnosis: Hypnosis for sleep can help a person learn how to release stress, which is a major cause of insomnia.
• Natural remedies: Certain supplements can be an important aspect of addressing sleep disturbances. Consult with a doctor about getting a blood test to see if you are lacking any specific vitamins.
• Pharmaceutical remedies: If other treatment and coping skills are not improving your sleep quality, it may be helpful to ask your doctor about prescription medications that can be beneficial.

In My Experience

There is no one solution for addressing sleep disturbances. It’s important for autistic individuals to try out a variety of remedies to find a solution that works best for them. Remember, we are ever changing beings–what worked for you at one time may not work forever. Be open to revisiting different approaches.