Sleep for autistic kids is often tricky. The autism/neurodivergent diagnosis finally helped make sense of our sleep troubles in childhood. But how do you help autistic children to go to sleep? Sleep and autism is a huge pain point for many families, and ours was no exception.
Sleep is the wonder drug that can make everything else seem ok. Bedtime routines for autistic kids can help them get the sleep they need too. If you get a decent sleep at night, the next day is manageable. If you don’t get a good sleep, then the rest of that week is a write-off! Sleep should be number 1 for any self-care – forget mediation, gratitude and eating a handful of almonds and just give me sleep.
Sleep is essential. Yet it can be difficult for autistic kids to go to sleep. A study of preschoolers in 2019 found that sleep problems are more than twice as common in children with autism. For children who struggle to go to sleep, stay asleep, or wake up during the night, here’s 5 strategies that can help. From routines, to sleep cards, sleep music soundtracks and co-sleeping, one strategy may not work but another might.
Sleep for Autistic Kids e-book
The importance of sleep for autistic kids
Getting a good night’s sleep is important.
Your brain needs sleep to remember what it’s learnt during the day. Sleep is also a time when our brain thinks about things and solves problems.
Your body needs sleep to grow and heal muscles, bones and skin. It’s also important as part of rest to fight sickness and stay healthy.
Sleep for kids is a great website that teaches kids the importance of sleep, in easy to read language.
Is sleep a problem?
With our first born, we weren’t experienced enough to know if his sleep was normal for a baby. I mean, how do you know if waking 5 times a night is normal for a wonder week or not? I remember one bad night when he was about 6 months old. We were on our first family holiday in a hotel. I didn’t want to wake up the rest of the hotel when he woke overnight. Except he deigned to wake up every hour, on the hour, 8 times over the night. I didn’t want to disturb our neighbours, so he got settled back to sleep by being fed every time. I hardly slept, and the next day we were snorkeling on the Great Barrier Reef. Not wanting to miss out, off I went into the water with no sleep – it’s a wonder I didn’t drown.
Going to a sleep clinic
We went to a sleep clinic when he was about a year old because he took forever to settle. It would take 40 minutes of rocking and patting to get him to sleep for a short 40 minute cycle. They recommended swaddling tightly and installing casters on the bottom of the cot to rock him. They said to let him learn to settle himself and try controlled crying or gradual release. But it didn’t work. Our stress levels went up, he cried for hours and didn’t settle. Nothing we read helped with sleep – we tried all the strategies but nothing seemed to fit.
Why is sleep so tricky for autistic kids?
Our autistic son not only struggled to go asleep, he couldn’t stay asleep.
At bedtime, he:
- didn’t seem to feel tired, possibly due to low melatonin hormone release which has been found in autistic people due to variations in the ASMT gene.
- still had his mind running at 100 km/hr, thinking, talking, processing and it wouldn’t shut down to allow him to switch off and go to sleep.
- experienced anxiety around separation, the dark, sensory inputs like needing white noise in the background (like a ceiling fan running).
During the night, he often woke up. He would then appear wide awake at the most inappropriate times in the early morning. Once awake, he would come in and wake us up. Even times when he didn’t wake us up, he would complain about being tired in the morning because his sleep had been intermittent and broken over night. This is not unusual. One study from 2019 found that up to 80% of autistic children has disrupted sleep. This compares to a reported 30% of neuro-typical children having sleep disruptions. The sleep troubles are real!
These sleep troubles may be due to low melatonin levels in autistic people. Melatonin, the sleep hormone, has been found to have low production levels in people with autism, possibly due to genetic variations in a gene. Problems with sleep might also occur more frequently for autistic children because of sensory issues, difficulty with transitions, obsessions that interfere with relaxation, or high levels of anxiety.
Why ‘normal’ sleep strategies don’t work for autistic kids
Looking back at the trouble with settling, should we have known something was different? In retrospect, everything makes sense. The trouble settling was related to sensory inputs, and he needed human touch and warm pressure to comfort him. He was never going to self-soothe and stop crying as he couldn’t manage his own sensory needs and calming. So, the autism/neurodivergent diagnosis helped make sense of our sleep troubles in childhood. But how do you help autistic children to go to sleep?
When our child was a baby, we survived on co-sleeping, swaddling, rocking and patting, and feeding to sleep. But sleep problems persisted as he got older and we had to expand our strategies until he reached about 9 years old.
5 strategies for better sleep
Over time, with much repetition, implementing proactive routines and habits have produced mostly independent sleepers for us, along with the help of modulating melatonin production. But it took much longer than it might take for a non-autistic child. Reading neurotypical books on sleep generally didn’t help and the strategies (like controlled crying) didn’t work. We had to explore much broader to find strategies that worked.
Wearing a tracker watch gave us insight into sleep patterns. Our son would stir in the early morning and have trouble going back to sleep. As our kids have gotten older, the strategies changed and we found new things that started to work. Tracking the sleep strategies we were trying in our planner, and how successful they were, was key to finding the right ones for our children with autism. The moral of this story is to try lots of things until you find what works for you.
Proactive exercise as part of a sleep routine
Bedtime routines and proactive daytime exercise outdoors helped to get our kids to bed. We try to get an hour of activity in each day. Wearing a tracker watch and aiming for 10,000 steps a day is one way to make sure our kids are getting the outside activity they need to be tired enough for bed. Our neurodivergent kids don’t do organised team sports (like, how could you possibly have the hand-eye coordination and understand the social rules of sport?). However, they do enjoy running around, playing at the park, riding bikes/scooters and doing youtube brain break video exercises. The step counters have been motivating for tracking and encouraging physical activity with our non-sporty kids.
Some of these 5 strategies might work for you, and you’ll probably need to try out several before finding something that works.
1. Sleep routines for autistic kids
Autistic kids love routines. They are familiar, fit in with a fixed mindset, and allow for predictable days.
Routines for sleep are no different, and help to prepare the mind and body for sleep, giving environmental cues that it’s time for bed. Some kids might be able to get by with a bath-teeth-story-bed routine. Other kids like ours need more help with co-regulating to slow down before bed.
Along with a sleep routine, we try to make sure there’s enough physical activity during the day, and that screens are off an hour before bed.
During the school term, we try to stick with a routine, with fixed bedtimes every day. Even changing bedtimes on weekends can make it tricky to get back into sleep during the week.
What’s a daily sleep routine with 5 steps to bed?
The 5 steps to bed song that we made up has made a difference, and helped our kids settle into bedtime. It also helps when they have sleepovers or go on school camp as they can try to sing it themselves and have the same triggers for sleep. Each of our kids have a different 5 steps – they choose what they want as their steps, and they demand the song before they go to sleep!
For example, our daughter’s 5 steps song is:
There’s one, two, three, four, five steps to bedtime, steps to bedtime.
Step one, 5 kisses. 1, 2, 3, 4, 5.
Step two, 3 hugs. 1, 2, 3.
Step three, highs and lows. What was something good today?
Step four, what will you dream about?
Step five, lie down and go to sleep.
Our son’s 5 step song is:
There’s one, two, three, four, five steps to bedtime, steps to bedtime.
Step one, 5 kisses. 1, 2, 3, 4, 5.
Step two, 3 hugs. 1, 2, 3.
Step three, highs and lows. What was something good today?
Step four, deep pressure massage and meditation.
Step five, lie down and go to sleep.
Our daughter likes to talk about her day and needs to have an idea for a dream before she goes to sleep. She also needs her chosen soft toy with her, and her sleep playlist on (of chosen quiet songs that she likes). Our son needs more sensory/physical input to calm down and a head to toe massage with meditation (“say goodnight to your toes, say goodnight to your legs, say goodnight to your…) is what works for him. Our son needs a wheat bag heated up (even in the middle of summer), his soft toy, and the fan on. He complains that his ears ring if there’s not background white noise, and the fan provides that.
2. Sleep Cards to encourage kids to stay asleep
We have a series of Sleep Cards on our son’s bedside. They contain sleep sayings, sleep facts, and day dreaming prompts. The cards helped encourage him that it was ok to be awake at night, and that he’ll fall back asleep soon (without disturbing us). They helped him to stay asleep overnight.
Sleep cards contain sleep sayings, day dreaming prompts and facts about sleep.
Sayings include positive affirmations around sleep:
- I will go back to sleep in time
- I’ll be OK. I can tolerate being awake before going back to sleep.
Day dreaming prompts gave our son something to think about while lying in bed waiting for sleep again. These were largely based on current interests.
- If I won a million dollars
- Imagine a day in Minecraft
- Think about what you’ll do in your next gaming session
Sleep Facts came from the kids’ website Sleep for Kids. This website teaches kids about the importance of sleep in easy to read language. Understanding sleep cycles, and how moving between deep sleep and lighter stages of wakefulness is normal, helped our son understand why he woke up overnight.
Get your own Sleep Cards
We’ve produced a set of sleep cards. They can be stuck onto index cards or cardboard to make hardy reference cards for overnight. With thick text, they can be read in low light. There are also blank templates, so you can add your own sleep sayings and day dreaming prompts that fit your child.
Waking up in the middle of the night, or waaaay too early is a common sleep problem. Along with the Sleep Cards, fitbit style watches or a digital clock in the bedroom might help. The watches can light up so you can tell the time even in the dark. Our son knows now that if it’s before 6am, he should stay in bed for a bit longer and daydream with the Sleep Cards. He can do reading if he needs to, but otherwise is encouraged to stay in bed and think about things. He’ll come out of his room once we’re up and tell us that he woke up at 4am, then went to the toilet, then woke up at 6am and lay and daydreamed about games.
Download all Sleep Cards here.
3. A consistent sleep playlist
A good sleep playlist is often slow (60 beats per minute), instrumental, and repetitive. While some people prefer white noise or nature sounds, others may like instrumental music for sleep. Both our kids have their own sleep playlist of about 5 songs that now triggers them to calm down and go to sleep.
Our kids like:
Relaxing and calm guitar music (because our daughter “hates piano music”)
City of the Sun guitar tracks
Sleep soundtracks from their favourite video games
4. Deep pressure, warmth or other sensory inputs
Having the right sensory input for sleep is important for many autistic kids. Our daughter dislikes heavy blankets, but loves cuddling up to a piece of clothing from mum and having all her soft toys around her in bed. Our son only goes to sleep with heavy blankets, such as weighted blankets or big quilts. He also has warm wheat bags that get microwaved before bed and provide comforting warmth. To counteract all the heat, he then needs a fan on that provides white noise during the night.
At other times for our daughter when she keeps hopping out of bed, putting her to sleep at the opposite end of the bed (pillow at the foot) sometimes works. Other times it’s getting her to sleep in a little kids fold out foam couch (must feel like being in a safe sensory cubby) either on the bed or on the floor is enough to keep her lying down in her room.
One of the bedtime routine steps has been a deep pressure massage, working from the head to the toes pressing down into the bed and providing calming sensory input.
5. Sleep for autistic kids with melatonin
The real turning point for us and many other parents of autistic kids is melatonin. This sleep hormone is often only found in low levels in autistic kids. Providing a natural boost through melatonin gummies, oral liquids or tablets just before bed can help. Our kids report that it helps them calm down, stop their mind buzzing constantly, and is sometimes the only thing that can really help them get to sleep. Go check with your doctor or paediatrician before using any melatonin for the first time.
Conclusion: sleep for autistic kids
Just like providing co-regulation for autistic kids with lots of physical activity and sensory input, getting to sleep can also need lots of adult support.
From having a consistent routine every night, to providing deep pressure massage before bed. Or having a sleep playlist that matches the bio-rhythm of a resting heart rate. It can take some experimentation and years of reinforcement, but good sleep can be possible with the help of effective sleep routines. Here are three final lessons on sleep, both for babies and older children.
Lesson #1 – Throw out the books
Helpful people gave us book recommendations, saying it saved them and their child. Well, that’s great but their child was not our child and nothing in the books helped – comparisons often don’t work for neurodivergent kids. Sleep looks different for children with autism. It only made us feel worse when we should have followed our gut feeling.
Lesson #2 – Ignore the Judgy McJudgy faces
Follow what’s working for you. If feeding on demand works, do it and forget about the schedule. Maybe co-sleeping keeps you sane; do it and forget about those that say children need their own rooms. If melatonin is the only things that works, use it. You do you, as long as it’s safe and not harming anyone.
Lesson #3 – Find the routine that works
Working out if you need to talk about the day more to debrief, or if a physical/sensory calm down is what’s needed, is half the battle. Our kids with autism just can’t switch off, their little brains run a hundred kilometres an hour and they just can’t stop to sleep without co-regulation. Keep persisting even though it’s a long journey!
Sleep for Autistic Kids e-book
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