Helping your child with autism get a good night's sleep

During the first few months of life, babies ease into a normal cycle of sleep and wakefulness. They gradually reduce the number of daytime naps and start sleeping for longer periods of time at night. But some children continue to have difficulty falling asleep or sleeping through the night, and the problem can persist long after children start school.

Sleep disorders may be even more common in children with autism. Researchers estimate that between 40 and 80% of children with autism have difficulty sleeping. The biggest sleep problems among these children include:

• Difficulty falling asleep
• Inconsistent sleep routines
• Restlessness or poor sleep quality
• Waking early

A lack of a good night's sleep can affect not only the child, but also everyone in his or her family. If you're bleary-eyed from night after night of waking up with your child, there are a number of lifestyle interventions and sleep aids that can help.

What causes sleep disorders in children with autism?

Researchers don't know for sure why autistic children have problems with sleep, but they have several theories. The first has to do with social cues. People know when it's time to go to sleep at night thanks to the normal cycles of light and dark and the body's circadian rhythms. But they also use social cues. For example, children may see their siblings getting ready for bed. Children with autism, who often have difficulty communicating, may misinterpret or fail to understand these cues.

Another theory has to do with the hormone melatonin, which normally helps regulate sleep-wake cycles. To make melatonin, the body needs an amino acid called tryptophan, which research has found to be either higher or lower than normal in children with autism. Typically, melatonin levels rise in response to darkness (at night) and dip during the daylight hours. Studies have shown that some children with autism don't release melatonin at the correct times of day. Instead, they have high levels of melatonin during the daytime and lower levels at night.

Another reason children with autism may have trouble falling asleep or awaken in the middle of the night could be an increased sensitivity to outside stimuli, such as touch or sound. While most children continue to sleep soundly while their mother opens the bedroom door or tucks in the blankets, a child with autism might wake up abruptly.

Anxiety is another possible condition that could adversely affect sleep. Children with autism tend to test higher than other children for anxiety.

What kind of effects do sleep problems have?

Not getting a good night's sleep can have a serious impact on a child's life. Research has shown that, in children with autism, there is a connection between lack of sleep and the following characteristics:

• Aggression
• Depression
• Hyperactivity
• Increased behavioural problems
• Irritability
• Poor learning and cognitive performance

But your child isn't the only person affected. If he or she isn't sleeping, there's a good chance you aren't either. One study shows that the parents of autistic children sleep less, have poorer sleep quality, and wake up earlier than parents of non-autistic children.