As a parent of an autistic child, we have to overcome several challenges day by day, and at night too! The autism community might argue about different subjects and urgent concerns, but one thing is common for everyone: sleep disorders. This is a problem that affects between 44% to 86% of autistic children, and most will continue to suffer with it during adulthood.
When a child or adult with high support needs has trouble sleeping, the entire family suffers with them. Keeping 24-hour supervision into someone who doesn’t sleep well is hard, especially because you also will not be sleeping enough during the night. So, what parents and caretakers can do? Put all our efforts into finding the right formula to give our children the best night’s sleep possible.
These are the things that have helped our family so far.
When my son was born, we didn’t have any specific routine at the house. It was only when his problems to fall asleep and stay asleep arose, that we started to look into the issue. Following our pediatrician’s guide, we began to study the Autism Treatment Sleep Tool Kit. It was as if someone opened a new world for us.
First of all, we have developed a set of activities which should be followed within at least one hour before going to sleep, and always in the same order. Starting by brushing the teeth, using the bathroom, being quiet and calm, reading a book, laying down on the bed, and sleeping. Sounds easy, right? Well, it was not! It took us some weeks to make him comfortable with this routine. We created a visual schedule to help him, and for the first weeks, I would join and participate, following the program.
We have also implemented another rule: no external stimulation one hour before bed. We would turn off TVs, video games, any loud music, and use a lower tone of voice. Once these steps started, we would then, set in motion the routine activities. One suggestion I would give is to leave the most stressful tasks earlier in the evening. My son gets super anxious when it is time for his bath, and especially when it comes to washing his hair. I just moved this activity earlier, so when the bedtime approach, he is already calmer.
A few issues might be keeping your child awake, besides the hyperactivity and anxiety. Bruxism, gastrointestinal issues, trouble to breath, and even some of the medicine taken are the most common issues. The best way for you to start treating the problem is to find what might be causing the wakefulness. Once you find the problem, you can work to solve it. Solutions might include changing your kid’s diet, checking the possibility to change the drugs prescribed, invest in activities to relieve the hyperactivity, and so on.
In my case, after paying attention to my son’s sleep pattern, I discovered he was suffering from a severe case of bruxism and cramps that would wake him up at night. Of course, all of this would increase his anxiety and fear of going to sleep. Once I found out these problems and started to treat it, I definitely noticed positive changes in his sleep pattern.
Weighted blankets promote a therapy called DTP, or Deep Pressure Therapy. Its weight distributes a gentle pressure across the body, as a warm and comforting hug. This type of blanket help to improve not only the sleep, but also comes in hand during some meltdown crisis. Its therapeutic properties help autistic kids who struggle with sensory issues and higher levels of anxiety.
My son loves his blanket, and I can see the difference in how calmer he gets. As soon as we started using it, combined with a strict routine and diet to prevent the cramps, he would sleep in fifteen minutes, and not wander around at night (or at least not as much as before!).
Bruxism is a common issue, especially for kids and their developing teeth. In autism cases, it can be even worse, due to the high stress and anxiety that kids suffer. It is also frequently an unfortunate side effect of antidepressants and other medications. My son was having a severe case of teeth grinding, and I had no choice but to introduce a mouthguard into his routine: https://www.proteethguard.com/custom-dental-night-guard/ Initially, I didn’t think he would get used to it, and we had a couple of rough times convincing him it was for the best. But, with time, he started to even fit by himself.
Using a mouth guard has an immediate effect. It creates a barrier between upper and lower teeth, protecting from any damages to the teeth, gums, and bones. In my son’s case, it also helped to reduce the loud noise he was making, while clenching his jaw, which I believe was one of the reasons he would wake up at night.
According to a few researchers, autism affects the circadian rhythm, which is responsible for “telling” the body when it is time to wake up or to sleep. To help his biological clock keep on time, we follow the same routine even during the weekends. I wake him up every day at the same time, let the daylight come in, and when it is time to sleep, all lights are dimmed out.
Besides the routine, I have also asked our doctor to prescribe melatonin, which is a hormone naturally produced by the brain during a good night of sleep. Melatonin keeps the internal 24-hour clock running well, and its treatment helped my son to fall asleep faster and wake up fewer times during the night. But of course, this treatment should be combined with other efforts, as mentioned above.
Helping your child to have the best night’s sleep possible is difficult, and some kids will endure these problems until their adulthood, but you shouldn’t give up. There are not many sleep studies for autistic children and adults yet, so it is our duty as parents to try to find the right pace within the family. Getting into the right track takes some time, and although you might still have a few bad nights, these efforts will undoubtedly provide a better life quality for your loved ones.
Also, don’t forget to seek autistic communities and associations in your region, since exchanging ideas and support is an excellent manner to keep your spirits high and learn with other’s experiences.