Sleep Workshop Summary
Jemma Swales has developed this workshop organised by SHINE for Autism with the intention of educating parents/carers about Sleep.
Many people have sleep issues. But for those on the autism spectrum, sleeping well may be particularly difficult.
Many people on the autism spectrum are likely to suffer from disturbed sleep patterns at some point in their lives.
Reasons for this could include:
• having difficulty settling, winding down and going to sleep.
• waking repeatedly during the night or having difficulty getting back to sleep after waking up to go to the toilet.
• increased anxiety or an inability to relax causing insomnia.
• social cueing problems, where an autistic person doesn’t make the connection between others in the house going to bed and their own need to sleep.
• Irregular secretion of the sleep hormone melatonin, which regulates sleep patterns, or having atypical circadian rhythms (body clock).
• Neurological conditions such as epilepsy.
• sensory differences, such as increased sensitivity to blue light from smart phones, laptops and other screens, or sensitivity to certain sounds or white noise, which may be upsetting or distracting and keep them awake.
• problems caused by food allergies, which could cause gastrointestinal issues and discomfort, or increased sensitivity to caffeine or other stimulants, which can disturb sleep.
• hypersomnia - sleeping too much. Increased exhaustion could be caused by the additional stress autistic people experience in social situations.
Sleep routines and habits
• Develop a positive bedtime routine that involves your child going through a few pleasurable activities in the 20 minutes or so before bed. You can use this routine wherever you and your child happen to be.
• Set a regular, age-appropriate bedtime for your child. It should be when you know your child will be sleepy, but not overtired.
• Make sure you give your child plenty of warning that bedtime is approaching. If your child doesn’t like to change activities with little warning, he might get upset If you suddenly decide it’s time for bed.
• Be consistent in how you warn your child that bedtime is approaching. You could use a cue like a clock or an appropriate picture to show your child it’s nearly bedtime.
• If your child gets upset and gets out of bed, quietly and calmly put them back to bed. You might need to do this many times, especially if you’re trying to develop a new bedtime routine.
• If your child won’t fall asleep without a particular object – for example, a toy, special pyjamas or pillows – try to think of ways to vary this. You might need to phase out the item, perhaps by gradually using different items at bedtime. This might stop your child from relying on just one.
• Encourage your child to fall asleep in their own bed.
• If your child experiences anxiety about going to bed or sleeping alone, you could try wrapping your child in a blanket, using a nightlight in the bedroom, or playing music in their room when they’re in bed.
Children with ASD who don’t sleep well are more likely to have behaviour problems during the day. As with all children, persistent sleep problems can negatively affect the learning abilities of children with ASD. And when children with ASD don’t sleep well, their parents are likely to experience poor sleep, stress and possibly depression. Improving your child’s sleep habits can help you avoid some of these issues.
Strategies for dealing with sleep disorders
Keep a sleep diary
Sleep diaries can be used to establish any unusual patterns of sleep and identify factors which may be influencing the person’s ability to sleep. If you are using other strategies to aid sleep, you will be able to track how effective they are. Sleep diaries are also useful because you can show them to professionals such as teachers, GPs or social workers, to give them a clearer idea of the impact sleep issues are having on your lives. Certain benefit application forms, for example Disability Living Allowance (DLA), ask you how often you have to get up in the night to help your child. You can send in a copy of the sleep diary to support your application. A sleep diary can show the person themselves what their sleep patterns are like. They can then be used to establish incentives for staying in bed and trying to sleep.
Establish a reassuring routine
Establish a basic, ordered routine for the evening, which can be followed anywhere. Use visual timetables to make it easier to follow. If possible, limit the person’s screen time (TV, computer, tablet, smart phone) or exposure to bright lights an hour or two before bedtime, as these can inhibit the production of the sleep hormone Melatonin. Some children may find the transition from sleeping in their parent’s room to their own room by themselves difficult. This can be related to difficulty with change but also the need for reassurance around bedtime and sleeping. Coping with waking problems may require consistent reassurance on your part and a creative approach to your child’s needs.
Make the bedroom more comfortable
Autistic people can have sensory differences, which make it harder for them to relax and go to sleep, as well as stay asleep. Their environment and surroundings can also play a role. It may help to:
-Block out light using dark curtains or black-out blinds.
-Reduce noise using thick carpet, shutting doors fully, turning off appliances, and moving your child’s bed away from a wall with activity going on the other side.
-Block out noises by letting the person use ear plugs or listen to music through headphones.
-Remove labels from bedding and night clothes, or try bedding and nightclothes made from other materials.
-Reduce smells coming into the room by closing the door fully, or by using scented oils that the person finds relaxing.
-Remove distractions, such as toys on the bed and pictures on the wall (unless the person finds these relaxing), and consider a different colour on the walls.
-Use relaxation techniques such as having a bath, massage, quiet time or gentle exercise such as yoga, to help the person wind down before bedtime.
Children can have difficulty understanding the need for sleep. A social story™ (developed by Carol Gray) could be used to explain this. They can also be used to reassure your child that they are safe when sleeping/alone.
Visual supports such as flow charts could also be used to explain sleep or children’s books that provide the biological explanation for sleep.
Getting some sleep yourself
Getting a proper night’s sleep is hugely important. It may have been suggested that you sleep when your child sleeps, but this won’t necessarily be convenient, especially if you have other people to care for and it can also be difficult to ‘switch off’ on demand. By the time you have got your child to sleep, particularly if they needed calming down, you may feel too wound up to sleep yourself.
Safety proof the person’s room so you can relax knowing that they cannot harm themselves while you are asleep. Find out more about community care and respite services. All parents of children with disabilities are entitled to be assessed to see if they’re eligible.