By Amy Highland
Those with autism spectrum disorder (ASD) are often well acquainted with sleep problems. Though statistics vary, it’s estimated that anywhere from 50 to 80 percent of people with ASD struggle to get a full night’s sleep. The problems include difficulty falling asleep, frequent night waking and early rising.
While sleep may seem like a simple act, the body actually goes through complex processes and changes to successfully fall asleep. Melatonin and other hormones have to be released at the correct time in the correct amounts for the body to pass through all five sleep stages. It’s during this time that the brain, immune system, and muscle tissue and other parts heal, rejuvenate, and recharge. Without that time, it can be difficult for the body to regulate itself. Additionally, family members and caretakers of those with ASD can also suffer from the effects of sleep deprivation.
ASD related-sleep problems can stem from a blend of different causes. Those with ASD often have irregular circadian rhythms. Circadian rhythms regulate the sleep-wake cycle based on exposure to natural light, temperature, meal timing, and other environmental factors. They trigger the release of melatonin and other important sleep hormones. Irregular circadian rhythms produce equally irregular amounts of melatonin, which interferes with the body’s ability to fall and stay asleep.
ASD may be accompanied by mental health disorders like anxiety or depression or medical conditions like epilepsy or acid reflux. These issues interfere with the ability to sleep. Additionally, these conditions may require the use of medications with side effects that interrupt the sleep cycle. Together, the combination of medical issues, medications, and changes in brain chemistry present an ongoing challenge for those with ASD and their families.
Autistic people and their family members can develop behavioral and environmental cues to help everyone get the rest they need. A consistent bedtime schedule and routine helps many people, even those without ASD, settle down at night. The key is consistency and order. A visual checklist often helps keep things running smoothly so that everyone remembers the bedtime process. The schedule could include getting into pajamas, brushing teeth, reading a book, or listening to quiet music. However, the whole process should take less than 30 minutes so as not to become overwhelming.
Try to create a relaxing evening atmosphere. Your bedroom (or child’s bedroom) should be cool, quiet, and dark to reduce distractions. Comfort is key. A mattress without lumps or valleys that supports their preferred sleep position (back, stomach or side) can make a big difference. If you need a snack before bed, keep it healthy and try to eat foods that promote melatonin production like yogurt, cheese, almonds, or bananas.
Bright light or light therapy is another option. Because the circadian rhythms respond to natural light, increasing exposure to bright light can help regulate the release of sleep hormones. Some people use a special light box or light bulb designed to give off blue light, which simulates natural daylight. Increasing light exposure in the morning helps the body adjust its natural rhythms to a regular sleep-wake cycle. Consult with a physician to make sure light therapy is used for the right duration of time and at the right time of day.
Remember, a healthy diet and regular exercise are also a part of a healthy lifestyle and give the body the best chance of functioning properly. Though improvement may happen over time, a consistent effort can help regulate hormones and habits for better sleep.
Amy Highland is a sleep expert at SleepHelp.org. Her preferred research topics are health and wellness, so Amy’s a regular reader of Scientific American and Nature. She loves taking naps during thunderstorms and cuddling up with a blanket, book, and cats.