Autism and Sleep Disturbance
The Duplin Times - 12/7/2017
All parents deal with a sleepless child sometimes, but for children with autism spectrum disorders (ASD), sleep can be especially elusive. What's worse, sleep disturbance often complicates their other symptoms.
A recent study in the journal Pediatric Nursing confirmed what many parents and professionals already guessed - children with ASD have more sleep problems than typically developing children.
It makes sense, then, that parents of children with ASD also report more sleep problems than parents of typically developing children, but there was another interesting finding. It turns out that parents of children with ASD also have more sleep problems than parents of children with other types of disabilities. Therefore, it appears ASD has unique features that make sleep problematic.
Children with ASD have more complicated sleep problems than those without it. First, it takes them longer to fall to sleep, then they have trouble staying asleep. Not only do they wake more often, but when they do, they stay awake longer. Finally, even with all these other sleep problems, kids with ASD are more likely to wake up too early. Over time, these kids and their families suffer chronic sleep deprivation.
Naturally, poor sleep causes other problems. Children with ASD who cannot sleep well may have more trouble with planning, organization, attention, and impulse control. Because they're tired and irritable, they may also develop behavior problems. Unfortunately for these families, getting help can be as hard as getting a good night's sleep.
While kids with ASD may need specialized sleep strategies, good sleep hygiene is the first step with any child. Sleep hygiene simply refers to the habits we have around sleep. For children, it includes activities such as a consistent bedtime, a soothing bedtime routine, and limiting TV or other electronics at bedtime.
Even with good sleep hygiene, however, children sometimes develop behavioral problems related to bedtime. In these cases, parents have to use behavioral strategies, such as a reward or punishment system, to get kids to cooperate when it's time to go to bed. When children have autism, starting a new behavior plan may be easier said than done.
Because children with ASD struggle with communication, it can be hard to prepare them for changes in expectations. In addition, since these children often become anxious or frustrated with any change in routine, behavior may worsen when parents switch things up. Families may need expert help to find strategies that make sense to the child.
When sleep hygiene and behavioral strategies fail, parents may have to manipulate the child's actual sleep patterns themselves. For example, you can change sleep timing by gradually moving bed times or wake times. It sometimes helps to schedule nighttime awakenings rather than allowing them to occur on their own.
In addition, controlling nap-time is especially important, particularly for young children in childcare settings that require naps. If you decide to work on sleep patterns, change only one thing at the time. You should also consider consulting a specialist, so you don't accidentally make sleep problems worse.
Finally, when all else fails, you may have to consider medication management. Each family must make medication decisions based on their child's needs and their unique family circumstances.
Melatonin is a natural sleep aid available over-the-counter. Although some studies have shown it effective, melatonin is not regulated in the same way other medications are, so quality varies. Even though you don't need a prescription, you should still ask your child's doctor how to use it safely.
In addition to over-the-counter remedies, doctors sometimes prescribe other medications to treat severe or chronic sleep disturbance. Again, the effectiveness of such medications has not been consistently proven, so you should discuss the pros and cons with your child's medical provider.
If you're caring for a child with ASD, take heart that most medical providers understand the sleep problems these children face, as well as how poor sleep affects all areas of family functioning. Don't hesitate to ask your pediatrician or a therapist for help, so everyone can rest better.