Sleep related problems in autism

The percentage of people on the Autism Spectrum who have sleep problems is not known, but may be as high as 80%.  Lack of sleep can impair health, learning and ability to cope with life’s challenges.  A good night’s sleep helps everyone deal with life events with more poise, a greater sense of available options, and more stamina.  Common problems include waking many times during the night and difficulty keeping to the same 24-houowl-2r sleep-wake cycle shared by most of us, in which we’re most wakeful in the daytime and sleepy at night.

The sensitivity to touch, texture, sounds, lights from the street or from electronic devices may all contribute to sleep problems.  It may also be that gastrointestinal problems or some other discomfort are part of the reason for poor sleep.  And of course your child’s sleep problems may be a cause of your own problems.  Good sleep is important for both of you!

We all have a built in clock as part of our biology.  It tends to make us increasingly sleepy after dark and to be wakeful during daylight.   This clock may not be working optimally in many people with Autism Spectrum problems.  These are circadian rhythm problems. The word comes from two Latin words, circa (around) and dies (the day).  Our circadian rhythm is what keeps us on a roughly 24 hour day.  Many biological processes follow and contribute to this rhythmic daily pattern.  When we’re sleeping, we’re resting and recuperating from the day. Our brain uses this time to help us learn things we practiced or saw during the day, and to forget some of the random, unimportant noise we’ve experienced.  Our immune system may be using this time to help us stay well.   Many hormones vary with the circadian rhythm.

A small spot in our brain consisting of about 20,000 cells called the suprachiasmatic nucleus receives inputs from our eyes and controls release of the hormone melatonin from the pineal gland.  Light suppresses the release of melatonin and blue light is the most effective.  Since melatonin promotes sleepiness, blue light induces wakefulness.  For this reason, it’s best to avoid the blue light from electronic devices in the two or three hours before bed time.  Compact fluorescent bulbs also put out a fair amount of blue light.  Bulbs that appear more yellow can help, and dimming lights will help also.  Bright light soon after awakening and throughout the daylight hours can also help with sleep.

Having a routine around sleep can be very important.  Favorite comfort objects such as toys or blankets can help.  For all of us, relaxation and comfort help us get to sleep.  Medications are usually not effective in the long term.

-Emily Diamond, Psy.D.