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Research suggests that autistic people are much more likely to suffer from dysfunctional sleep. Why, and what are some solutions?

When you think about the struggles autistic people may face, sleep disorders are probably not going to be the first thing that comes to mind. Yet, research that has been conducted — almost always regarding children, rather than adolescents and adults, on the spectrum — shows that sleep problems are shockingly common in people with ASD.

 

Take this data, for instance:

  • Over half of all young autistic children, up to the age of five, were found to have some sort of sleep problem. Most of those who did had this problem on a daily basis. 
  • Insomnia was identified as the most common sleep problem in autistic children — and keep in mind that this doesn't just include an inability to fall asleep in the first place, but also problems staying asleep through the night and consistently waking up (much) earlier than planned or wanted. 
  • A quarter of young autistic children had breathing problems during sleep. 
  • "Parasomnias", unusual sleep-related habits like sleep walking and talking, were also quite common. 
Autistic adolescents were also found to suffer from insomnia in large numbers, with some studies reporting that up to eight in every 10 young people on the spectrum have problems going to sleep or staying asleep. Though research is lacking, rare studies that do address sleep in (young) adults on the spectrum suggest that these problems stick around well beyond childhood. 

What sleep problems are most common in autistic people?

One study of teenagers and young adults on the autism spectrum found that many people had trouble falling asleep — something that may result in lying awake for a very long time. Some people also consistently wake up very early, while others experience breathing problems during sleep that awaken them, or snoring (both of which indicate obstructive sleep apnea). All of these issues can mean that a person ultimately ends up with less sleep than they need to feel rested and be fully functional during the day time. 

It comes as no surprise, then, that many also reported feeling sleepy in the day, often leading to a need to nap at school, work, or home, even if they didn't want to. 

What causes sleep problems in autistic people?

A lot of different factors can be responsible for sleep problems. They'd range from physical medical issues such as sleep apnea, asthma, and epilepsy to stress, anxiety, and depression — which are more common among people on the autism spectrum. Sensory issues, which could include anything from an uncomfortable mattress to bright street lights shining into the bedroom or too much or too little noise, can also contribute. Then, any change in routine is also rather likely to cause trouble sleeping. Like neurotypical people, autistic people may also lie awake worrying or thinking about ways to deal with problems. 

Sleep problems resulting from social worries are tricky, because they're a vicious cycle — our behavior, ability to think clearly, and mood, all improve with better sleep and deteriorate when our sleep quality does, while poor sleep quality will make them worse. 

Can sleep problems be fixed?

Better sleep can radically improve your quality of life, so I hope so!

Whether you're an autistic adult or the parent of an autistic child, you may try to:

  • Evaluate stress levels and see if depression or anxiety play a role in poor sleep. In this case, therapy can help. Autistic adults may decide to try to remove stressors, introduce stress-relief techniques, and make positive changes before they seek therapy, of course, 
  • Rule physical medical issues in or out with the help of a medical exam. 
  • Eliminate more easily fixable barriers to good sleep — maybe a weighted blanket, white noise machine, more comforting bedtime routine, meditation, blinds that shut out lights from outside, a different bedtime, and other similar changes can help. 

Anecdotally, some autistic people report that practicing meticulous "sleep hygiene" has been helpful in allowing them to achieve better sleep, as well. Committing to a screen-free wind-down routine before bed, having a nice shower, making sure you are properly hydrated, and going to bed at the same time each day can all help some people. To get up on time, tips like making sure you cannot reach the alarm from your bed, giving yourself time to wake up without the need for social interaction, and setting up a strict routine can be beneficial. 

In some cases, melatonin supplements will be very helpful in allowing autistic people to fall asleep more easily and stay asleep for longer, ultimately improving the duration and quality of sleep. 

If the changes you've tried to make on your own haven't helped and you're still suffering from a lack of sleep, that's bound to affect every single thing you do during the day, too — your mood, ability to cope, and performance are all going to suffer. You are ultimately going to want to get to the bottom of the cause of your sleep dysfunction and find a solution. Your family doctor is a good first step, whether anxiety is the cause of your poor sleep and you could do with cognitive behavioral therapy, or you have a physical problem that would benefit from medication or surgery. 

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