Have you ever walked into your child’s room to find them sleeping on the floor? I mean, you put them in bed, and you find them curled up on the floor. Or, if you’re like me, you feel like your autistic child is sleeping too much.
Raise your hand if you’re a huge fan of sleep. [raises hand wildly] I have always valued sleep and have a history of being pretty militant about bedtimes and sleep.
I recently did an informal poll on my Facebook page, asking parents when they put their 12-year-old to bed based on wake-up times.
I was floored at how late some kids stay up!
ADHD Sleep Disorders
According to a study done by WebMD, as many as 80% of children who have autism or ADHD experience irregular sleep patterns or sleep disturbances. We know that a lack of regular, good-quality sleep can lead to such problems as obesity, diabetes, high blood pressure, and more.
Since Autism Spectrum Disorder (ASD) is a lifelong neurologic condition, this is something I wish the medical community took more seriously.
Having approached my own medical teams with sleep concerns, I know what it’s like to get that shrug and have the doctor say, “Yeah, some kids really have trouble staying asleep.”
First, let me tell you that I am militant about sleep for all family members. I also want to remind everyone that I am not a doctor, nor do I play one on the internet.
Lack of adequate sleep has been linked to everything from obesity, diabetes, heart disease, and more.
Sleep has so many health benefits, including:
- Reduce inflammation, which can lead to cancer.
- Improve memory
- Cell repair–so your body goes through repair and restoration
- Can reduce stress and depression
I mean, think about it. As adults, we feel like crap when we don’t get enough sleep, right? So why would we expect our kids to respond any differently?
Silent Seizures during Sleep
Up to 30% of autistic kids experience seizures. There are many things that I wish I knew about seizures, but one is very important: Seizures can happen during sleep, and you may not know it.
Lack of adequate sleep, or being sleep-deprived, can lower a person’s seizure threshold. What that means is that it’s “easier” for their brain to have seizures when they lack sleep. Many parents are nodding because our kids have had a sleep deprivation EEG done by our local neurologist. They actually require you to deprive your child of sleep because it increases the chances that they will see a seizure during the EEG.
Talk to your neurologist if you have concerns.
Managing sleep can make a huge difference in a child’s overall well-being. Read on to learn more about identifying if your child has sleep issues and how to overcome them.
How to Tell if Your Child Has a Sleep Disorder
Sleep disorders are very common in children with autism—about 40%–80%, actually. That’s huge!
But it should offer parents some consolation in knowing they are not alone.
How Much Sleep, by Age
First, here is a guideline for how much sleep your child should get.
- Ages 1-3: 12–14 hours
- Ages 3-6: 10–12 hours
- Ages 7-12: 10–11 hours
Signs of Irregular Sleep Patterns or Sleep Disturbances
- Sleeps less than normal (time includes naps)
- Has difficulty falling asleep
- Stays up very late or wakes up very early
- Gets up in the middle of the night to play for an hour or more
- Has disturbed sleep: tossing and turning, head-rolling
- Has difficulty breathing while asleep, snoring, etc.
- Very tired during the day despite (seemingly) being in bed all night
It’s a good idea to keep a sleep diary for your child. It would help keep track of their sleeping patterns and disturbances. This information can be used by your doctor to help with a diagnosis. Push for a sleep study or EEG if you suspect seizures! They can be happening without you seeing them.
Autism and Its Effects on Sleep
Researchers are just beginning to uncover how autistic individuals differ neurologically when it comes to sleep.
But, if a child is neurodiverse, and processes stimulation differently during the day, why would we think that it would be any different in the overnight hours?
Seek Professional Help for Autism and Sleep
The first thing you want to do is reach out to your child’s pediatrician. They may refer you for a sleep study, or ask for one.
A sleep study is often a joint effort between a pulmonologist (who handles sleep apnea) and a neurologist (will evaluate the brain’s activity).
If you are referred for a sleep study, it is likely they will ask you for a sleep diary. I have provided a free printable sleep tracker at the bottom of this post for you to get started. You can print it today and start working on it while you’re waiting for your appointments.
What causes sleep problems with autism?
First, you want to rule out anything medical. As stated above, please rule out anything medical. Many people don’t know this, but there are about 40-50 different types of seizures. Many of them happen while a child is sleeping. There is even a phenomenon known as ESES, which is a type of sleeping seizure activity.
Not all seizures are the “grand mal” kind we think we know. Many are invisible, except on an EEG or sleep study. Approximately 30% of autistic individuals also have some kind of seizure activity.
I can’t stress enough how important it is to get this checked out. Please follow up on it.
Also, if your child has global hypotonia, that means they have low muscle tone everywhere–INCLUDING their breathing passage. Low tone can lead to sleep apnea.
Sleep and Sensory Issues
During the day, our kids process information and sensory input differently than we do. This would include their interoception. (click that link if you don’t know what interoception is.)
So, even while lying in bed at night, it would make sense that they are still processing information differently than we do. Some examples could be:
- The hum of a ceiling fan or furnace may be unbearably loud.
- They may be too hot, too cold, or too uncomfortable.
- Some kids need closure and cannot rest until a particular activity has been completed.
- They may feel and hear things we typically can ‘tune out,’ but they do not have that skill set.
In addition, our kids’ neurodiversity doesn’t end at 9:00 every night. My child actually stims in his sleep and always has. Looking back on my pregnancy, he never stopped moving.
You’ll never convince me that he wasn’t stimming in utero.
- They may struggle with the transition from active to inactive.
- The quiet time may bring anxious fears to the surface (like it does with many adults)
- My child does some of his stereotypy even while sleeping—active hand and body movements I see during the day.
My Autistic Child is Sleeping Too Much
Our bodies require a certain amount of sleep to perform adequately. The specific requirement varies by age, health status, and other factors.
Some people are just wired to require less sleep. It is rumored that people like Martha Stewart and Apple CEO Tim Cook only sleep 4 hours a day.
Autism and Sleep
My son sleeps 12 hours a day, 7-7, daily. And he’s a teenager. We’ve tried a lot of different things and have seen many specialists. This is largely due to poor quality of sleep, so his brain is trying to get more.
Here are some tips to get you started with some autism sleep help.
What Causes Sleep Disorders?
First, you want to talk with your pediatrician or neurologist (or developmental ped) about sleep issues and rule out anything medical. Sleep apnea and other disturbances can happen even if you don’t hear snoring. Before getting a sleep study done on your child, your doctor may recommend that you keep a sleep diary. So I would do that before you ask, so you already have it out of the way.
These are some factors that might be causing a child to have troubled sleep.
- Daytime habits
- Not getting enough physical activity during the day
- Taking long naps (more than 20 minutes) late in the day
- Eating too much dinner and/or eating too late in the evening
- Consuming caffeine or sugar in the evening
- Bedtime habits
- Exposed to a lot of noise and activity before bed
- Doing something different every night
- Falling asleep on the couch or parents’ bed
- They need to put a lot of toys beside them on their bed
- Having a bedroom that is too hot or cold, noisy, or has too much light
- Social and mental health challenges
- Not being able to say or ask what they want or need, which keeps them up
- Anxiety about certain issues or incidents
- Not noticing social cues, like not understanding that it is bedtime when people start preparing for bed.
- Melatonin imbalance
- Not releasing tryptophan, an amino acid that makes melatonin, during the night
- Producing melatonin during the day makes them sleepy
What Are the Effects of Having Sleep Disorders?
Children with ASD who have a poor quality of sleep tend to behave differently than they normally would. They can be a handful and unruly.
You might think that they are just like that, but in reality, they just might not be getting enough good sleep at night.
Here are some of the effects that you can see when your child has sleep disorders.
- Shows signs of aggression – It’s normal for people who lack sleep to be irritable. If your child is grumpy and petulant, it may be the effect of not having enough sleep.
- Shows signs of depression – Since there is an imbalance of chemicals happening in their brain, it may cause them to feel unhappy and stressed.
- Displays hyperactivity – If your child is unable to keep his attention on one thing, is fidgety and seems like he has to do something all the time, he might be experiencing hyperactivity.
- Performs poorly in class – Since your child is hyperactive and can’t concentrate on lessons, he is not learning and is unable to follow instructions for the activities. This results in poor learning and bad grades.
- Cognitive issues-Insufficient sleep is linked to poor memory skills and much more. School performance may improve if you can improve their sleep.
If your child is experiencing sleep disorders, chances are, you are not getting quality sleep either.
How to Help Your Child Get Better Sleep
You don’t really need to spend a fortune on medications and therapies for your child to get better. In fact, you can do everything right at home. All you need is patience and persistence to do it every day.
The most important thing to do is build a routine.
- Keep a daily schedule
- Determine the time when your child needs to sleep and wake up.
For example, your child is a 5-year-old who needs 10–12 hours of sleep. He has to be in school by 8 AM. It takes him over an hour to prepare in the morning. This means that he has to be up at 6 AM.
To get at least 10 hours of sleep, he has to be in bed by 8 PM every night, even on days without school.
Move your child’s bedtime to the ideal time.
When you start this new schedule, your child’s sleepy time will likely differ. What you should do is gradually increase the time he goes to bed. Every 2 days, adjust the time by 15 minutes until you reach the ideal bedtime.
Having a fixed bedtime every day can help your child fall asleep faster.
Daytime Habits to Improve Sleep
Start the day by giving your child a healthy breakfast or a smoothie with fruits, milk, and yogurt.
Just like plants, he needs bright sunlight in the morning to stop his body from releasing melatonin, the hormone that makes him sleepy. This should keep him alert in school.
Ensure your child gets ample exercise throughout the day; about 3 to 4 hours of physical activity is awesome but not reasonable for most households. Aim for 60 minutes and go from there. You can find ideas and resources on the Play 60 website.
Avoid candies, chocolates, soda, coffee, tea, or energy drinks from late afternoon onwards. These contain caffeine and sugar, which keep us awake at night.
Bedtime Habits to Improve Sleep for Kids
- At least an hour before bedtime, no more stimulating activities like running around, watching TV, and playing video games.
- Use heavy curtains and thick carpets, and set the thermostat at 60 to 67 degrees Fahrenheit (15.6 to 19.4 degrees Celsius).
- Place the clock somewhere your child will not be able to look at it while in bed.
- Create a nighttime routine: bathing, brushing his teeth, reading a book, etc. Institute a “relaxing diet,” much like a sensory diet, in the evening. You can do this by reading a book, practicing deep-breathing exercises, playing soft music in the background, and giving a gentle massage.
- Monitor your child’s sleep. Ensure there is no snoring, he can breathe normally, and he’s not tossing, turning, or sleepwalking.
Consider creating a “calming corner” in your child’s room.
While it might seem silly, think outside the box. If worries are keeping your child up at night, think about something like a worry doll. You never know what might work!
If his sleep is disturbed during the night, patiently put him to sleep by repeating the bedtime routine.
Keeping a routine will help your autistic child get a good night’s sleep and improve his overall well-being. After just 2–3 nights of following a routine, improvements can often be observed. If you don’t see immediate results, don’t fret; for some children, it may take 2-4 weeks or even longer.
However, if your child still hasn’t improved after 4 weeks, it is better to consult your family doctor or pediatrician for help.
But our kids may be experiencing things during the day (and at night, too!) that make them more tired than the average person.
- If a person has ARFID or a very selective diet, nutritional deficiencies may make them more tired than usual. Ask your pediatrician or an RD about this.
- Seizures during the day or night make a person more tired than usual.
- Dehydration can make you tired. Encourage water consumption during the day.
- Just “being” you; when you have autism and have to work extra hard either to process information or filter out information can make you tired.
- Low muscle tone, a lack of fine motor skills, and other physical issues mean it takes more work to get through the day, and you’ll be more tired at night.
Sleeping on the Floor
My son loves sleeping on the floor and often resists moving to the bed. I have noticed that when he is asleep on the floor, he hardly snores at all. Whereas, in bed, he snores a lot. He’s had multiple sleep studies and refuses to wear a CPAP.
He knows that he gets better sleep when he’s on the floor, and I can’t argue with him. He does. We’ve purchased special pillows, special mattresses, and a flat board instead of a box spring. He still prefers the floor.
As best as they can communicate, ask them why they prefer the floor. See what you can replicate with a firmer mattress, different kinds of pillows, more/less/different blankets and so on. Maybe try a futon or a thick yoga mat-like pad on the floor.
And if everything else fails…who cares? As long as the floor is clean, safe, and comfortable for them, does it really matter?
Autism Sleep Help
Look, I don’t want to give you the same tired information of “make sure you have a bedtime routine” and stuff like that. But the truth is, a lot of that stuff can work. It also can backfire.
I remember when K was small, I had this Putumayo Dreamland CD.
It was calming music I’d put on to bring him to a calm level and get him ready for sleep. When he was in a ‘resist bedtime’ phase, whenever I’d put that CD on, he’d howl, scream, and throw a fit.
It wasn’t calming at all to him—it signaled that bedtime was coming and he didn’t want bedtime.
Still, I would try everything out there in addition to seeing specialists.
- See a doctor and specialists to check out the possibility of sleep apnea and seizures.
- Always ask your doctor before trying herbal supplements like melatonin and chamomile, especially if they take other medications. They may have dangerous interactions with your child.
- Try a routine, but use your child’s input as much as possible. What calms them?
- Make fresh air and outdoor activity a part of your daily routine.
- Limit screens for 90–120 minutes before bedtime. Blue light from screens can affect REM sleep.
- In addition to the sleep tracker, keep a diet diary so you can look for food interactions. Some food additives and sugars can affect sleep.
- Work with a GI doctor if your child has GI issues. An uncomfortable GI system and full bowels can disrupt sleep.
- Sure, browse online for things like special pillows, sleepy time lights, music, and stuff like that. But, first, don’t bankrupt your family by trying things. Second, know that some things, like a weighted blanket can cause pain rather than comfort.
- Use your child’s input to the maximum extent possible; they know what is comfortable for them.
Most importantly… allow yourself to think outside the box. Look, I love my bed, my flannel sheets, and my down comforter.
But not everyone loves what I love, or is comfortable sleeping the way I sleep.
We all have preconceived notions of what comfortable, soothing sleep “should” look like. If I could replicate my son’s comfort and sleep position in his bed, I would. But the positioning he uses to sleep on the floor would put him at severe suffocation risk if we replicated it on the bed.
So, I leave him on the floor.
I know of some kids who sleep with noise canceling headphones on. I had a client who preferred to sleep with his shoes on.
What matters is that they are comfortable and getting enough sleep.
“Let it Go” Method
It’s hardly ideal, but we have done this a few times over the years. First, we stuck to all of our nighttime routines. But we also did a few other things.
I made sure that all toys that make noise were either turned off or removed from the room.
I also have a video monitor to keep an eye on him during the night (mostly for seizures). But, then I used a baby gate and let him go in his room.
If he wants to wake up in the middle of the night and look at books in the dark, and he falls asleep on the floor (usually what happens) then so be it. I just made sure he is safe, keep an eye on him with the monitor, but I don’t fight it.
Getting up in the middle of the night a zillion times and returning him to his bed was making us both nuts. Sometimes his nighttime waking happens a few days in a row, sometimes it lasts a few weeks.
But, I just make sure that he’s safe and let it go. I always tell his team when he’s going through one of these spells in case he has extra seizures due to sleep deprivation or is cranky and irritable.
Good luck and hang in there!
Printable Sleep Tracker
Here you go, print as many as you need! This will be helpful for when you go visit specialists.
ADHD Sleep Disorder: Causes, Symptoms, and Treatment
Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects an estimated 10% of children and 4% of adults in the United States. One of the most common side effects of ADHD is sleep disorder.
Understanding ADHD Sleep Disorder
The symptoms of ADHD sleep disorder include difficulty falling asleep, staying asleep, and waking up. People with ADHD may also experience restless sleep and nightmares. These sleep problems can lead to daytime sleepiness, fatigue, and difficulty concentrating.
The diagnosis of ADHD sleep disorder can be challenging because the symptoms of ADHD and sleep disorder often overlap. A healthcare provider may use a combination of physical exams, sleep studies, and questionnaires to diagnose ADHD sleep disorder.
Circadian Rhythm Disruption
People with ADHD sleep disorders often experience a disruption in their circadian rhythm. The circadian rhythm is the body’s internal clock that regulates sleep and wake cycles. Disruption of the circadian rhythm can lead to difficulty falling asleep and staying asleep.
Research has shown that people with ADHD have a delayed circadian rhythm, which means that they tend to stay up late and have difficulty waking up in the morning. This delayed rhythm can make it difficult to maintain a regular sleep schedule, which can worsen the symptoms of ADHD.
Understanding the symptoms and diagnosis of ADHD sleep disorder, as well as the disruption of the circadian rhythm, is crucial for proper management of this condition.
There are several treatment strategies for managing ADHD sleep disorder. These strategies can be divided into three categories: Behavioral Interventions, Medication and Supplements, and Lifestyle Modifications.
Behavioral interventions can be an effective way to manage ADHD sleep disorder. These interventions include cognitive-behavioral therapy (CBT), sleep hygiene practices, and relaxation techniques. CBT can help individuals with ADHD understand the relationship between their thoughts, behaviors, and emotions and how they impact sleep.
Sleep hygiene practices involve creating a sleep-conducive environment, such as keeping the bedroom dark, quiet, and cool. Relaxation and mindfulness techniques like deep breathing, meditation, and progressive muscle relaxation can help individuals with ADHD relax and fall asleep faster.
Medication and Supplements
Medication and supplements can also be used to manage ADHD sleep disorder. Stimulant medications like methylphenidate and amphetamines can improve ADHD symptoms and help individuals with ADHD fall asleep faster. However, these medications can also cause insomnia, so they should be taken earlier in the day.
Melatonin supplements can also be effective in helping individuals with ADHD fall asleep faster and stay asleep longer. However, it is important to talk to a healthcare provider before taking any supplements.
Lifestyle modifications can also be effective in managing ADHD sleep disorder. These modifications include regular exercise, avoiding caffeine and nicotine, and establishing a regular sleep schedule. Regular exercise can help individuals with ADHD fall asleep faster and improve the quality of their sleep.
Avoiding caffeine and nicotine, especially in the evening, can also help individuals with ADHD fall asleep faster. Establishing a regular sleep schedule can help individuals with ADHD regulate their sleep-wake cycle, making it easier to fall asleep and wake up each day.
Managing ADHD sleep disorder requires a comprehensive approach that addresses all aspects of sleep hygiene. By combining behavioral interventions, medication and supplements, and lifestyle modifications, individuals with ADHD can improve the quality of their sleep and reduce the impact of ADHD on their daily lives.
Impact on Daily Life
Individuals with ADHD often experience sleep disturbances that can have a significant impact on their daily lives. This section will explore the effects of ADHD-related sleep problems on learning and work, as well as their social and emotional implications.
Effects on Learning and Work
Sleep deprivation and other sleep-related issues can hurt an individual’s cognitive abilities, including memory, attention, and decision-making. This can make it difficult for individuals with ADHD to perform well in school or at work.
According to a study published by the National Institute of Mental Health, sleep-deprived individuals with ADHD have a harder time completing tasks and are more likely to make mistakes than those who are well-rested.
Social and Emotional Implications
Sleep problems can also have social and emotional implications for individuals with ADHD. Chronic sleep deprivation can lead to irritability, mood swings, and difficulty regulating emotions. This can make it harder for individuals with ADHD to form and maintain relationships with others.
In addition, sleep problems can exacerbate existing symptoms of ADHD, such as impulsivity and hyperactivity. This can make it even harder for individuals with ADHD to control their behavior and make good decisions.
The impact of sleep problems on individuals with ADHD can be significant. It is important for individuals with ADHD to seek treatment for their sleep problems to improve their quality of life and reduce the negative impact of ADHD on their daily functioning.
Frequently Asked Questions
What strategies can help people with ADHD improve their sleep quality?
Individuals with ADHD can take several steps to improve their sleep quality. Experts recommend establishing a consistent sleep schedule, avoiding stimulants such as caffeine and nicotine before bedtime, and creating a relaxing bedtime routine.
Maintaining a comfortable sleep environment is also important, which may involve adjusting the temperature, reducing noise and light, and using comfortable bedding. Additionally, regular exercise and exposure to natural light during the day can help regulate sleep patterns.
How does ADHD medication influence sleep patterns?
ADHD medication can have both positive and negative effects on sleep patterns. Stimulant medications, such as methylphenidate and amphetamines, can make it more difficult to fall asleep and stay asleep, especially if taken late in the day. However, some non-stimulant medications, such as atomoxetine and guanfacine, may improve sleep quality. It is important to discuss any concerns about medication and sleep with a healthcare provider.
Can ADHD lead to sleep disorders such as sleep talking or sleep walking?
ADHD does not directly cause sleep disorders such as sleep talking or sleep walking. However, individuals with ADHD may be more prone to these conditions due to their hyperactive and impulsive behavior. Sleep talking and sleepwalking are both considered parasomnias, which are abnormal behaviors that occur during sleep. Treatment for these conditions may involve addressing underlying sleep disorders or implementing behavioral interventions.
What is the connection between ADHD and experiencing vivid dreams or nightmares?
There is some evidence to suggest that individuals with ADHD may be more likely to experience vivid dreams or nightmares. This may be because ADHD can disrupt the normal sleep cycle, leading to more frequent awakenings during the night.
Additionally, some medications used to treat ADHD may affect the content and frequency of dreams. However, more research is needed to fully understand the relationship between ADHD and dreaming.
How does sleep paralysis affect individuals with ADHD?
Sleep paralysis is a condition in which a person cannot move or speak while falling asleep or waking up. Although sleep paralysis is not directly caused by ADHD, individuals with ADHD may be more likely to experience this condition due to their disrupted sleep patterns. Sleep paralysis can be a frightening experience, but it is generally not harmful and does not require treatment.
What is the relationship between ADHD and delayed sleep phase syndrome?
Delayed sleep phase syndrome (DSPS) is a sleep disorder in which a person’s sleep-wake cycle is delayed by several hours, making it difficult to fall asleep and wake up at desirable times. Although ADHD is not a direct cause of DSPS, individuals with ADHD may be more prone to this condition due to their difficulty regulating sleep. Treatment for DSPS may involve implementing strict sleep schedules, using bright light therapy, and taking melatonin supplements.