By guest writer Jackson McMahan
From childhood to adulthood, many autistic people often find themselves struggling to fall asleep. Sleep problems can be a frustrating part of having autism because they lead to situations like spending an hour (or three!) falling asleep, or waking up in the middle of the night and being unable to fall back asleep. I know from my experience as an autistic person with sleep problems that there have been many nights I wasn’t able to fall asleep until 5 or 6 a.m. – if at all.
Although everyone has the potential to have trouble falling asleep, it has been noted that autistic people in particular can be vulnerable to sleep issues. One study found that 64 percent of subjects from the autistic group reported having poor sleep quality compared to 46 percent in the comparison group.
With good quality sleep elusive for many autistic people, it raises questions like why so many autistic people have trouble falling asleep, what impact it can have on their health, and how they can manage their sleep problems. With this blog post, I aim to answer these questions.
Evidence for Sleep Problems in Autistic Adults
Quality sleep is characterized by falling asleep in 30 minutes or fewer once you get into bed, spending at least 85 percent of your time in bed asleep, waking up in 20 minutes or fewer, plus getting enough sleep for your chronological age. Any deviation from these standards would indicate problems with sleep.
Research has indicated that autistic individuals are more likely to experience sleep problems than their neurotypical peers.
One study measured different aspects of sleep and found that autistic adolescents and young adults had more difficulty transitioning to bed and took longer to fall asleep compared to typically developing peers. Another study showed that even when sleep issues are less frequently reported by autistic teens and young adults, there are objective measures showing that their childhood difficulties with sleep continue. They have just adapted better to them over time.
Research shows many autistic individuals have sleep-wake cycles and melatonin and cortisol profiles that differ from the neurotypical population, which may contribute to their sleep challenges. Their internal body clocks may be misaligned, leading to difficulties in falling asleep and waking up at appropriate times.
Many autistic individuals have co-occurring conditions that make it harder to achieve and maintain quality sleep. Some of these include anxiety, depression, attention deficit/hyperactivity disorder (ADHD), and sensory processing disorder (SPD).
Finally, sensory sensitivities may be contributors to sleep challenges. Heightened sensory sensitivities, especially to noises, lights, or even textures can make it challenging to relax and fall asleep.
Consequences of Sleep Problems on Autistic Adults
Regardless of what causes an autistic person to have sleep problems, it can have a profound impact on quality of life. Research shows that sleep benefits our cognitive functioning, mood, mental health, and cardiovascular, cerebrovascular, and metabolic health. In other words, healthy sleep is necessary for us to be both physically and mentally healthy. Therefore, being unable to get enough sleep will cause problems that prevent us from functioning at our best.
It is notable that sleep problems affect autistic adults’ quality of life differently than how they typically affect people without an autism diagnosis. One study found that autistic adults with poor sleep quality and high stress levels experience worse quality of life than non-autistic adults with similar sleep quality and stress levels.
How to Improve Quality of Sleep
Although sleep problems are annoying to deal with, there are thankfully many strategies available to improve the quality of sleep. What helps neurotypical people improve sleep quality often helps autistic people, but some of these tips will have an even greater positive impact if you are autistic. Let's dive in!
Establish a Consistent Sleep Schedule
Having a set time to wake up is the most important thing you can do to regulate your body’s internal timer. It's even more important than the time you go to bed. By maintaining a regular schedule, your body will better be able to register when it’s time to fall asleep and when to wake up. Just remember to make sure your sleep schedule allows you to get the required amount of sleep someone your age needs.
Create a Sleep-Friendly Environment
If your sleeping space is too light, loud, or warm, this can seriously impact sleep. Improving your environment to make it more sleep-friendly can improve your sleep. Try experimenting with light-blocking curtains, ear plugs (if you can tolerate them), or a white noise machine. You can also try making the room cooler to see if this helps.
You can also do things that make the environment feel more relaxing like using lavender essential oil in a diffuser. When you enter the room, this will help cue your brain that it's time to relax.
Manage Sensory Sensitivities
Neurodivergent people can have sensory sensitivities that can contribute to poor sleep. If you find yourself having trouble sleeping because of sensitivities, consider changing your bedding materials or pillow to find a different one that makes falling asleep easier. Many find weighted blankets a huge help. Experiment and figure out what works best for you.
Use Relaxation Techniques
Relaxing before falling asleep is another commonly cited way to improve your sleep. For example, you can spend a few minutes meditating before going to bed. The benefit to using one of these techniques is that they allow you to enter a more relaxed state. This in turn can make falling asleep easier. Relaxation techniques, like deep breathing and progressive muscle relaxation, can even be used while trying to fall asleep.
Exercise Regularly
Exercising during the day can help tire you out before going to bed. Figure out a timeframe where you can head outside and engage in physical activity like running or even just walking steps around your neighborhood. Just remember to avoid exercising a few hours before going to bed as that can make you energized instead of making you sleepier.
Limit Exposure to Electronics Before Going to Bed
We live in a day and age where we can find ourselves spending hours a day looking at a screen. It can be staring at our computers for work, our TVs for entertainment, or our phones for looking at messages. This means our eyes are often exposed to blue light, which is emitted from screens.
Although blue light is noted for having some positive effects like helping our reflexes, it also has a negative effect on our ability to sleep since the light affects our circadian rhythms and ability to produce melatonin. Because of this, it is advised to limit exposure to electronics before going to bed.
Thankfully, we do have some control over how much blue light our eyes are exposed to. If you must use your computer or phone at night, there are settings that let you filter out the blue light emitted by them during certain hours of the day. Just Google how to enable a blue light filter on your specific device.
Minimize or Avoid Stimulating Substances
Substances like caffeine, alcohol, and tobacco can interfere with our sleep patterns, so it is better to minimize or avoid using them altogether. If you find yourself needing to drink coffee or some other caffeinated beverage, remember to only drink those in the morning because the effects of caffeine can stay with you for up to ten hours.
Create a Bedtime Routine
Bedtime routines are a chance to perform actions that tell your brain that it’s time to go to bed. For autistic people in particular, since many people on the spectrum like having routines they can follow, a bedtime routine allows them to have a comforting ritual they can follow before falling asleep.
There are many ways you can construct a bedtime routine, so planning one can be a flexible process. To use myself as an example, I like to read for half an hour before I prepare for bed.
What is important to remember about constructing a bedtime routine is that you need to make sure what you do will allow you to fall asleep more easily. For example, you shouldn’t exercise within a few hours of bedtime because that will make you more energetic, not less.
Try Cognitive Behavioral Therapy for Insomnia
Cognitive behavioral therapy for insomnia (CBT-i) was created by the U.S. Veterans Administration (VA) and is an evidence-based intervention for treating insomnia without medication. The VA recognized the prevalence of insomnia among veterans, particularly those with post-traumatic stress disorder (PTSD) and other mental health conditions.
Traditional approaches to treating insomnia often rely heavily on medication, which may not be suitable for everyone due to potential side effects and the risk of dependency. Additionally, medication alone does not address the underlying causes and behavioral patterns contributing to insomnia. Not to be confused with regular cognitive behavioral therapy (CBT), CBT-i aims to change thoughts and behaviors that interfere with getting quality sleep.
Consult a Healthcare Professional
If you find that none of these suggestions are working, then you may want to contact a healthcare professional that specializes in sleep disorders. The healthcare professional should be able to provide advice that’s personalized to your needs and explore other treatment options.
Conclusion
In conclusion, sleep problems are a common challenge for many autistic individuals, affecting their ability to fall asleep and stay asleep. Research has shown that autistic people are more likely to experience sleep issues compared to their neurotypical peers. These sleep problems can have a significant impact on their overall well-being, including cognitive functioning, mood, mental health, and physical health.
Fortunately, there are various strategies that can help improve the quality of sleep for autistic individuals. Establishing a consistent sleep schedule can regulate the body's internal clock and promote better sleep patterns. Creating a sleep-friendly environment by adjusting lighting, sound, and temperature can also enhance sleep quality. Additionally, incorporating relaxation techniques, managing sensory sensitivities, and avoiding stimulating substances can contribute to better sleep.
It is important to recognize that each individual may respond differently to these strategies, and it may take some trial and error to find the most effective approach. Seeking guidance from healthcare professionals, including sleep specialists or mental health counselors experienced in sleep disorders, can provide personalized advice and explore additional treatment options.
By addressing sleep problems in autistic individuals, we can improve their quality of life, enhance their overall health and well-being, and support them in reaching their full potential. Sleep is a fundamental aspect of human functioning, and by prioritizing good sleep hygiene, we can make a positive impact on the lives of autistic individuals.