Clinically reviewed by Claire Ellis, M.S., BCBA, LBA, National Director of Training & Development.
From the day a child is born, parents talk to one another and each other about how much sleep their child is or isn’t getting. Good sleep impacts the day tremendously, so it’s no wonder that parents do everything possible to help their children get a good night’s rest. Research has shown that as many as 80% of children with autism spectrum disorder are affected by sleep issues. Inconsistent or inadequate sleep can exacerbate problem behaviors, so establishing a more consistent bedtime routine is worth the effort.
Why Is a Sleep Routine Important?
When a child has a regular bedtime, it creates a sense of predictability in family routines. But it’s not only for Monday through Friday. It’s important that newly established routines carry through seven days a week. When all caregivers are committed and abide by a consistent bedtime routine, a child is more likely to learn the skills to fall asleep & stay asleep without disruption. This is especially important for children with autism, who are frequently most successful with predictable and consistent schedules. Bedtime routines should be short, predictable and expected. School-age children typically need 10-11 hours of sleep, however, there is research that suggests children with autism may need less.
Tips for Children with Autism to Sleep Better
Morning Routine
Waking up at the same time everyday is the best way to get started on a consistent bedtime routine. Opening up the windows from the very beginning of the day will help with this. Also, the wake time should be the same every day, regardless if your child ends up going to bed later the night before. If your child is extra tired, avoid letting them sleep more than one hour later than normal. This could throw off a predictable schedule before the day even begins.
Daytime Routine
What your child does during the day will impact their sleep at night, and how smoothly bedtime does or doesn’t go. First of all, ensure your child gets plenty of physical activity. Whether that’s walking with a parent in the morning, gym class or recess at school, or an after-school sport or activity, moving their body and releasing energy is very beneficial to winding down at night. In the same way, their circadian rhythm will be better when they are exposed to sunlight during the day. Getting outdoors is ideal; but if weather or other conditions don’t make that possible, be sure to open the curtains to allow plenty of sunshine inside your home.
Your child’s entire daily schedule will impact sleep, and that includes mealtimes. Keep meals around the same time every day, and feed your child dinner 2-3 hours before bedtime to allow plenty of time for their meal to settle.
Addressing Naps
Naps can help provide your child with much needed rest, especially during busy summer months, and offset problem behaviors that may occur when a child is tired. Younger children may especially benefit from a short afternoon nap, but by age 5, naps could interfere with nighttime sleep. If your child does need a nap, try ending the nap between 3 and 4 pm. If possible, those naps should also happen in the child’s bedroom, with a similar routine to the one they follow at night. Consistency is key!
Setting Regular Bedtimes
Bedtime should be predictable and short—15 to 30 minutes, and the same each time. If your child tries to lengthen the bedtime routine, try to keep your exit as short and predictable as possible. If you linger, it can only make it harder. Some children may benefit from a visual to-do list of what to expect during a bedtime routine. That way they know that after a bedtime story, their caregiver leaves the room, turns on the sound machine, and turns on the nightlight, as an example. If they know what to expect, it can make following their established sleep routine easier.
The environment itself should be dark, quiet and cool. Temperature can play a part in a restful night’s sleep, so ensure that the room is a comfortable climate. Consider adding a white noise machine or fan for background noise and to drown out any normal sounds that could wake your child. Get curtains if there are outside street lights that peek in. Also, when teaching your child to follow a healthy sleep routine, ensure they are sleeping in their own room, and that they fall asleep alone. The reason this is important is that your child may wake in the middle of the night. By teaching your child to sleep alone from the beginning, they can also fall back asleep in the middle of the night on their own rather than waking a parent.
Establishing a Comfortable Sleep Environment
Pajamas, bedding textures could affect your child’s sleep. Ask your child how comfortable their bedtime feels and check pajamas to make sure there aren’t tags sticking out or scratchy zippers that could irritate them. Find pajamas they like and that have smooth, soft fabrics. Be sure to make changes if you are noticing discomfort. Also, take a look at their bedding, especially with the change of seasons. Summer months they may be more comfortable with light sheets and a quilt. During the winter, your child may like more layers and a heavier duvet cover. These details make a big difference in how successful their nighttime sleep may be.
Making Healthy Sleep Associations
As your family works on adding these sleep tips, keep bedtime soothing, enjoyable and comfortable. Creating healthy sleep associations is an important part of establishing a new and consistent routine. Use a soothing voice, rub your child’s back, and give extra affection so they associate bedtime with love and comfort. When possible, keep the bedtime routine as free from conflict as possible and avoid stressful interactions with caregivers or siblings so that the environment remains a peaceful one conducive to sleep.
Stimulants to Avoid Before Bed
There are specific stimulants to avoid before bedtime that can have physical effects on your child that make winding down for bed difficult. First, your child should avoid caffeine throughout the day, which can drastically affect sleep, but especially 3 to 5 hours before bedtime. Also, do your best to keep their bedrooms free of screens, such as video games or iPads. The bright lights and blue light of those screens can impact their ability to fall asleep and stay asleep.
Most importantly, remember that change takes time. Expect any changes that you make to take at least two weeks before you see change taking hold. Your BCBA at Acorn Health is a great resource to ask more about this information if your child is experiencing sleep issues.
If you are looking for ABA services for your child with autism, please reach out to Acorn Health at 844-244-1818.