Children with autism frequently struggle to sleep due to difficulties falling asleep, frequent awakenings during the night and restless restlessness. These issues could be caused by various factors.
Sensory issues, lack of melatonin production and coexisting mental health conditions such as anxiety can all pose challenges to mental wellness. This article will explore these issues as well as provide ways of managing them effectively.
1. Sensory issues
Sensory challenges, which affect many children with autism, can interfere with sleep. Sensory issues may be triggered by various sounds, lights, smells or textures and could result in discomfort or meltdowns that prevent restful restorative sleep for proper management of mood and behavior management. They may also interfere with circadian rhythms because certain stimuli signal to the body when it is time to wake up or go to bed.
Sensory processing issues typically take the form of oversensitivity (hypersensitivity) and undersensitivity (hyposensitivity). Children who exhibit hypersensitivity may avoid sensory input because it overwhelms them; those with hyposensitivity, however, seek sensory stimulation even though it causes discomfort – with many children with autism experiencing both forms of responses simultaneously.
Studies have established the connection between poor sleep and differences in sensory integration/processing and sensory processing differences, but also differing measures of sensory integration/processing differences and sleep problems, using different measures of each. Furthermore, correlations rather than causation were used. For instance, Short Sensory Profile has strong correlations with sleep disturbance scores for control children; however this measure only accounts for 1-6% of variance variance in autism cases.
Over time, children with sensory issues develop strategies to adapt and deal with these challenges. This may involve shutting down, avoiding situations which might trigger sensory overload or using strategies that help manage sensations they’re experiencing; such as licking or tasting objects to gain more of an idea of their texture, or wearing sunglasses and hats when outdoors.
Sensory issues aren’t officially recognised in the DSM-5, though experts do believe it may be part of autism spectrum disorder. Most doctors don’t treat sensory issues alone but as part of overall treatment for an diagnosed condition; they believe sensory processing issues may worsen other mental health conditions, including anxiety and depression; research is ongoing into finding treatments.
2. Anxiety
Autistic individuals may struggle to sleep soundly due to anxiety related symptoms like fear of failure and physical discomfort, which often disrupt their sleeping cycles. Once asleep, their thoughts might be interrupted by sensory input from outside or snoring from family members; depression symptoms that are common among autism individuals may also impede sleeping patterns, and certain medications can have side effects which interfere with restful rest.
People with autism are at an increased risk for sleep disturbances than the general population, particularly insomnia, which is one of the primary issues impacting autistic people. Difficulties falling or staying asleep is among the primary concerns, often leading to feelings of fatigue during the day and inability to concentrate, so ensuring enough restorative rest at nighttime is vitally important.
Sleep difficulties among those living with autism remain unclear, although behavioral aspects, biology and co-occurring conditions may all play a part. According to experts, children may experience sleep disturbances because they’re unable to pick up social cues in their environment – such as light levels and circadian rhythms – that indicate it’s time for bed. They might also struggle with sensory sensitivities and stimming behavior which make settling down difficult.
Research has also demonstrated that those with autism tend to spend less time in REM sleep compared to neurotypical people, which can have detrimental ramifications on both mood and functioning. Since restorative sleep plays an essential role in memory processing and learning processes, this lack of restful REM can negatively impact both mood and functioning.
Behavior treatments for people with autism who experience insomnia include relaxation techniques, exercise, dietary modifications and cognitive behavioral therapy. Medication to treat anxiety, depression or ADHD may also be prescribed by medical professionals in order to assist with sleep problems; in severe cases a sleep study may also be conducted in order to monitor brainwave activity for eight hours and identify what’s causing their restless nights.
3. Circadian rhythms
Studies linking circadian rhythm disruption with autism are numerous; one recently conducted suggests it may alter behavioral responses differently in people with autism than previously believed: by altering how they respond to certain stimuli.
This research, published in Translational Psychiatry on October 3rd, used accelerometer data to estimate sleep-wake patterns among over 200 adults with autism. Researchers discovered that both sleep duration and insomnia traits, which include difficulty falling asleep or waking up during the night, were related to behavioral traits; however, the most significant associations were between behavior and motor activity: higher daytime and nighttime motor activity was linked to more thought problems, aggression, and restricted behavior.
Researchers speculate these behaviors may be tied to abnormal sleep-wake cycles in those with autism, potentially hindering their ability to process environmental cues that help entrain their circadian rhythms. Furthermore, duplicating FMR1 (Fragile X Mental Retardation Protein) was associated with autism; further supporting their theory that disrupted circadian rhythms contribute to many symptoms associated with autism such as cognitive deficits and social impairments.
But they were surprised to discover that duplicating or deleting a sleep risk gene didn’t significantly increase insomnia risk and only marginally raised odds of more than two thought problems. Furthermore, a linear regression analysis of sleep duration and insomnia traits indicated that individuals with the 16p11.2 deletion (which encompasses several circadian pathway genes) experience 22 minutes shorter sleep per night than their counterparts without it.
Researchers continue to explore the relationship between sleep and behavior in individuals with autism, and some behavioral traits are predictive of whether they display certain responses (such as withdrawal or aggression). Yet the relationship is complex, possibly including bidirectional effects. For example, some may suffer from anxiety issues which make sleeping harder while others use medications which disrupt it, leading to disruptive behaviors and disruptive sleep cycles.
4. Sleep apnea
People with autism often struggle to fall asleep quickly and frequently wake up during the night, leaving them exhausted throughout the day and making concentration or completion of tasks difficult. Sleep-disordered breathing could also present itself, leading to symptoms and problems in life.
One study suggests maternal sleep apnea during gestation may contribute to autism in male offspring, particularly male rats exposed to intermittently low oxygen levels at rest during their second half of gestation developed autism-like behavioral changes in their offspring such as impaired cognitive and executive functions, abnormal juvenile communicative vocalizations and grooming behavior – changes which correlated with changes in brain structures like the hippocampus and prefrontal cortex.
Recent research suggests that obstructive sleep apnea is more prevalent among children with autism spectrum disorder (ASD) than among their counterparts who don’t.1 This may be caused by increased inflammation and an inability of the body to heal damage caused by repeat episodes of interrupted breathing during sleep.2 Such effects have been linked with attention deficit hyperactivity disorder (ADHD), social anxiety disorder and reduced sensitivity to sensory stimuli – all traits characteristic of people living with ASD.
Occluded sleep apnea (OSA) causes symptoms like excessive daytime drowsiness and fatigue; it also poses serious health threats like heart disease and stroke, impacting relationships among family, friends and coworkers as well as their quality of life overall.
Sleep disorders in autism may be treated through lifestyle and environmental changes, medications and noninvasive medical testing. Caregivers for autistic individuals should try establishing routines at bedtime, maintaining consistent sleeping schedules and recording their sleeping patterns for better monitoring. If behavioral and environmental adjustments do not improve sleep patterns sufficiently, seeing a doctor for an evaluation might also help – they may identify additional contributing factors like mood stabilizing drugs, reflux issues or medical conditions that inhibit melatonin production as potential culprits.
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