How to Promote Sleep in Children on the Autism Spectrum

If your child is having difficulty falling asleep, evaluate your family's bedtime routines and habits. Your child's bedroom should be dark (use a night light if needed), cool, and unexciting. If possible, your child's play space should be in a location other than the room used for sleeping. You want your child to associate their bedroom with sleep, not play.

Have a well-structured routine at bedtime. Many families find that calming activities before bed help promote sleep, for example, a quiet bath, relaxing bedtime story, soft music, or massage.

Also, don't neglect what your child does during the day. Being exposed to bright outdoor light and physical activity, especially in the early morning, will help a child fall and stay asleep at night. However, cognitive and sensory over-stimulation, especially occurring close to bedtime, can cause increased arousal and anxiety, which may carry over throughout the day, including bedtime. Avoid all electronics, such as TV, video games, iPods®, etc. before bedtime, because this stimulation can cause your child to have trouble falling asleep.

A sleep schedule is critical. The bedtime routine should be about the same each night and there should be no more than one hour difference between bedtime on weekends and weekdays. The actual bedtime routine should begin 20 – 40 minutes before the set bedtime. The bedtime routine should also be done in the same order nightly. Some children benefit from a visual schedule with pictures and/or words to remind them of the routine.

To help monitor your child's sleep habits, keep a sleep diary. A sleep diary should include the days of the week, the time your child goes to bed, the time your child falls asleep, when your child is asleep, and whatever anecdotal events may play a role in your child's ability to sleep. This will make you more aware of your child's routines and perhaps alert you to changes that need to be addressed.

Children should learn to fall asleep alone. If your child leaves the bedroom after being put to bed, you might institute a token reward system. Start with a system that allows your child to feel like he or she still has some control over bedtime. For example, provide a bedtime pass exchangeable for one excused departure from the bedroom after bedtime. If you do need to return to your child's room after putting him or her to bed, make your returns brief, avoid eye contact, and limit physical contact.

Additional Resources:

• Autism Speaks® Sleep Tool Kit, Containing Sample Sleep Diary