Sleep is important for our physical, emotional, mental, and spiritual wellbeing. Sleep exhaustion and deprivation has been scientifically proven to cause depression, anxiety, heart failure, diabetes, stroke, and even death. Sleep deprivation affects concentration, memory, and cognitive function, making mistakes and accidents far more likely. Issues surrounding sleep has been proven to be more common in neurodivergent people, particularly autistic people.
Two scientific theories as to why some autistic people struggle with sleep is due to abnormalities with rapid sleep movement (REM) and melatonin. Some autistic people have reduced REM sleep (associated with dreaming and memory consolidation) and a lack of melatonin in some autistic peoples’ brains means a disruption of circadian rhythm causing some people to feel very sleepy during day and/ or being awake at night/frequently waking up at night. Hypersomnia which is sleeping too much and not feeling refreshed after a long night’s sleep is also common in some autistic people- the reason for hypersomnia is not widely understood but believed could be due to stress, sensory issues, burn out, masking and fatigue. Other issues relating to sleep disturbances amongst autistic people include side effects relating to epilepsy, food intolerances and sensitivities, sensory issues at bedtime and depression and anxiety causing insomnia.
I spoke with E, a mother of two whose oldest child J, 7 has autism.
“We noticed issues with J’s sleep from when he was around 8 months old where he would make repetitive movements, sway and head bang when trying to get himself off to sleep. J would murmur, shout, and sing whilst making these movements. I had mixed feedback from health professionals on this, some saying they had never seen anything like it after showing them video recordings and some saying it was perfectly normal especially in children with autism. We were advised to always keep the baby monitor camera on him and to put cushions down on the floor to stop him from hurting himself. When he was diagnosed with autism at 4 years old, he was prescribed 1 mg per night of melatonin. This helped him get off to sleep but did not help him stay asleep, so he continues to wake up several nights in the night with the same symptoms. We were advised that we could increase the dose up to 6mg per night to see if this helped which it did not even after several months, so we reduced it back to 1mg. We have been told he could grow out of this, however, at 7 years old he continues to have the same issues, however, he has not injured himself, so we are continuing to monitor him before deciding whether this needs further investigating.”
E mentions that an increase of J’s melatonin medication has not helped J stay asleep throughout the night. A journal titled, ‘Melatonin and Comorbidities in Children with Autism Spectrum Disorder’ written by Gagnon and Godbout in 2018 which discusses studies where melatonin is used on animals and humans with physical and metal illnesses.
“The purpose of this review was to highlight the potential effect of melatonin on these health issues. Briefly, animal, and human studies have shown that melatonin improves anxiety and gastrointestinal dysfunction, whereas studies in animals have demonstrated positive results on sensory processing but results in humans are heterogeneous. Anxiety, sensory processing dysfunction/pain, and gastrointestinal problems are known to have a negative effect on sleep. It is thus reasonable to think that melatonin could at least partially draw some of its positive effects on sleep in ASD by acting on these alternative routes.”
I also spoke with another mother, V whose 8-year-old son also has autism,
“B struggles to fall asleep; he also has a lot of anxiety about being alone when asleep too. I have to put on the same song for him every night for him to fall asleep. He wakes up every night at least once and needs the music to settle him once again. Typically, he sleeps from 9:30pm until 6am but if he had the choice, he would wake up earlier.”
V explains that anxiety is causing B’s sleep issues and that listening to the same song on repeat is comforting to him and its also a common form of stimming for some autistic people. Music has been scientifically proven to help with relaxing thoughts, ease of anxieties and improvement of both the quality and duration of sleep.
For parents who are struggling to think of ways to help their child sleep throughout the night, there are some things you can do to help.
· A strict evening routine- which should still be followed during weekends and half terms.
· Bedroom to have sensory lights, music and/or white noise.
· Exercise before bed.
· No caffeine or sugar in the evening.
· No electronics in the evening.
By Alexandra Farnese