Autism and Sleep Disorders - What You Need to Know

by Cara Koscinski MOT, OTR/L April 27, 2017

Autism and Sleep Disorders - What You Need to Know

Sleep is important for health and optimal function throughout the day. We have all felt the effects of a poor night’s sleep. Any parent of a newborn baby will confirm the stress and frustration that comes from not getting enough sleep. The National Institute of Health reports that, “Sleep plays a vital role in good health and well-being throughout your life. Getting enough quality sleep at the right times can help protect your mental and physical health, quality of life, and safety.” Some cultures have even implemented nap time for adults in order to increase productivity.

We all know that a single night of bad sleep is frustrating, but for many parents of children with autism, stress and negative health effects occur because of persistent disrupted sleep. To get an idea of how much sleep a child should be getting, consult the National Sleep Foundation.

Link Between Autism and Sleeping Issues

According to Autism Speaks, up to 80% of children with autism experience difficulties with sleep. It is well-known that lack of sleep increases irritability and difficulties dealing with frustration during the day. Additionally, children with autism often have coexisting conditions such as gastrointestinal reflux, sensory processing difficulties, seizures, and even unpleasant side effects caused by medication. Any of these alone may disrupt sleep, but a combination can prove catastrophic. Sleep issues may also be compounded by the typical stressors children deal with, like school and friends, which can cause anxiety and worry.

An extensive study completed by the Archives of Disease in Childhood reviewed sleep patterns of children with autism. They reported that:

“Clear differences in sleep patterns began to emerge around 30 months of age and continued through the 11-year end point. Over this span, children with ASD slept, on average, significantly less per night than other children their age. They tended to both fall asleep later and wake earlier than their peers. The largest sleep gap – averaging three quarters of an hour – occurred between 6 and 7 years of age.

Parents of children with autism were also significantly more likely to report three or more wakings per night. By the time the children were 7 years old, more than one in ten children with autism were waking three or more times a night. By contrast, this was true of just 1 in 50 of other children this age.”

As you might imagine, the stress surrounding sleep can affect the entire family and disrupt the peaceful rest required for optimal function. Parents, siblings, and the entire rhythm of the household are affected. Also, when stress is present, our body produces chemicals such as cortisol and adrenaline which cause both short and long-term health effects.

Typical Sleeping Issues for Those with Autism

Parents of children with autism report that their children have difficulty both falling asleep and remaining in bed during the entire night. Frequent night waking and lack of REM sleep can have terrible long-term effects on a growing child’s brain and body. A study by Veatch et al. reported “problems with sleep-onset delay were concurrent with sleep duration problems in 66% of children, night wakings in 72% of children, and bedtime resistance in 66% of children.” When a parent realizes the critical need for sleep, but the child is resistant, a great deal of frustration occurs. This compounds an already stressful situation. Knowledge is power, so let’s review some helpful tips you can use with your child.               

Tips to Help Get a Child with Autism to Sleep

  • Routine is critical for all children, but especially important for children with autism. Remember to keep bedtime consistent so children know what to expect.
  • Eliminate screen time (computers, video games, and cell phones) at least two hours prior to bedtime.
  • Post visual reminders of the activities leading to sleep since many children learn better with pictures.      
  • Take photos of your child completing activities such as putting pajamas on, brushing teeth, and using the toilet. Refer to the pictures each night so children stay on the task at hand and do not become distracted. If your child likes to take control, place the pictures on a strip of Velcro® and remove each photo as the step is completed. The physical act of removing the photo can be extremely motivating for some kids.
  • Take a warm bath with calming music. Create a spa-like environment for children and help them to take deep, cleansing breaths.
  • Encourage kids to use a crème and massage arms, legs, and trunk. The deep and even pressure is often relaxing.
  • Read a story before bedtime. Keep it short and positive.
  • Keep lighting in the room soft and use night lights or lamps instead of overhead lights.    
  • Try calming scents such as lavender and vanilla. Many companies make bedtime sprays or you can make your own out ofspray bottle with water and essential oils.
  • Use blankets and bedding that the child chooses and are soft and comfortable
  • Remember that many children with autismhave sensory processing differences. Consider using a weighted blanket, like the ones sold by Harkla. There are many parents who report that the extra weight helps their  child feel calm and ready for sleep. To learn more about how weighted blankets work, click here.

It’s important for parents to know they are not alone! Many families struggle with children who have sleep difficulties. Remember to teach your child that sleep is important for growth and development. Not all strategies work for every child, so mix and match the tips we’ve given. If you have a tip, let us know! We love hearing from our readers.


Humphreys JS, Gringras P, Blair PS, Scott N, Henderson J, Fleming PJ, Emond AM, Sleep patterns in children with autistic spectrum disorders: a prospective cohort study.Archives of Disease in ChildhoodPublished Online First: 23 September 2013. doi: 10.1136/archdischild-2013-304083.

Veatch, O.J., Reynolds, A., Katz, T., Weiss, S.K, Loh, A., Wang, A., and Malow, B.A. Sleep in Children With Autism Spectrum Disorders: How Are Measures of Parent Report and Actigraphy Related and Affected by Sleep Education? Behavioral Sleep MedicineVol. 14, Iss. 6, 2016.


Cara Koscinski MOT, OTR/L
Cara Koscinski MOT, OTR/L

Pediatric occupational therapist, Cara Koscinski, MOT, OTR/L, author of The Pocket Occupational Therapist Book Series, is a veteran clinician of 20+ years specializing in Sensory Processing Disorder, reflex integration, trauma informed care, and autism. She obtained her Master of Occupational Therapy degree in 1997 from Duquesne University. In addition to her longstanding work as a private practice OT, Cara is a successful entrepreneur, having started two companies. Her products can be found in special needs catalogues and websites across the US and UK. Cara’s latest venture is The Pocket Occupational Therapist Book Series. As an author, Cara brings her expertise as a pediatric occupational therapist and mother of two children with autism to parents, caregivers, families, and educators in an easy-to-read, easy-to-follow format. All five books are available at The Pocket Occupational Therapist website at and on Amazon.

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