Wilse Webb, a prominent sleep researcher, called sleep “...the gentle tyrant: It can be delayed but not defeated.”
Ask the parent of a newborn baby, or the caregiver of a child with autism, about sleep deprivation. Most will tell you about the lack of focus, mood changes, health issues, and lack of restorative sleep that they experience. As a parent of two children with autism, I’m quite familiar with this and have struggled with both of my sons and their difficulty sleeping. I cannot begin to count the number of sleepless nights I’ve spent with my boys. According to TreatAutism’s website, 83% of children diagnosed with autism, have sleep disorders.
Each of us produces various hormones that create a daily rhythm. It’s called the circadian rhythm and we experience daily sleep and wake cycles. We know that light affects our body’s sleep. When it’s a dreary day, we feel like staying under the cozy blankets all day. Also, some people develop seasonal depression in the winter months when the daylight hours are shorter. Many people who work the night shift invest in light-blocking curtains so their body will produce the required melatonin with the darkness. Think about a newborn baby. Most have their rhythms mixed up since they do not have the luxury of seeing the daylight. It’s quite dark tucked in the womb! It takes time for them to sort out their days and nights so parents learn to survive on little sleep.
Melatonin is a naturally occurring hormone made in the pineal gland located in your brain. It is released at specific times which generally coordinate with times we sleep. In the late afternoon and early evening, and as the sun sets, our body increases production of melatonin. The rise of melatonin continues throughout the night and then begins to drop in the early morning hours. The increased melatonin allows us to sleep through the night and the gradual drop causes us to wake with the morning light. Consider seasonal time changes, jet lag, and those who work the night shift. Even a small change of an hour or two can greatly affect sleep! It’s also worth noting that melatonin production decreases with age. This explains why some older adults require less sleep per night than younger adults.
Any time a supplement is added, the child’s pediatrician should be consulted. Most people do not know that supplements, such as melatonin, purchased over the counter are not FDA (Food and Drug Administration) regulated. So, the actual amount of melatonin in the product can vary from brand to brand. Ask your pharmacist which brand is the most consistent. When you find a brand that works, continue using the same product. Melatonin supplements come in pills, liquids, and lozenges. According to Sleep.org, the dosing ranges from one to ten milligrams. When many of my families begin melatonin, they are told to begin at the lowest dose about one or two hours prior to bedtime. According to Dr. Craig Canapari, director of Yale Pediatric Sleep Center, “In general, I would start at a low dose (0.5–1 mg) and increase slowly. Recognize that melatonin, unlike other medications, is a hormone, and that lower doses are sometimes more effective than higher ones, especially if the benefit of it reduces with time.”
I suggest visiting his website as he has helpful information for parents of typically developing children and those with special needs.
As a pediatric occupational therapist, I often consult with parents about ways to help their children with sleep issues.
Children with autism not only have difficulty falling asleep, but they can experience problems staying asleep throughout the night. Overnight awakenings change with a child’s age and HOW we encourage them to go back to sleep. Many families simply feel exhausted and, after waking up hour after hour with their child simply give up and decide to sleep with their child or permit their child to sleep in their bed. I have been there…….my advice is don’t do it! Remember that a small, sweet child grows into a teen who may be taller than you! Once, my husband and I were so tired that we moved our son’s matters into our room. When his behavior therapist began working in our home, she advised against co-sleeping. We were not working toward better bedtime routines and she taught us the basics. Live and learn! The Autism Speaks/Autism Treatment website offers an excellent handout that has proved invaluable to many families.
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