It doesn’t hurt for us autism grandparents to be knowledgeable about autism sleep disorders – whether or not our grandchildren ever sleep with us. If they do have overnighters with us, we can put our knowledge into action, and if they never do, we can let their parents know that we’ve done some sleep research that may be helpful.
It’s common for persons on the autism spectrum – children and adults – to have chronic sleep disorders: difficulty falling asleep and difficulty staying asleep. A 2019 research study found that 80% of pre-schoolers experience abnormally disruptive sleep. Another study showed that children with autism spend 15% of their sleep time in the REM (rapid eye movement) stage, while neurotypical children average 23%. REM sleep is critical for learning. And too little sleep exacerbates autism challenges such as stimming and social behaviors.
But there are some things that can be helpful. The first thing to do is to get a medical analysis. For example, is your grandchild taking a medication (such as for ADHD) that contributes to sleep problems? Are there gastro-intestinal problems (common with autism)? You can even get a professional sleep assessment, but it takes place in a laboratory and includes a variety of wires and sensors – an environment that doesn’t appear to be sleep-friendly and thus may not be appropriate for many persons.
Once a medical analysis has been completed, the next thing to consider is the sleeping environment. Is the lighting too dark or too light? Some children with autism respond well to wearing a sleep mask. What about sound? Some persons sleep better with zero sound, others with a soft “white” noise such the sound of a gentle rain. Headphones or earplugs can be tried. What about the temperature in the room? For most persons colder is better than warmer. What about dolls or stuffed animals? Many children sleep better when holding a favorite “friend.” Constant experimentation with the sleeping environment can eventually result in a condition that greatly approves sleep.
Most professionals recommend that an established bedtime “routine” is helpful for sleep – a routine that begins from 15 to 30 prior to sleep time. They also recommend that the routine be written, or demonstrated by pictures or objects – in a way that the child can comprehend. The pre-sleep routine should not include television or any sort of tablet or computer screen. It should include normal pre-bedtime things such as brushing teeth, putting on pajamas, going to the bathroom, etc., but should also include calming things such as reading or listening to music. And once a routine is established, the recommendation is to stick to it until it becomes ingrained.
Regarding food, it is almost unanimously recommended that there be no meals within at least a couple of hours prior to bedtime.
There are other unanimous recommendations that may seem obvious: don’t allow late afternoon naps; get lots of physical exercise during the day; and no caffeine (including that found in chocolate and some sodas) within 5 hours of bedtime.
Adults with autism may be able to take Ambien for improved sleep, but children shouldn’t take it. Melatonin supplements may be helpful for children.
If your child has developed a need for a parent to sleep in the bed with him, it is beneficial to wean him of this need. This can be done very gradually. Begin by telling him that you will sleep with him for most of the night, but not all of it – and that he’ll be fine by himself after you leave. You may want this initial stage of weaning to include only a 10% reduction in the time you stay in the bed. Then gradually increase the amount – with appropriate praise each morning – until you stay in the bed only until he falls asleep.
The next stage is to begin bedtime with you sitting on the bed, perhaps with your arm around the child. Then after a few nights of lessening this, begin bedtime with you sitting in a chair next to the bed. Then over the coming days move the chair farther and farther away while giving the child less and less attention. You get the idea. The duration of this weaning process varies from child to child – sometimes taking as long as several months. But successful weaning will have long-term benefits.
Autism Speaks (www.autismspeaks.org) has website information on sleep problems, and one gimmick that is suggested is a “Bedtime Pass” – a coupon that the child can use just one time during the night in exchange for a kiss or hug or drink or water or whatever. And if the child goes the entire night without using the Bedtime Pass, he might be rewarded with a sticker in the morning. And then a certain number of stickers might result in a store-bought prize.
Sleep patterns usually change with adolescence – the biggest difference being the need for a later bedtime, usually an hour or so.
One of the best ways we autism grandparents can be helpful, even if we live a thousand miles away, is to be knowledgeable. Our grandchildren’s parents are usually so busy with day-to-day responsibilities that they simply don’t have as much time as we do to search the Internet or read books to find possible solutions for their children’s challenges. When our children lament to us that our grandchildren are experiencing difficulties, we can volunteer, “Would you like for me to do some research on that and let you know what I find?” Sometimes this type of third-person advice is even better received than us saying, “Well, if he were my child, I would . . .”