How Common Is Sleep Disturbance in Children on the Autism Spectrum?

Sleep problems are common in all children, but particularly in children on the autism spectrum. A recent study reported moderate to severe sleep disturbances in 66% of children on the autism spectrum as measured by actigraphy (a microcomputer worn at night during sleep to monitor motion) and parent report, compared to mild sleep problems in 45% of typically developing children.

Research indicates that core deficits of Autism Spectrum Disorder (ASD) and underlying neurophysiology may predispose children on the spectrum to conditions that threaten sleep. The consequences of this can be severe because poor sleep in children can alter learning, attention, and performance.

According to the National Sleep Foundation, here are the recommended hours of sleep per day for different age groups:

• Infants: 14 -15 hours
• 1 – 3 yr. old: 12 – 14 hours
• 4 – 11 yr. old: 10 – 11 hours
• 12 – 21 year old: 8 1/2 – 10 hours
• Adults – 7 – 9 hours per day

There are several different forms of sleep disturbance. One or more may affect individuals on the autism spectrum. They include:

• Trouble Falling Asleep: Children may have a hard time falling asleep if there is a lot of activity in the household, if they had a bad day at school and worry, or if they are hyperactive or hyper-aroused. They may not connect bedtime with falling asleep or may simply want to spend time with the rest of the family.
• Night Waking: All children wake up briefly multiple times throughout the night, but the majority do not ever realize it and go right back to sleep. Children who wake up in the middle of the night may stay awake if they don't know how to fall back asleep on their own or if they do not understand that nighttime is for sleeping. They may stay awake because they are used to getting food, attention, or other reinforcement when they wake. Some children wake because they need to use the bathroom or because they have had an accident during sleep.
• Early Waking: Children may wake up early (for example, at 04:00 a.m.) and stay awake for the day because of decreased melatonin production or because they have problems falling back asleep when they wake.
• Night Terrors: This is a sleep state where a child screams out and flails but is still asleep. Night Terrors often occur in very young children and usually stop as the child matures. Children do not remember night terrors in the morning; therefore, night terrors are more upsetting for parents than they are for children.

Medical Reasons for Sleep Issues:

Sleep may be affected by medical problems including seizures, allergies, asthma, obstructive sleep apnea, reflux, and medication side effects. It is important to fully investigate these potential causes of sleep disturbance with your health provider.