Promoting good sleep habits for children with autism spectrum disorder

Habits and routines that promote sleep help all children – with or without ASD – feel sleepy and ready for bed at the right time. That is, a time that’s appropriate for their age and sleep needs.

Before focusing on ASD-related issues, it’s important to

• understand your child’s sleep patterns and how much sleep your child needs
• focus on some basic tips for promoting healthy sleep habits.

You can improve the sleep of your child with ASD by working on:

• regular sleep cycles
• positive bedtime routines
• appropriate bedtimes.

Regular sleep cycles

Children with ASD can find it more difficult than other children to establish and maintain a regular pattern of sleeping and waking (a ‘sleep cycle’). This is partly because regular sleep cycles are influenced by daily routines.

Children with ASD sometimes have trouble understanding and following routines. They might be attached to their own unusual routines, even becoming inflexible about usual family routines. They might also be unable to pick up cues that bedtime is approaching because of their communication difficulties.

You might be able to improve the sleep cycle of your child with ASD by working on your child’s understanding of routines overall.

Positive bedtime routines

Here are some ideas that might help you establish a positive bedtime routine for your child with ASD.

• It might help to use a chart with pictures showing your bedtime routine, so your child understands the steps.
• Praise your child for successfully completing steps in the routine. Put stickers on the chart to show when your child completes a step correctly.
• As your child gets better at following the bedtime routine, you can phase out praise for specific behaviours in this routine.
• Sometimes children with ASD can become fixed on a routine or an object they associate with bedtime. If this is your situation, try to vary routines from night to night – for example, use different coloured toothbrushes on different nights. Or you could gradually introduce other objects, such as soft toys or different pairs of pyjamas.

Appropriate bedtimes

An appropriate and regular bedtime is an important part of children’s sleep cycle and bedtime routine. Although sticking to an appropriate bedtime can sometimes be hard for children with ASD, there are things you can do to help.

• The first step is to work out the best time for your child to go to bed. You can do this by observing when your child is usually alert or sleepy, and how much sleep your child needs to be well and alert during the day. For example, you might notice your child generally needs 11 hours sleep. You also know you won’t make it to school on time unless your child is up at 7 am. So you can work out that 8 pm is the ideal bedtime. This also means that evening activities – dinner time, pre-bedtime and bedtime routines – need to take this into account.
• Give your child clear cues when it’s nearly bedtime. For example, half an hour before bedtime, start some quiet activities in the family room. Fifteen minutes before, clean your child’s teeth and go to the toilet. And then into bed.
• Sometimes children aren’t sleepy at bedtime. After you’ve set an appropriate bedtime for your child, start moving your child’s sleepy time towards the set bedtime. To do this, start giving your child bedtime cues 5-10 minutes earlier every couple of days. It might take a few weeks, but you should be able gradually to match your ideal bedtime with your child’s sleepy time.

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