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Showing posts sorted by relevance for query sleep problems. Sort by date Show all posts
Showing posts sorted by relevance for query sleep problems. Sort by date Show all posts

Frequent "Night Wakings" and Moodiness in Children on the Autism Spectrum

“My son wakes in a terrible, nasty mood. He goes to bed happy, laughing and loving. Nothing that I do can deter him from ruining his day and the day of those around him. I have tried everything to help him turn the day around - from being extra cheerful, music, ignoring, consequences, taking away privileges, talking about it, timeouts, etc... Although I do everything that I can to make sure that he gets adequate sleep (9pm-7am) he has been diagnosed with frequent night wakings. The doctors will not do anything about it. He was diagnosed with ADHD, age 5. However, I realized at age 7 that it was something much more complex than that. Finally, this past winter, he was diagnosed with mild-to-moderate ASD. We have provided countless hours of traditional and non-traditional therapy yet he still struggles a good portion of the time. His father passed away January '14 so that does not help matters -- and he has entered precocious puberty (being treated). Would you please be willing to give me suggestions to help get him off that path as quickly as possible so that everyone can go on about their day?”

__________

I think the harder you try to fix this, the worse you may be making it. Sometimes you just have to let a child be angry and upset. Kids need to vent, too.

Let's try this: Stop trying to change it. I'm sure your efforts to "cheer him up" annoy him even further. Give him permission to be moody. You can even say something like this first thing in the morning: "Good morning, this is the time you have a mood, so go ahead and get started." [reverse psychology]

But first, tell him tonight, while he is in a good mood, that you are giving him permission to have a mood in the morning. Then remind him in the morning using the line I just mentioned. In addition, while he is disgruntled in the morning, you can say things like, "I know honey – it's hard to get up and get going in the morning, isn't it?" In this way, you aren't punishing, ignoring or cajoling -- rather you are validating his feelings. Try it!

==> How to Prevent Meltdowns and Tantrums in Asperger's and High-Functioning Autistic Children


Having said that, here are some common reasons for “night wakings” and tips for dealing with them:

1. Children may be awakened during the night due to an urge to urinate, thus your son should avoid drinking fluids before bedtime. Some kids may have urinary tract problems that awaken them even when their bladders aren’t full. If your son has frequent night wakings, try to find out if bathroom trips are contributing to the problem.

2. Children who suffer from heartburn may experience frequent night wakings. Heartburn is associated with sleep-disordered breathing, and can be dangerous in some cases. If you think your son may suffer from heartburn, consult your doctor for treatment options. Meanwhile, avoid acidic and hard-to-digest foods before bedtime.

3. Children who suffer from headaches are more likely to suffer from frequent night wakings. It’s not clear if headaches cause sleep problems, or sleep problems are causing the headaches. Either way, it’s a good idea to have your youngster’s headaches checked by a doctor.




4. Night terrors are distressing, disruptive, and cause night wakings. But night terrors differ from nightmares. A youngster may move (even sleep walk) during a night terror, which puts him at risk of hurting himself. Have you ever noticed your son sleep walking?

5. Nightmares are associated with REM sleep, and they are more likely to occur after a youngster has been sleeping for several hours. When a youngster wakes up immediately after a nightmare, he is likely to remember it. Triggers for nightmares include anxiety and medications that interfere with REM sleep. Children who awaken from nightmares need to be reassured that their dreams are not real. Also, check to see if any of your son’s medications are contributing to sleep problems.

6. Worried, frightened children have more sleep problems. Research suggests that ignoring a youngster’s fears may lead to nightmares and emotional problems. Thus, it’s important to take an active role in teaching your son to overcome his fears.

7. When children are overtired, their sleep may become more restless – and they suffer more frequent night wakings. If your son is overtired, he needs more sleep. An earlier bedtime may help.

8. Children often learn to associate falling asleep with certain forms of comforting stimulation (e.g., parental soothing, a particular sleep environment, etc.). These sleep aids may be very effective, but if your child becomes dependent on them, he fails to learn how to fall asleep on his own. Thus, if your son is used to falling asleep in your presence, but wakes up alone, he may not be able to settle himself back to sleep. If you want your son to develop self-soothing skills, you may want to consider sleep training.

==> How to Prevent Meltdowns and Tantrums in Asperger's and High-Functioning Autistic Children

9. “Sleep disordered breathing” includes interrupted breathing (i.e., sleep apnea), loud breathing, snoring, and troubled breathing during sleep. Sleep disordered breathing can restrict the oxygen supply to a youngster’s brain and cause serious health problems. It is also associated with attention problems, daytime sleepiness, frequent night wakings, hyperactivity, nighttime crying, and poor sleep quality. If you suspect your son suffers from sleep-disordered breathing, consult your doctor.

10. Kids who have experienced traumatic events are likely to suffer from night wakings and other sleep disturbances (and you did say his father passed away recently --- BIG FACTOR THERE!). Even everyday stressors disturb sleep. Children experiencing family stress suffer more night wakings and get less sleep overall. These sleep problems are associated with elevated stress hormone levels. Check to see if your son is experiencing an inordinate amount of stress for some (perhaps hidden) reason. Grief counseling may be in order as well.

Morning moodiness is associated with the "sleep inertia" phase, which is a transitional period of fatigue that usually lasts between 5 and 20 minutes after a child first wakes, though it can go on for a longer time in some cases. The process of waking up is slow – it’s not like a light switch. Feeling excessively grouchy in the morning is not enjoyable, but does not necessarily indicate having had a poor night of sleep.

Why some kids are able to cheerfully connect their sleep inertia phase with the rest of their day is much more specific and individualized. Moodiness might be associated with not getting enough rest and being tired, but it might also be symptomatic of having a bad attitude about the day. For some children though, chronic morning moodiness is simply a symptom of an over-scheduled life, with too little sleep, and not enough things that bring them joy on a day-to-day basis.

 
Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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What are some other conditions that Aspergers children may have?

Most Aspergers (high functioning autistic) children and teens have at least one comorbid (i.e., co-existing) condition in addition to their autism diagnosis as listed below:

1. Co-occurring mental disorders— Kids with Aspergers can develop mental disorders (e.g., anxiety disorders, attention deficit hyperactivity disorder (ADHD), depression, etc.). Research shows that children and teens with Aspergers are at higher risk for some mental disorders than those without Aspergers. Managing these co-occurring conditions with medications or behavioral therapy, which teaches kids how to control their behavior, can reduce symptoms that appear to worsen a youngster's Aspergers symptoms. Controlling these conditions will allow kids with Aspergers to focus more on managing their disorder.

2. Fragile X syndrome— Fragile X syndrome is a genetic disorder and is the most common form of inherited intellectual disability, causing symptoms similar to Aspergers. The name refers to one part of the X chromosome that has a defective piece that appears pinched and fragile when viewed with a microscope. Fragile X syndrome results from a change, called a mutation, on a single gene. This mutation, in effect, turns off the gene. Some children may have only a small mutation and not show any symptoms, while others have a larger mutation and more severe symptoms. Around 1 in 3 kids who have Fragile X syndrome also meet the diagnostic criteria for Aspergers, and about 1 in 25 kids diagnosed with Aspergers have the mutation that causes Fragile X syndrome. Because this disorder is inherited, kids with Aspergers should be checked for Fragile X, especially if the moms and dads want to have more kids. Other family members who are planning to have kids may also want to be checked for Fragile X syndrome.


3. Gastrointestinal problems— Some moms and dads of Aspergers kids report that their youngster has frequent gastrointestinal (GI) or digestion problems (e.g., stomach pain, diarrhea, constipation, acid reflux, vomiting, bloating, etc.). Food allergies may also cause problems for kids with Aspergers. It's unclear whether these kids are more likely to have GI problems than neurotypical kids. If your youngster has GI problems, a doctor who specializes in GI problems, called a gastroenterologist, can help find the cause and suggest appropriate treatment. Some studies have reported that kids with Aspergers seem to have more GI symptoms, but these findings may not apply to all Aspergers kids. For example, a recent study found that kids with Aspergers in Minnesota were more likely to have physical and behavioral difficulties related to diet (e.g., lactose intolerance or insisting on certain foods), as well as constipation, than kids without Aspergers. The researchers suggested that kids with Aspergers may not have underlying GI problems, but that their behavior may create GI symptoms (e.g., a youngster who insists on eating only certain foods may not get enough fiber or fluids in his or her diet, which leads to constipation). Some moms and dads may try to put their youngster on a special diet to try to control Aspergers or GI symptoms. While some kids may benefit from limiting certain foods, there is no strong evidence that these special diets reduce Aspergers symptoms. If you want to try a special diet, first talk with a doctor or a nutrition expert to make sure your youngster's nutritional needs are being met.

4. Intellectual disability— Many kids with Aspergers have some degree of intellectual disability. When tested, some areas of ability may be normal, while others—especially cognitive (thinking) and language abilities—may be relatively weak. For example, a youngster with Aspergers may do well on tasks related to sight (e.g., putting a puzzle together) but may not do as well on language-based problem-solving tasks. Kids with Aspergers often have average or above-average language skills and do not show delays in cognitive ability or speech.

5. Seizures— One in four kids with Aspergers has seizures, often starting either in early childhood or during the teen years. Seizures, caused by abnormal electrical activity in the brain, can result in: (a) staring spells, (b) convulsions (i.e., uncontrollable shaking of the whole body) or unusual movements, and (c) a short-term loss of consciousness or a blackout. Sometimes lack of sleep or a high fever can trigger a seizure. An electroencephalogram (EEG), a nonsurgical test that records electrical activity in the brain, can help confirm whether a youngster is having seizures. However, some kids with Aspergers have abnormal EEGs even if they are not having seizures. Seizures can be treated with medicines called anticonvulsants. Some seizure medicines affect behavior; changes in behavior should be closely watched in kids with Aspergers. In most cases, a doctor will use the lowest dose of medicine that works for the youngster. Anticonvulsants usually reduce the number of seizures but may not prevent all of them.

6. Sensory problems— Many kids with an autism spectrum disorder either over-react or under-react to certain sights, sounds, smells, textures, and tastes. For example, some may: (a) have no reaction to intense cold or pain, (b) experience pain from certain sounds – and sometimes cover their ears and scream (e.g., vacuum cleaner, a ringing telephone, a sudden storm, etc.), and (c) dislike or show discomfort from a light touch or the feel of clothes on their skin. Researchers are trying to determine if these unusual reactions are related to differences in integrating multiple types of information from the senses.

7. Sleep problems— Kids with Aspergers tend to have problems falling asleep or staying asleep, or have other sleep problems. These problems make it harder for them to pay attention, reduce their ability to function, and lead to poor behavior. In addition, moms and dads of Aspergers kids with sleep problems tend to report greater family stress and poorer overall health among themselves. Fortunately, sleep problems can often be treated with changes in behavior (e.g., following a sleep schedule, creating a bedtime routine, etc.). Some kids may sleep better using medications such as melatonin, which is a hormone that helps regulate the body's sleep-wake cycle. Like any medication, melatonin can have unwanted side effects. Talk to your youngster's doctor about possible risks and benefits before giving your youngster melatonin. Treating sleep problems in kids with Aspergers may improve the youngster's overall behavior and functioning, as well as relieve family stress.

8. Tuberous sclerosis— Tuberous sclerosis is a rare genetic disorder that causes noncancerous tumors to grow in the brain and other vital organs. Tuberous sclerosis occurs in 1 to 4 percent of children with Aspergers. A genetic mutation causes the disorder, which has also been linked to mental retardation, epilepsy, and many other physical and mental health problems. There is no cure for tuberous sclerosis, but many symptoms can be treated.

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism
By

Aspergers & Associated Conditions

“Our son is diagnosed with AS. He has stomach problems, difficulty sleeping, and can’t stand loud noises of any kind. Is this part of AS, or are these totally separate issues?”

It’s very likely that these issues are part of the Aspergers (AS) condition. There are a number of concerns that often accompany a child with Aspergers and High-Functioning Autism. Here are the primary ones:

1. Fragile X syndrome is a genetic disorder and is the most common form of inherited intellectual disability, causing symptoms similar to Aspergers. The name refers to one part of the X chromosome that has a defective piece that appears pinched and fragile when viewed with a microscope. Fragile X syndrome results from a change, called a mutation, on a single gene. This mutation, in effect, turns off the gene. Some people may have only a small mutation and not show any symptoms, while others have a larger mutation and more severe symptoms. Around 1 in 3 kids who have Fragile X syndrome also meet the diagnostic criteria for Aspergers, and about 1 in 25 kids diagnosed with Aspergers have the mutation that causes Fragile X syndrome. Because this disorder is inherited, kids with Aspergers should be checked for Fragile X, especially if the mom or dad wants to have more kids. Other family members who are planning to have kids may also want to be checked for Fragile X syndrome.



2. Some moms and dads of kids with Aspergers report that their youngster has frequent gastrointestinal (GI) or digestion problems (e.g., stomach pain, diarrhea, constipation, acid reflux, vomiting, bloating, etc.). Food allergies may also cause problems for kids with Aspergers. It's unclear whether kids with Aspergers are more likely to have GI problems than typically developing kids. If your youngster has GI problems, a doctor who specializes in GI problems, called a gastroenterologist, can help find the cause and suggest appropriate treatment. Some studies have reported that kids with Aspergers seem to have more GI symptoms, but these findings may not apply to all kids with Aspergers. For example, a recent study found that kids with Aspergers in Minnesota were more likely to have physical and behavioral difficulties related to diet (e.g., lactose intolerance or insisting on certain foods), as well as constipation, than kids without Aspergers. The researchers suggested that kids with Aspergers may not have underlying GI problems, but that their behavior may create GI symptoms (e.g., a youngster who insists on eating only certain foods may not get enough fiber or fluids in his or her diet, which leads to constipation). Some moms and dads may try to put their youngster on a special diet to control Aspergers or GI symptoms. While some kids may benefit from limiting certain foods, there is no strong evidence that these special diets reduce Aspergers symptoms. If you want to try a special diet, first talk with a doctor or a nutrition expert to make sure your youngster's nutritional needs are being met.

3. Some kids with Aspergers have some degree of intellectual disability. When tested, some areas of ability may be normal, while others—especially cognitive (thinking) and language abilities—may be relatively weak (e.g., a youngster with Aspergers may do well on tasks related to sight such as putting a puzzle together, but may not do as well on language-based problem-solving tasks). However, most kids with Aspergers often have average or above-average language skills and do not show delays in cognitive ability or speech.

4. One in four kids with Aspergers has seizures, often starting either in early childhood or during the teen years. Seizures, caused by abnormal electrical activity in the brain, can result in: (a) staring spells; (b) convulsions, which are uncontrollable shaking of the whole body, or unusual movements; (c) a short-term loss of consciousness, or a blackout. Sometimes lack of sleep or a high fever can trigger a seizure. An electroencephalogram (EEG), a nonsurgical test that records electrical activity in the brain, can help confirm whether a youngster is having seizures. However, some kids with Aspergers have abnormal EEGs even if they are not having seizures. Seizures can be treated with medicines called anticonvulsants. Some seizure medicines affect behavior; changes in behavior should be closely watched in kids with Aspergers. In most cases, a doctor will use the lowest dose of medicine that works for the youngster. Anticonvulsants usually reduce the number of seizures but may not prevent all of them.

5. Many kids with Aspergers either over-react or under-react to certain sights, sounds, smells, textures, and tastes. For example, some may: (a) have no reaction to intense cold or pain; (b) experience pain from certain sounds (e.g., a vacuum cleaner, ringing telephone, sudden storm, etc.) and cover their ears and scream; (c) dislike or show discomfort from a light touch or the feel of clothes on their skin. Researchers are trying to determine if these unusual reactions are related to differences in integrating multiple types of information from the senses.

6. Kids with Aspergers tend to have problems falling asleep or staying asleep, or have other sleep problems. These problems make it harder for them to pay attention, reduce their ability to function, and lead to poor behavior. In addition, moms and dads of kids with Aspergers and sleep problems tend to report greater family stress and poorer overall health among themselves. Fortunately, sleep problems can often be treated with changes in behavior (e.g., following a sleep schedule or creating a bedtime routine). Some kids may sleep better using medications such as melatonin, which is a hormone that helps regulate the body's sleep-wake cycle. Like any medication, melatonin can have unwanted side effects. Talk to your youngster's doctor about possible risks and benefits before giving your youngster melatonin. Treating sleep problems in kids with Aspergers may improve the youngster's overall behavior and functioning, as well as relieve family stress.

7. Tuberous sclerosis is a rare genetic disorder that causes noncancerous tumors to grow in the brain and other vital organs. Tuberous sclerosis occurs in 1 to 4 percent of people with Aspergers. A genetic mutation causes the disorder, which has also been linked to mental retardation, epilepsy, and many other physical and mental health problems. There is no cure for tuberous sclerosis, but many symptoms can be treated.

8. The particularly high comorbidity with anxiety often requires special attention. One study reported that about 84 percent of Aspergers kids also met the criteria to be diagnosed with an anxiety disorder. Because of the social differences experienced by those with Aspergers (e.g., trouble initiating or maintaining a conversation, adherence to strict rituals or schedules), additional stress to any of these activities may result in feelings of anxiety, which can negatively affect multiple areas of one’s life, including school, family, and work.

Children with Aspergers may also be diagnosed with:
  • ADHD
  • Bipolar disorder
  • Obsessive compulsive disorder
  • Tourette syndrome
  • Clinical depression
  • Visual problems

More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

 ==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

 ==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

 ==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

 ==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book

 ==> Highly Effective Research-Based Parenting Strategies for Children with Asperger's and High-Functioning Autism

==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism

By

Sleep Problems in Teens on the Autism Spectrum

Question

I'm a single mother and don't know how to deal with my 13 yr old anymore. He doesn't want to go anywhere or do anything which is hard when you have to, and I am now homeschooling him due to trouble going to school. A big problem right now is sleep issues… he is so active at night and tired during the day. At the moment he is not falling asleep till about 1 or 2 am, and I've tried waking him up earlier to reset his body clock but I can't get him out of bed. I don't know how to get him back into a healthy sleep routine.

Answer

Studies find that approximately 73% of kids with ASD level 1 (high-functioning autism) experience sleep problems, and these problems tend to last longer in this group than they do for kids without ASD. For example, kids on the spectrum are more likely to be sluggish and disoriented after waking. Laboratory research has begun to describe the unique physiological presentation associated with sleep problems in kids with ASD, including disruptions in the sleep stage most associated with cognitive functioning (i.e., REM or Rapid Eye Movement sleep). In addition to physiological differences, some of the sleep difficulties in this population may be related to anxiety.

The impact of poor sleep is unequivocal. Poor sleep negatively impacts mood and exacerbates selective attention problems commonly found in kids with ASD, as well as impairing other aspects of cognitive function.
 

There is no one panacea to manage sleep problems in autistic kids. However, there are many interventions that are likely to be helpful. In general, moms and dads need to understand and be prepared for resistance to change that these kids often show. Moms and dads should also be prepared for problems to get worse before they get better as kids often initially challenge but then gradually become accustomed to new routines.

A good place to start an intervention targeted at improving sleep is changing lifestyle behaviors and environmental conditions that can influence sleep/wake patterns. These include exercise, napping, diet, and aspects of the bedroom and sleep routine.

Exercise & Activity—

The goal is decreasing arousal as bedtime approaches. To achieve this it may be useful to have a scheduled period before bedtime (approximately 30-45 minutes) in which the aim is calmness and relaxation. During that period, media such as television, computers, electronic games, and music should be limited as they can stimulate the youngster through activity, sound, and light. 
 
The availability of VCR and DVR technology makes it easier to control when kids can watch particular shows, thereby avoiding conflict over missing favorite programs that are shown in the late evening. The presence of televisions in kid’s bedrooms has been consistently associated with sleep problems and should be avoided at all costs. Likewise, computer access in a youngster’s bedroom is discouraged for sleep as well as for safety reasons.

In general, exercise during the day is associated with better sleep. However, exercise within 2-4 hours of bedtime can lead to difficulties in falling asleep, as it can disrupt the natural cooling process of the body that leads to rest at night. Having the youngster soak their body, particularly their head, in a calm bath that is as warm as can be tolerated 90 minutes before bedtime may be useful too. 
 
When the youngster gets out of the bath, core body temperature will drop rapidly; this is believed to help them to fall asleep faster. Using a waterproof pillow and avoiding the pulsation associated with showers is recommended. The use of progressive muscle relaxation, deep breathing and imagery exercises is the most widely researched treatment for insomnia in kids and may be useful for kids with autism as well.

Napping—

Controlled and limited (e.g., 20-30 minutes) napping is generally positive. However, longer daytime sleeping can be negative in that it makes it more difficult for the youngster to fall asleep at the ideal time in the evening. If the youngster’s sleep problems are associated with falling asleep, which is common for kids on the spectrum, it is advisable to avoid daytime napping.

Diet—

It is recommended that kids with sleep problems avoid all caffeine, alcohol, tobacco, high fat food, and monosodium glutamate (MSG). In contrast, food rich in protein may promote better sleep. Large meals within 2-3 hours of bedtime should also be avoided. A small carbohydrate/protein snack, such as whole wheat bread and low-fat cheese or milk before bedtime can be helpful to minimize nighttime hunger and stimulate the release of neuro-chemicals associated with falling asleep. For kids who often wake during the night to use the bathroom, and then have trouble falling back asleep, limited fluid intake in the 2 hours prior to bedtime is also recommended.

Melatonin is a natural brain hormone associated with sleep onset. There is some evidence that natural production of melatonin may be reduced in these young people on the spectrum. While melatonin supplements may be useful, a common side effect may be increased sluggishness in the morning. As discussed above, this is already a common problem for kids with autism. Use of melatonin and other alternative remedies should be discussed with a physician.
 

The Bedroom—

It is important that the bed and the bedroom are associated with sleep and are not associated with activity. When kids have sleep problems, it is highly recommended that their bed and bedroom activity be limited to sleep only. It is important to make sure that extreme changes in temperature are avoided during the night. 
 
Increasing light is associated with decreases in the release of the neuro-chemical melatonin which triggers sleep onset. Thus, it is important to get the sunlight flowing in the youngster’s room as soon as possible in the morning. Conversely, darkening the room at night is critical. When a youngster’s fear of the dark is an issue, behavioral psychotherapy may be necessary. We also recommend moving the clock so that the youngster is not watching the time while lying in bed.

Sleep Routine—

Setting and maintaining a regular time to sleep and wake may be critical. Moms and dads often make the mistake of allowing their kids to sleep much later on non-school days to “make up” for sleep. While this may be useful to a certain extent, allowing the youngster to sleep late in the day makes it difficult for them to fall asleep at an ideal time later in the evening. It is easier to wake a sleeping youngster then to force an alert youngster to go to sleep. Thus, we recommend that you keep your youngster on a regular schedule on non-school days and avoid drastic changes in the time that the youngster wakes. 
 
Likewise, having your kids go to bed when they are not tired conditions them to be awake in bed. It is recommended that you let your kids stay up until they are tired while maintaining their waking time in the morning. Then once they begin falling asleep within 10 minutes of going to bed, begin to move bed time earlier by 15 minutes at a time.

With carefully monitoring and patience, many moms and dads can make changes in a youngster’s life that promote better sleep. Improved sleep supports better mood, sustained attention and general health. However, for many families professional consultation is often necessary to design or maintain the appropriate intervention. When you need help, speak with other moms and dads of special needs kids about their experiences and ask your primary care doctor for referrals to a sleep expert.
 
More resources for parents of children and teens on the autism spectrum:
 
____________________

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COMMENTS:
•    Anonymous said…  She said she was a single mom I assume she has to work to provide... so she may not be able to adjust her schedule... I am single mom of HFA 11yr old with simular issues... and I am debating homeschooling but I am only one person !!!!
 •    Anonymous said… Exactly my thought. We have a 6pm rule. No electronics after that time. Increased his exercise, and it works for us. No drugs needed. X
 •    Anonymous said… Exercise, no electronics on in the house after 6 (a bored brain is a tired one), wake up same time every time with daylight, and same basic diet. We do a fruit/veg/chia smoothie to start the day. My son loves to seek electronics at night (all electronics blocked during certain hrs and collect xbox and remotes every night)
 •    Anonymous said… Go to your GP and try him on Melatonin, a natural hormone that helps us to sleep. We produce it in our bodies but some have less than others hence the difficulty sleeping. It may take a little while to find the right dosage that is agreeable to his body. My son is 13 and is on it. He was like a new born with sleep patterns until he was 6 yrs old. By 11 I was going nuts. He is much better now thank goodness and gets the rest that his body and mind needs to grow and function properly. You may have to restrict the internet/pc use at night and reward him with it during the day only so as to encourage him to sleep at night. The 'blue light' projected from the pc/laptop suppresses the normal secretion of melatonin and doesn't really help ones circadian rhythms. Getting off any electronic devices atleast an hour or two before regular bedtime allows the brain to begin the whole process of slowing down and releasing that melatonin. Look, I for one know that all of this information works but unless we as the parents/carers put it into practise, our kids will never do it. I'm not perfect, some days I forget to give my son his dose at the right time and then he's struggling to wake up at the right time the next morning and so I pay the price with his bad mood and getting to school on time etc. But we all have to start somewhere right? He was doing the school refusal thing last year and not wanting to leave the house or socialise at all. We enlisted the help of a psychologist who specialised in ASD and the school and recommitted to being the driving force behind implementing new routines. Baby steps was and is what it takes at the moment for my son and I. Its so tough for him especially I know, as I'm sure it is for your son but we have to push them out of their comfort zones for them to face challenges and grow from them. How else will they grow and learn? They wont! Plain and simple. Unfortunately its up to us. We become their "Executive Secretaries" as stated in the book "The Complete Guide to Aspergers Syndrome" by Tony Attwood.
 I think I have gone on too much already but I hope you will find what your son needs to help him sleep and learn and grow. Wishing nothing but joy and success for our special Aspies!!!
 •    Anonymous said… i also have a 12 yrs old with similar tendancies. Our Pead told us to avoid any Blue lights (whether that be in ceiling light or of electronics) after 4pm as it over stimulates their brain. I am now also trying reading before bed. I feel your pain
 •    Anonymous said… I could have written this about my (undiagnosed) 11 year old. She also is now totally not Going to school (it's always been an issue but is much worse lately), she doesn't sleep and basically stays up all night every night (sometimes until 5-6am). She gets into bed ok at around11-12 but won't/can't sleep. She is very aggressive verbally and physically towards me almost all of the time and is very anxious. She doesn't go out with her friends or actually talk to them at all anymore. (She's never had tons of friends but now doesn't talk to the ones she did have) I'm also a single mum and have w younger daughter who is really effected by all this. It's so hard! I can't really offer any advice I'm waiting on things happening from the countless referrals that have gone in to community peads, cahms, child psychologist, education physcholigist etc xx
 •    Anonymous said… I guess it doesnt work for everyone. If there is a physical activity or sport that he likes to do then try to do it everyday as it will help use up that 'boy' energy during the day. A bath or warm shower at night, a warm drink, reading some stories, di...See More
 •    Anonymous said… If you're homeschooling anyway flip your schedule to match his. Do schoolin the afternoon. Theres a whole raft of studies about teen boys needing to sleep later. Make wake up time 10am and shift things. If the way everyone else does things isnt working for you and him create your own path.
 •    Anonymous said… I'm not a Dr but have Aspergers girls and their consultants prescribed "Melatonin" it worked a treat to get their bodies back in a sleep routine and we only use it now if required. Hope this helps xx
 •    Anonymous said… I've had similar issues, and since I've started to listen to his feelings, I work around him more now allowing him to sleep in as many days as possible, he is amuck happier boy all round for it 🏻
 •    Anonymous said… Melatonin did nothing for our grand son any thing else
 •    Anonymous said… My 8yr old grandson exactly the same.Wont go to school awake all night and his mum and dad cant get help for him in newzealand its shocking I feel sad for you.
 •    Anonymous said… My Aspie son has just turned 17 and his sleeping patterns starting changing at about 13yrs old. I know how you feel and it's really hard. I'm now told by UK Social that my son is neglected and we can't parent him because we don't enforce his sleeping pattern and he lives for the Internet (it's the only form of Social life the poor boy has!). Can you flipping believe it! I don't know what to suggest tbh, because as you know it's not like parenting our sons when they were little boys where they knew bed time was bed time. It gets so much more challenging.
Maybe go onto "The National Autistic Society" website and go onto the Members Forum (you can browse as a "Guest"). There are so many parents in the same boat trying to manage their Teens through to Adulthood.
 •    Anonymous said… my daughter doesnt go to bed till 1 or 2 am every day.....Melatonin diesnt wirk for her she needed stronger stuff but ended up ODing on perscription stuff....now we just let her stay up and I wake her at 7:45 for school every day
 •    Anonymous said… My daughter had similar sleep pattern issues thru the early teens (although she did lots of drama classes in the evenings so socializing wasn't an issue). All teenagers naturally will stay awake later and sleep in. The beauty of home ed is we can accomodate their changed natural bio rhythms. I treasured my mornings to myself and we did educational stuff in the afternoons/evenings. Is there anything he would like enough to entice him out of the house? Other than saying don't worry, it will pass (it did with my daughter and I miss those precious me time mornings!) I don't know what to advise. But try not to worry too much about the sleep, it is normal and entirely natural during puberty, as is needing more sleep, instead explore ways to get him outside.
 •    Anonymous said… My daughter takes melatonin a half hour before bedtime I give her 4mg in apple juice and she takes it other wise she would be up all night long. She's 12 and has been taking it since she was 2. No more sleep issues ever
•    Anonymous said… My Dr put my son on Clonidine 0.1mg to help him sleep at night otherwise he would be up all night
 •    Anonymous said… My son is 11 and has a similar pattern. He has been on increasing doses of melatonin for 3 yrs. The problem is it us meant to only be given for a month then nothing then for another month, in an attempt to train the body. The breaks just send my son back into vampire mode within days. He was quite sick for a few day so Dr prescribed phenegan for anti nausea. This knocked him out.... you can buy over the counter from Boots, alot if chemists won't sell it to you though. But I found that boots did when I explained my son was aspie and it calmed him down. Understand this is only used when the melatonin is wearing off and body is used to it. I use it maybe once a month just so he gets a decent nights sleep @weekend.
Maybe worth a try as I know many Dr's don't like to prescribe melatonin unless forced. We get all his meds through Camhs xx
 •    Anonymous said… Should talk to you'r doctor about what you can give him to help him sleep.May be you should look into a therapist to go to for help with your son. Has help with me.
 •    Anonymous said… Society imposes routines that aren't fit for all, if he's feeling ok and is willing to take responsibility for himself and things that need to be done then maybe you could be more flexible. I say this because my 13yo son is in a similar position, I worry that he doesn't have a social life but he's much calmer out of school and no longer being bullied. I'm a single parent too and have to leave him home alone while I go to work, but he's safer there than he ever was in school.
 •    Anonymous said… This sounds similar to what we experienced through the middle school years. Puberty is challenging for anyone, seems even more so for young people on the spectrum for some reason. Maybe because there was no go to rule book to reference since most info out there refers to neurotypical teens. It could be depression as well. Hang in there.
 •    Anonymous said… Turn electronics OFF
 •    Anonymous said… Unless you were/are an Aspie teenage with sleep problems, you dont have a clue what its like, it is not their fault REMEBER that! you can feed them all the tablets and chemicals you want but at the end of the day it only masks one of the many issue that we have to deal with, they are not the instigator they are the victim of their own biology.
 •    Anonymous said… we do 3 mgs of Melatonin at night. I was amazed at how much it helped my 7 year old. You can take breaks on weekends and holidays if you want but during the week we use it each night. He even said, "mom! I actually slept last night!!!"
 •    Anonymous said… We use 2 mg Clonidine and 3mg Melatonin for years. It was a life saver!
 •    Anonymous said… We use melatonin 20 minutes before bed with a warning that the tv,electrinics/internet,will be off soon. After 20 minutes we remove tv remotes,game paddles,etc and turn off the lights. Works for us.
 •    Anonymous said… Yes!! This can be a problem. Our teenager must have a sleep aid.
 •    Anonymous said… Yes, melatonin does nothing for my sleepless son also 🙁
Post your comment below…
By

Help for Sleep Problems in Children on the Autism Spectrum

"I need suggestions on how to help my child fall asleep and stay asleep! It takes him a long time to settle down, and even when he finally gets to sleep, it's not long before he wakes up and we start the whole process all over again."

Studies find that approximately 73% of young people on the autism spectrum experience sleep problems, and these problems tend to last longer in this group than they do for kids without the disorder. For example, kids on the spectrum are more likely to be sluggish and disoriented after waking.

Laboratory research has begun to describe the unique physiological presentation associated with sleep problems in these children, including disruptions in the sleep stage most associated with cognitive functioning (i.e. REM or Rapid Eye Movement sleep). In addition to physiological differences, some of the sleep difficulties in this population may be related to anxiety.

The impact of poor sleep is unequivocal. Poor sleep negatively impacts mood and exacerbates selective attention problems commonly found in kids with Aspergers and High-Functioning Autism, as well as impairing other aspects of cognitive function.

There is no one panacea to manage sleep problems for these children. However, there are many interventions that are likely to be helpful. In general, moms and dads need to understand and be prepared for resistance to change that these “special needs” kids often show. Parents should also be prepared for problems to get worse before they get better as kids often initially challenge - but then gradually become accustomed to - new routines.

A good place to start an intervention targeted at improving sleep is changing lifestyle behaviors and environmental conditions that can influence sleep/wake patterns. These include exercise, napping, diet, and aspects of the bedroom and sleep routine.

Many children with ASD level 1, or High-Functioning Autism, have problems sleeping through the night or getting to sleep due in large part to sensory issues. Sensory dysfunction is typically an issue for kids on the autism spectrum. Many moms and dads are forced to try medications, or natural supplements (e.g., melatonin) to try to regulate sleep patterns. These may be beneficial.

Using sensory integration therapy can also be helpful so that the youngster can learn to regulate his or her activity level. The idea behind sensory integration therapy is that it is possible to "rewire" the brain of the child with sensory processing difficulties. Practitioners of sensory integration therapy are usually occupational therapists. Their focus is on the following systems:
  • proprioceptive (i.e., helping the child work on his ability to manage his body more appropriately; for example, to run and jump when it's time to run and jump, to sit and focus when it's time to sit and focus, etc.)
  • tactile (i.e., normalizing the child’s reactions to touch)
  • vestibular (i.e., helping the child to become better aware of his body in space)

A trained sensory integration therapist evaluates the child for sensory defensiveness, hypersensitivity, and sensory cravings, using several different scoring techniques. Some of the standard tests include:
  • The PEERAMID for ages 6-14 years
  • The Bruininks Osteretsky Test of Motor Proficiency for ages 5-15 years
  • Sensory Integration and Praxis Tests (SIPT) for kids between the ages of 4 to 8 years, 11 months
  • The Test of Sensory Integration for kids between the ages 3 to 5 years (TSI)

Depending upon the needs of your youngster, the therapist may use various techniques such as:
  • brushing and joint compression
  • deep pressure therapy, which may include squeezing, rolling, etc.
  • gross motor play such as wall climbing, balance beam, etc.
  • jumping on a mini or full-sized trampoline 
  • playing with a toy that vibrates, is squeezable, etc. 
  • swinging

Sensory integration therapists also may develop a sensory "diet," which may include a variety motor activities (e.g., spinning, bouncing, swinging, squeezing balls or silly putty, etc.), as well as therapist-provided interventions such as brushing and compressing arms and legs. The idea is that this "diet" will be provided throughout the day, whether by trained therapists, by the child’s teacher, or by the child’s parent. 

* Additional information on this topic can be found here:  Settling and Waking Problems



 
Resources for parents of children and teens on the autism spectrum:
 

==> Videos for Parents of Children and Teens with ASD
 
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Here's what other parents have had to say:

•    Anonymous said... A friend of mine uses melatonin, for her son and has done for few years now. They use a low dose and only on school nights, never in holidays or fri or sat night. tThis is a godsend for them as he was only sleeping a couple of hours a night.

•    Anonymous said... A good routine, dont rush them and my best friend Melatonin. Its been shown that asd kids produce much less melatonin than their peers. Hideously expensive here in the uk and hard to get in the uk prescription only £200+ for a months supply but over the counter in the usa for $15 three months worth. Go figure.

•    Anonymous said... Chamomile tea, warm bath, aromatherapy, benadryl......any combination of the above.

•    Anonymous said... I have a routine. Often I will lie down with her for1-5 mins which we agree on beforehand and we have a music box which seems to soothe her. Took a long time to get this routine. Initially I was just glad to get her out of my bed now its much easier

•    Anonymous said... melatonin has been a life-saver for us! Talk with your dr. but there's usually no issues whatsoever. My aspie/severe SPD kiddo was the same way...up and down all night long. We started him on 3 mgs and that would help him drift off but he kept waking all night still. So we upped to dose to 6 mgs and that has worked awesome! Finally we can ALL get some rest!!

•    Anonymous said... Melatonin no side effects, safe. We noticed a huge difference in daytime behavior right away as well, a good nights rest is amazing.

•    Anonymous said... My aspie takes medications. He struggled with sleeping for awhile, but now with meds he sleeps better and is less irritable.

•    Anonymous said... My son will sit in the bathroom until he is calmed down enough to go to sleep. Sometimes it's an hour.

•    Anonymous said... Not enough light, too much light? Room to noisy, room too quiet? Hot and sweaty then gets cold when asleep? Needs something over his head Scared of spiders / monsters / shadows Lots and lots of things you can try, keep melatonin as a last resort

•    Anonymous said... our 5 yr old has same problem. In the beginning, we avoided medication. We tried aromatherapy, soothing bath + massage, classical music, etc., but nothing worked. He would sleep for 45 min., then jump to his feet in bed while screaming scared out of his mind. This would happen 2-3 times every night. After 1 yr. of minimal sleep, we had our son's Pediatric Behavioral Specialist prescribe him medication to aide in his sleep & help w/anxiety. He put him on Guanfacine 1/2 tablet at night. It also helps calm him due to severe anxiety. He's been on it for 2 yrs & it has done wonders for him. He's never had any side-effects from this medicine. Good luck in finding the best method for your child. I'll be praying for your son & your family!

•    Anonymous said... Physical activity helps, particularly yoga and gardening. As a last resort use melatonin and of course cannabidiol.

•    Anonymous said... Routine . Routine . Routine . Then he will still wake up tho about every few hours . My son is 13 . At age four we started clondine . Till he was about 7 then seroquel for a year . Off and on meletonin . It's not good for all night staying asleep . We tried trazadone also . Actually to get him to naturally stay asleep will take him getting older . My son at 13 can and will go to bed, early actually, and stay asleep with usually nothing . Ambilify in morning now and orap at night . But because he active and older its much much better . No problems with sleep at this time ! Good luck , just be patient and get help so YOU can get rest ! I'm catching up on mine during these "slow" years lol things have leveled out for now , as much as they can anyways . Never a dull moment that's for sure !

•    Anonymous said... We have used clonidine for the last 4 years. It has made a world of difference in our family. We have not noticed any negative side effects.

•    Anonymous said... We start our bedtime ritual an hour early. It includes bathroom, changing clothes, brushing teeth, etc. in the same sequence every night (the process is prompted by "ten minutes to bedtime.....5 minutes to bedtime....."). All of this is navigated/ motivated by reward. For us it is a book of his choosing and prayers from mom and dad. If he chooses to be uncooperative or takes too long playing in the bathroom sink, he is reminded he may be losing his book time. Also, we have always told him that he didn't have to go right to sleep if he is not tired, but he did have to stay in his bed and rest. He always goes to sleep within a reasonable time.

•    Anonymous said... We use a kids hypnosis cd on repeat and Relax & Sleep aid from the dollar tree. It has Melatonin in it. But I heard bad things about melatonin in larger quantities. Always research meds even the herbal ones

•    Anonymous said... Our doctor put our son on trazidone. He would fall asleep but not stay that way. I would find him up playing on his tablet or sleep walking. The meds help him stay asleep and we see such a HUGE difference in his behavior after a good sleep

•    Anonymous said... We used melatonin for almost a year but he started waking up and it became ineffective. So we brain stormed, as usual, and now we do our best to get some of his energy out. We do stretches. We put him in a long shower or bath depending on how he is feeling. I rub lavender baby oil on his legs and feet and neck. It has seemed to be more effective.

•    Anonymous said... We used to have the same issue. Still do from time to time but it's rare now. Our Dr.told.US to try melatonin . It's natural over over the counter. Found with vitamins and supplements. It helped.a lot!
 
*    The trick is finding the routine that works. We went through a lot of trial and error. After several years of melatonin, she was able to power through it and it no longer worked. We struggled for a while and then found that a sound machine, a diffuser with calming essential oil, 3mg of melatonin and rolling her tightly in her favorite blanket works. If we miss one of these components - it doesn't work.
 
Please post your comment below… 
By

Settling and Waking Problems in Children on the Autism Spectrum

"My son has a terrible time getting to sleep, but then in the mornings, I have a terrible time getting him up and out the door for school. Any suggestions?"

Unfortunately, it seems that virtually all kids with Aspergers and High-Functioning Autism (HFA) are likely to suffer from disturbed sleep patterns at some point or another. Sleep problems can be divided into three main categories: (1) settling problems, where the youngster has difficulty going to sleep at the appropriate time, (2) waking problems, where the youngster wakes repeatedly during the night, and (3) arousal problems, where the child has a hard time waking up in the morning due to such a restless night.



Coping with settling/waking/arousal problems will require consistent reassurance on your part -- and a creative approach to your youngster's needs. Here are some tips:

1. Allergy and food sensitivities: Kids on the autism spectrum are perhaps more likely than their peers to be sensitive to foodstuffs (e.g., sugar, caffeine, additives, etc.), which can keep them awake. If your youngster frequently has sweet or caffeine-rich drinks and foodstuffs near bed time, then it is worth checking whether this could be disturbing his sleep.

2. Medication: Medical interventions are typically seen as a last resort in treating sleep disorders in kids because they can be habit-forming and do not treat the root cause of the problem. As a general rule, it is better to minimize the medication your youngster is on, but at certain times it may be desirable to have a mild sedative on hand (e.g., going on vacation). Some moms and dads have also found that using medication in tandem with a behavioral approach can help to restore a good sleep pattern. The combination is crucial, because without the behavioral intervention when the medical treatment ends, the youngster is likely to return to his old sleep patterns.

3. Melatonin: This is a hormone secreted by the pineal gland which has been shown to regulate sleep patterns. In kids with the disorder, their patterns of melatonin secretion may be irregular, so it is not that they don't produce it, but that they don't produce it at the right times of day. Some foods are rich in melatonin (e.g., oats, rice, sweet corn, tomatoes, plums, bananas and Brazil nuts).

4. Natural remedies: Many of the natural remedies available from health food stores are supposed to treat insomnia and other sleep disorders. These may have similar effects to conventional medicines but carry less risk of side-effects than conventional sedatives. You could also try contacting a homoeopath.

5. Removing stimulants from the diet: Changing your youngster's bedtime routine can be stressful, and if they are used to having certain drinks or snacks near bedtime, suddenly switching to something different may be counter-productive. However, you could change to decaffeinated drinks, replace ordinary chocolate with sugar-free chocolate bought in health food stores, use carob powder to replace cocoa and chocolate, switch to sugar-free drinks or replace sugar in drinks with sweetener or fruit sugar, which may help some kids. Alternatively, you could try gently phasing certain foods out over a period of days or weeks so that your youngster is consuming less and less sugar and caffeine overall without having anything suddenly taken away from them.

6. Lack of social sense: Kids with Aspergers and HFA may have difficulty understanding why and when they need to sleep. Problems with social cueing (i.e., learning why and in what order things should happen) are common in these children, and this may mean your youngster doesn’t make the connection between his family going to bed and his own need to sleep.

7. Establishing a routine: Kids on the spectrum respond well to routine and structure because it allows them to feel safe and in control. Whatever routine you try to impose needs to be something you feel comfortable implementing and that your family can agree on. It may take several weeks for it to alter your youngster's sleep patterns. It can help to present this routine visually, using a timetable for example, so your youngster knows exactly what to expect, including getting up in the morning. If the routine needs to be altered, it can then be explained visually. It may be that your youngster's timetable needs to be more detailed so that he is told exactly what to do when going to bed, for example, draw the curtains, get in to bed, turn light off, lie down, pull cover up, etc. It may also be worth setting aside some time to prepare for the next day in the routine. This could include getting the school bag ready or making a list/timetable of things that need to be done the next day.

8. Using relaxation techniques: Kids with Aspergers and HFA may not be able to articulate their need to unwind and relax, and they may feel more anxious and confused around bedtime. Relaxation techniques can be introduced in low-key, non-intrusive ways. Some possible techniques are as follows:
  • Adding a few drops of lavender oil to your youngster's bath or pillow.
  • Giving your youngster a massage. 
  • Introducing an hour's quiet time before the youngster's bedtime. 
  • Providing the youngster with a set time to talk about their day or their worries as part of the evening routine. 
  • Physically exhausting your kids is a good way of ensuring that they sleep! Many kids with Aspergers and HFA enjoy rough and tumble play, and although this may seem to be the opposite of the points made above regarding quiet time, it might be more effective for some kids. 
  • Relaxation aids such as music and yoga can be very useful. 
  • Some moms and dads have reported having lighting (e.g., a lava lamp) in the bedroom can be helpful.

9. Dealing with sensory issues:
  • It’s worth considering if smells in the room, or coming from other parts of the house, may affect children with heightened senses.
  • Some kids are exceptionally sensitive to light, so sleeping when there is even a very dim light on could be very difficult for them. Putting up thick curtains will block out as much light as possible in your youngster's room. 
  • Some moms and dads have found that their kids can be woken by very slight sounds at night. Ear plugs, or music playing on headphones, could be used to block out noise for those kids who are comfortable with wearing these.
  • The layout of the room may need to be adjusted. Although it may be comforting for some kids to have lots of their belongings around them, it may serve to be quite distracting for others. Even the colors of the room or pictures on the wall may be disturbing. 
  • Touch sensitivity is extremely common in Aspergers and HFA. Some kids experience certain types of touch as physical pain. Labels on bed clothes and different materials can also be uncomfortable. Some kids respond well to a weighted blanket, which is made from thick blanket material like a quilt with the pockets filled with beans.

10. Keeping a diary: If you think your youngster may have a sleep disorder and you want to get an idea of the extent of the problem, it is a good idea to keep a sleep diary as the initial step to solving the problem. If you decide to try any routines or behavioral modifications to help your youngster to sleep, then the sleep diary will allow you to see if what you are doing is working consistently, sporadically or not at all.


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

==> How To Prevent Meltdowns and Tantrums In Children With High-Functioning Autism and Asperger's

 ==> Parenting System that Significantly Reduces Defiant Behavior in Teens with Aspergers and High-Functioning Autism

 ==> Launching Adult Children with Asperger's and High-Functioning Autism: Guide for Parents Who Want to Promote Self-Reliance

 ==> Teaching Social Skills and Emotion Management to Children and Teens with Asperger's and High-Functioning Autism

 ==> Parenting Children and Teens with High-Functioning Autism: Comprehensive Handbook

==> Unraveling The Mystery Behind Asperger's and High-Functioning Autism: Audio Book
==> Parenting System that Reduces Problematic Behavior in Children with Asperger's and High-Functioning Autism
By

Asperger's Kids & Sleep Problems

"We are parents of a newly diagnosed son (age 9) with high functioning aspergers. He wakes up in the middle of the night. He is in good health. We have tried Valerian, but that has not helped much. Is this a common trait for children with autism? Could this be hormonal? Can you suggest anything to remedy this?" 


The first known attempt to evaluate the sleep patterns of kids with Aspergers and High-Functioning Autism (taking into account sleep architecture and the Cyclic Alternating Pattern or CAP) finds that these boys and girls have:
  • sleep restlessness
  • problems related to initiating sleep
  • morning problems
  • daytime sleepiness
  • a high prevalence of some sleep disorders

The study, authored by Oliviero Bruni, MD, of the Center for Pediatric Sleep Disorders at University La Sapienza in Rome, Italy, focused on 8 kids with Aspergers, 10 with Autism, and 12 healthy control kids. The moms and dads of these kids filled out the following materials:
  • Autism Diagnostic Observation Schedule, a semi-structured, standardized assessment of communication, social interaction and play or imaginative use of materials for children who have been referred because of possible Autism spectrum disorders
  • Child Behavior Checklist, a questionnaire used to examine daytime behavior in kids
  • Pediatric Daytime Sleepiness Scale, which evaluates the relationship between daytime sleepiness and school-related outcomes
  • Sleep questionnaire

In addition, the kids took the Wechsler Intelligence Scale for Children, which measures verbal IQ, performance IQ and a full-scale IQ, and also underwent an overnight poly-somnogram, or sleep study.

Several sleep parameters (i.e., time in bed, sleep period time, number of awakenings per hour, and sleep efficiency) were evaluated. CAP, a periodic EEG activity of non-REM sleep characterized by repeated spontaneous sequences of short-lived events (phase A) with the return to background activity identifying the interval that separates the repetitive elements (phase B), was also scored.

According to the results, 50 percent of the kids with Aspergers were reluctant to go to bed, while 75 percent felt a need for light or a television in the bedroom, 87 percent had difficulty getting to sleep at night, and 75 percent fell asleep sweating. In addition, 50 percent felt un-refreshed when waking up in the morning, 87 percent had difficulty waking up in the morning, and 87 percent felt sleepy during the day.

With respect to the CAP (in comparison to healthy controls), subjects with Aspergers showed a lower total CAP rate in the first two sleep stages, but not in slow wave sleep. In addition, they showed an increased percentage of synchronized EEG patterns and a decreased percentage of desynchronized EEG patterns. Further, the duration of the A and B phases, and consequently the entire CAP cycle, was longer. Compared to the kids with Autism, Aspergers subjects showed an increased CAP rate in slow wave sleep and a decrease in the second sleep stage. The duration of the A phases was longer, as well as the CAP cycle duration.

This study showed peculiar CAP modifications in kids with Aspergers and represented an attempt to correlate the quantification of sleep EEG oscillations with the degree of mental ability or disability.

Aspergers is one of several Autism Spectrum Disorders (ASDs) characterized by difficulties in social interaction and by restricted and stereotyped interests and activities. Aspergers is distinguished from the other ASDs in having no general delay in language or cognitive development. Although it is not mentioned in standard diagnostic criteria, there are frequent reports of motor clumsiness and atypical use of language.

It is recommended that kids in preschool sleep between 11-13 hours a night, school-aged kids between 10-11 hours of sleep a night, and adolescents about nine hours a night. Here are just a few tips to help your youngster sleep better:
  1. At bedtime, do not allow your youngster to have foods or drinks that contain caffeine. This includes chocolate and sodas. Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.
  2. Do not let your youngster fall asleep while sitting in the car during transport, sitting in front of the TV, being held, rocked, etc.
  3. Establish a relaxing setting at bedtime.
  4. Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your youngster ready to go to sleep each night.
  5. Interact with your youngster at bedtime. Don't let the TV, computer or video games take your place.
  6. Keep your kids from TV programs, movies, and video games that are not right for their age.
  7. Supplements such as melatonin and ZMA have been found to be effective in a significant number of cases.

Kids are encouraged to inform their moms and dads of any sleep problems they may have. Caretakers who suspect that their youngster might be suffering from a sleep disorder are encouraged to consult with their youngster's doctor or a sleep specialist.


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

COMMENTS: 

*   Anonymous said... wondering if anyone on here can help,,i have a 12 year old son who cant sleep,his doctor at camhs put him on melatonin which worked for a few weeks,now it dosnt seem to be,,he cant drop off too sleep which means hes getting 5 hours a night even on school nights and his school have rang me to say that hes nodding off in class,ive tryed routine etc but dosnt work,once he is asleep he will stay asleep but he cant drop off in the 1st place 
*   Anonymous said... I have problems sleeping and no-doctor will provide me with any medication and im suffering too.
*   Anonymous said... my lad had to have assesments 1st to see if he really needed it,it was a last option for me,,some foods have melatonin but low levels of it.
*   Parenting Aspergers Children - Support Group said… http://www.myaspergerschild.com/2010/01/aspergers-children-and-sleep-problems.html
*   Parenting Aspergers Children - Support Group said… Try ZMA (Zinc Monomethionine Aspartate). This is a new recommendation that is getting some amazing results!!
*   Anonymous said... Any advice for children with AS that have sleep issues? He takes 5 mg melatonin and .1 clodnine before bed but is still up every two hrs he is 3.5 yrs old 
*   Anonymous said... My son was the same way when he was younger. I kept trying higher doses of melatonin but it only gave him headaches. So then I did the reverse and gave him a very small dose of 300 mcg and it worked! Now he is 8 and we have added a long, warm bath to his routine and he reads about 45-60 minutes on his own. It really seems to calm him down.
•    Anonymous said... Clonidine for my aspie to
•    Anonymous said... In the U.S. at least, melatonin is not prescription - it's sold with vitamins and supplements - maybe have a look?
•    Anonymous said... It is common for our family. He wakes up just enough for his brain to start moving- and he's up. We have discovered him in our car, in the backyard and also setting off fireworks in the kitchen. (he found our hiding spot!) Our family doctor prescribe an antihistimine and it helps both his sleep issues and some of his eating issues. My son is Asperger's/ADHD, so it is also combatting the medicine he takes during the day- for his appetite. And believe it or not- and I am not a medicine pusher- his sleep at night and getting up through the night seemed to normalize once I had him on adhd medicines. I was warned to stay away from melatonin for prepubescent boys, the doctor said they hadn't fully tested it. But, there was some indication that it may retard there physical/sexual development.
•    Anonymous said... Melatonin didn't work for my 9 yr old aspie. Clonidine works for him.
•    Anonymous said... Melatonin for my little ones
•    Anonymous said... Melatonin has been great for my 8 year old son, don't know how I managed without it
•    Anonymous said... Melatonin has opposite effect on my aspie teen, keeping him awake more than he is (don't think he's slept a night in his life) and giving him extreme nightmares. So we r still at a loss. Physical exercise helps but hard to get him to move much.
•    Anonymous said... Melatonin works for my 8yr old Aspie.
•    Anonymous said... My 13 year old son still wakes up most nights unless he stays up really late. Can make for a rough day when he is tired and grumpy. I just make him go to his room and recalibrate. I have heard from my other friends that this is pretty normal.
•    Anonymous said... My 13 yr old (high functioning female AS) has never slept very well or very long. The only thing that seems to work with her is extreme amounts of physical exercise. Her main hobbies are JuJitsu and climbing and she does 2 - 4 hours a day of one or the other. Even with that she rarely gets more than 5 hours sleep in 24. Having said that she doesn't seem to suffer from this 'lack' of sleep and at 13 is quite capable of keeping herself occupied at night with books or Gameboys. Nobody else in her class can understand why she has an official bedtime on school nights of 11:30 - 12! She has found her own balance over the years and it seems to work for her. 19 yr old ('more' AS than her) on the other hand can now quite happily sleep for 12-14 hours a day if left to his own devices which comes with it's own set of problems ...
•    Anonymous said... My 8 yr old began using melatonin 2 years ago... We started with 0.5 mg and are now using 2.5 mg. he needs it almost every night but on weekends I hold off to see if he can go to sleep on his own. Which he can sometimes . Melatonin has significantly reduced the 1-2 hour falling asleep snuggle sessions we use to have to do. He still would wake every night and rise early. After we began a gluten and dairy free diet this summer (due to allergies found by the naturopath) we had our first night where he slept all night. Honestly it has happened less then 5 times in his life! We are now 3.5 months into this dietary change and last week he slept through the night 5 school nights in row! I continue to see he sleep improving . Not perfect but huge improvements. The diet has also helped his growth as he had only gained about 3 pounds in over 2 years And had not changed show size in 2.5 years. In past we did a trial with guanfecine as some have mentioned and he did sleep but usually at school which was not the point . All the best as you search for what will work for your child.
•    Anonymous said... my daughter can't go to sleep until past midnight every night and then can't get up in the morning.... but drugs are not routinely prescribed in UK. We struggle.
•    Anonymous said... My eight year old was finally put on Clonidine and MOST nights, he sleeps well.
•    Anonymous said... My son (now 12) was diagnosed at about the same age...I could NOT keep that kid asleep all night long for ANYTHING. I finally tried Melatolin (I don't know how to spell that)...he has not had a problem sleeping since then. I have read that Aspie kids don't produce the same levels of Melatolin as others. I hope that helps.
•    Anonymous said... my son had the same problem. Melatonin worked pretty well for him. Now he is 15 and no longer needs it.
•    Anonymous said... My son has hfa he also had ADHD which is now completely gone with nuerotherapy, diet and learning program's. he wakes in the night to play the iPad etc to calm himself, we started yesterday treating his beta which is the back part of his brain. We just had two weeks school holidays and they were the best EVER, not one meltdown and biggest shock of all I could reason with him - unbelievable. He is calm and focused. We are in Australia and this has worked for us
•    Anonymous said... Our son is 7 and wakes during the night but will lay and listen to his music we keep on low all night for him. We find this helps him a lot.
•    Anonymous said... The simple supplement of Melatonin sometimes works. My daughter is 13, and Melatonin would help, but taken too often she would begin waking up too early in the mornings. However, sometimes a couple of nights is all it takes to establish a sleep rhythm.
•    Anonymous said... They have put my son on GuanFACINE and he sleeps throughout the night. He is only 6. We tried 4 different ADHD medications and all increased his hyperactivity.
•    Anonymous said... We have to use Clonidine for my daughter. she wakes several times but goes right back to sleep
•    Anonymous said... We tried everything with my 9 year old Aspie. Nothing worked. We finally bought him a weighted blanket, custom made. He hasn't had an issue since. He has slept every night in his own bed the whole night since it came in the mail
•    Anonymous said... We use 5mg time-release Melatonin for our 10 year old. We found it worked 80% of the time. I added 100mg of L-Theanine and now it's a winner. We also have a custom weighted blanket, purchased from DreamCatcher Weighted Blankets. The combo ensures he gets a good, solid 10-11 hours a night and he falls asleep fast. One last thing we added, that I almost forgot, is a white noise machine for his room. It helps him to shut out his thoughts and quiet down.
•    Anonymous said... we use over the counter sleeping pills
•    Anonymous said... Where did you get the blanket Allison? My son has been waking up a lot and now is starting to sleep walk, I wonder if the blanket would work.
•    Anonymous said... Yes Melatonin has worked for my Aspie.
•    Anonymous said...  5am every morning here.
•    Anonymous said...  Our doctor had a try a few things that never worked, then a different doctor said he can just take Melatonin, which has been working very well for my 9-year-old.
•    Anonymous said... A nutritionist told me that melatonin was potentially dangerous for kids. (Can't remember why, I'll check.) Relaxing routines including breathing, relaxation exercises, warm baths with lavender, reading, etc. do help. My now 13 yo son use to come to our room at least once a night until he was about 11. I'm afraid they are just wired differently. Benadryl is helpful also, but they are not going to have the same sleep habits as nuerotypicals.
•    Anonymous said... Essential oils. Melatonin causes seizures an dB brain bleed in children.
There is also something called Lorinthine. It's amazing
•    Anonymous said... I call them " all nighters" mine has them several times a month...melatonin helps
•    Anonymous said... I love essential oils & we diffuse lavender & vetiver at bed time. It works wonders for instant relaxation & peaceful sleep! BTW - I have to add that therapeutic grade essential oils, ONLY -- like Young Living Essential Oils.
•    Anonymous said... Many nights with only 4 hours sleep, yep
•    Anonymous said... Many people on the spectrum are low in magnesium. I give that to my 10 yr old son before bed. Not only does he sleep better, his disposition is better. He is less angry, more understanding! You can do a search on it. smile emoticon. Good luck!
•    Anonymous said... Melatonin gets my vote
•    Anonymous said... Melatonin should be the best option given it is the crucial hormone for sleep.
•    Anonymous said... My 8yr old is the same he takes Catapres and Melatonin at nite, works great for a couple of weeks but he tends to repeat cycles so two weeks later we are back to sleepless nites, he can stay awake quite happily for 36+ hrs at a time smile emoticon
•    Anonymous said... Our son is 8 with the same diagnosis. Our doctors put him on trazadone to help him sleep. I notice a big difference when he doesn't get enough sleep
•    Anonymous said... The extended release formulation of melatonin works quite well
•    Anonymous said... Try Essentials oils . We use a combination of Lavender, Peace & Calming and Cedarwood. It seems to work great.
•    Anonymous said... Try melatonin
•    Anonymous said... We have never had trouble with our ADHD And HFA son - we have a strict bedtime its black and white - if we do not follow it there can be troubles. When he had his ipad he would wake in the middle of the night to play it but since its broken that hasnt been an issue.
•    Anonymous said... We use melatonin too! Seems to help, but he is still an early riser.
•    Anonymous said... We use P5P plus, it is B6 with Magnesium, we have used it for 4 years it calms our son and he sleeps well. We administer it at bedtime.

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