Sleep – a guide for autistic adults

Many people have sleep issues, but if you’re an autistic person, you may find sleeping particularly difficult.

Here we look at why autistic people may have difficulty sleeping and some strategies that can be used to improve sleep.

Why might I struggle to sleep?

Many autistic people are likely to suffer from disturbed sleep patterns at some point in their lives.

Reasons for this could include:

having difficulty settling, winding down and going to sleep
waking repeatedly during the night, or having difficulty getting back to sleep after waking up to go to the toilet
increased anxiety or an inability to relax causing insomnia
social cueing problems, where you don’t make the connection between others in the house going to bed and their own need to sleep
irregular secretion of the sleep hormone melatonin, which regulates sleep patterns, or having atypical circadian rhythms (body clock)
neurological conditions such as epilepsy
sensory differences, such as increased sensitivity to blue light from smart phones, laptops and other screens, or sensitivity to certain sounds or white noise, which may be upsetting or distracting and keep you awake
problems caused by food allergies, which could cause gastrointestinal issues and discomfort, or increased sensitivity to caffeine or other stimulants, which can disturb sleep.
hypersomnia - sleeping too much. Increased exhaustion could be caused by the additional stress autistic people experience in social situations.

What can help?

Keep a sleep diary

Keeping a sleep diary will highlight any unusual patterns of sleep and identify factors which may be influencing your ability to sleep. If you are using other strategies to aid sleep, you will be able to track how effective they are.

Sleep diaries are also useful because you can show them to professionals such as , GPs or social workers, to give them a clearer idea of the impact sleep issues are having on your life.

Establish a bedtime routine

Try to establish a bedtime routine that you can follow in different settings, for example if you are on holiday or staying with family and friends.

There is some research to suggest exposure to bright lights from screens (TVs, computer, tablet, smart phone etc) can inhibit the production of the sleep hormone Melatonin. You might, therefore want to reduce your screen time before bed.

Make the bedroom more comfortable

You might find certain sensory aspects of your bedroom distracting, making it harder to relax and go to sleep, as well as stay asleep. Your environment and surroundings can also play a role. It may help to:

block out light using dark curtains or black-out blinds
reduce noise using thick carpet, shutting doors fully, turning off appliances, and moving your bed away from a wall with activity going on on the other side
block out noises by using ear plugs or listening to music through headphones
remove labels from bedding and night clothes, or try bedding and nightclothes made from other materials
reduce smells coming into the room by closing the door fully, or by using scented oils that you find relaxing
remove distractions, such as electronic devices near the bed and pictures on the wall (unless you find these relaxing), and consider a different colour on the walls
use relaxation techniques such as having a bath, massage, quiet time or gentle exercise such as yoga, to help you to wind down before bedtime.

Diet

If food sensitivity/stomach discomfort is affecting your sleep, visit your GP or a dietitian for advice. We also suggest that you visit a dietitian before introducing any major dietary changes to check that your diet is still balanced. Limit caffeine and other stimulants, especially near bedtime.

Medication

According to The Sleep Council, melatonin is a naturally occurring hormone which our bodies produce when it gets dark to help us sleep. Synthetic melatonin supplements are only available on prescription in the UK. Some people are prescribed synthetic melatonin for sleep problems, for more information, you should speak to your GP.

Natural remedies

Health food stores offer "natural" remedies which claim to treat insomnia and other sleep disorders. It’s important to consider how such products might interact with any other medication you may be taking. If you are thinking of trying a “natural” or “alternative” remedy, you should discuss this with your GP first.