Children on the autism spectrum can have significant issues around sleep. These issues impact all family members as you stumble through another day on three hours’ sleep – you’re simply exhausted.
Sleep is a complex issue, one that may need medical attention when sensory and behavioral supports aren’t enough. But before you make an appointment at the sleep clinic, try modifying your home environment first.
Don’t think I’m crazy when I tell you that a good night’s sleep begins at dinner time. That’s right. Children living with autism thrive within routines, so establishing one that eases your child into sleep should start early and with a clear transition signal, such as dinner time.
Your bedtime visual schedule (see our earlier post on creating visual schedules) can start with a picture of dinner followed by pictures of the rest of the evening’s events. Keep your eye on the end goal – sleep – so all events on the visual schedule should lead your child naturally to that state of mind.
A good and consistent bedtime routine is fundamental and the most important factor when it comes to getting your child to bed. Think about it. You have a bedtime routine – shutting off the lights, locking the door, laying out the items you will need for tomorrow, brushing your teeth, reading a book, etc. All these things transition you into a state that is ready for sleep. This is what you are creating for your child.
Tips for setting up a routine that will knock them out
- Dinner time signals the start of the evening, a slowing down and a return home to relax – thus a natural start to the bedtime routine. Try “closing the kitchen” when dinner is finished. Turning off the kitchen light at this time is a natural visual cue. You may decide to re-open the kitchen at a later time if a bedtime snack is part of your routine.
- What you include in your routine depends on your family and your child’s interests. After dinner activities in your summer routine might look different than the after dinner activities in your school year routine.
- Try to keep electronics to a minimum in the evening. The brain is stimulated by electronics/technology at a time that you are trying to help your child quiet his/her brain. Evening is a good time to read, play a game, play with toys, go for a walk, etc.
- About an hour before you want your child to be settled into bed, begin to close down the house as you move toward the bathroom and bedroom. When toys are picked up in your living area, turn off the light to signal to your child that the house is closing down. Darkness also signals the brain to produce its own melatonin, the naturally occurring sleep hormone.
- If at all possible turn the bathroom lights to a dim setting while your child prepares for bed.
- Nighttime baths can be very calming to the sensory system. Follow bath time with wrapping your child snuggly in a towel which will further calm his/her sensory system. You can give some deep pressure while your child is wrapped in the towel.
- Once pajamas are on your child can brush teeth and use the toilet (if not in a diaper). When you are finished in the bathroom turn out the light. By now the house should be fairly dark and your child will be physically winding down.
- Follow your child into their room. Sit on the bed or in a chair to read together. In order to avoid a bedtime power struggle, decide with your child – beforehand – how many books you are going to read.
- When books are finished, tuck your child snuggly into bed.
Be sure to use your visual schedule during each part of the bedtime routine. This keeps it predictable. Ideally this schedule was made with your child, so power struggles or resistance to the routine can be diffused by referring to the schedule you made together.
Try writing a bedtime Social Story. It can be a very helpful strategy to help your child understand and comply with the bedtime routine.
And finally, be consistent. Adhering to the bedtime routine may be difficult at first, but giving your child a foundation upon which they can rely eases anxiety while preparing their minds and bodies for sleep. Adapt the routine as necessary but not before it has been established and consistent.
Things to consider to help your child stay in bed
- weighted blankets
- quiet music
- quiet book on CD
- a dim night light
- make sure all toys/distractions are out of sight
- practice meditation/visualization or belly breathing