Insomnia and Autism

Sleep problems are very common to individuals on the autism spectrum. Up to 86% report trouble sleeping. Up until now, autism researchers and clinicians have assumed that difficulty falling asleep, waking up multiple times during the night and never getting a full night’s rest accompany autism. But new evidence suggests that trouble sleeping in infancy predates and even predicts a later autism diagnosis.

We all know a baby sleeps through much of their infancy. Their brains are busy growing and developing while they slumber. When sleep is interrupted, so is brain development. Sleep is crucial for synaptic plasticity, which is key to learning and memory. A neuron or nerve cell, is an electrically excitable cell that communicates with other cells via specialized connections called synapses. This essential process of synaptic plasticity is known to be altered in autism. Early sleep loss during critical periods of development can disrupt the brain wiring that establishes binocular vision in infants. It has also been found to impair social bonding in animals.

University of Washington autism investigators Lucia Peixotoby and Annette Estes propose that abnormal sleep is not just a symptom of autism, but a key contributor to it.

Given this premise, we would expect the sleep problems of individuals with ASD to be present from a very early age and predict the severity of their autism. Current studies affirm their hypothesis. Autistic children have twice the sleep issues of their neurotypical peers. Their poor sleep has been linked to traits including severe repetitive and restricted behaviors later on.

Current science points to alterations in the genes that regulate the circadian clock which regulates your sleep/wake cycle as a precursor to troubled sleep. But for as much as we know, the realm of sleep is still uncharted territory. Researchers are keen to hone in on the mechanisms underlying insomnia in autism with hope of finding ways to enhance the quality of life for autistic individuals and their families.

Caregivers can’t solve the problems of insomnia in autism, but there are some strategies that help pave the way to better sleep. These include:

• Eliminating sugar and caffeine (colas).
• Talking to your pediatrician about your child taking melatonin.
• Establishing a routine that follows a specific order. You can make a chart with pictures for your child to follow and check off.
• Creating an enticing environment. Surround them with the things they love. A soft blanket, a favorite stuffed animal, a glowing nightlight, cozy pajamas.
• Eliminating screen time at night: The light from the screen disrupts the production of melatonin, a hormone that’s necessary for sleep; exposure to a screen, whether it’s watching a video or playing a game, will keep their mind active and occupied
• Winding down to quiet activities
• Bathing or Showering
• Pressure touch is known to be calming, especially for those with autism. Gentle massage or rub-down, using downward strokes. Moving your hands against the body in the direction of hair growth is especially soothing.
• Soft, musical background
• Comfortable bedding and a weighted blanket. A weighted blanket stimulates deep pressure receptors that can be very calming. *When shopping for a weighted blanket for your child, be sure to look for options with non-toxic filling and ones that can be washed. You’ll also want to factor in the right weight for your child. Typically, the formula is 10 percent of your body weight, plus or minus 1-2 pounds
• Bedtime stories
• White Noise, calming music or guided meditation

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[h/t]

SPECTRUM Losing sleep: How researchers miss a key contributor to autism
Lucia Peixoto, Annette Estes / 16 July 2020

SPECTRUM Autistic children’s repetitive behaviors linked to sleep, sensory problems
BY PETER HESS / 20 APRIL 2020

Body clock genes may set pace for sleep issues in autism
BY RACHEL NUWER / 19 JUNE 2015