As the clocks go back and thoughts turn to how to persuade young children to stay in bed for that extra hour, we take a look at why sleep can be such a struggle for someone on the spectrum and what we can do to help.
Sleep problems are thought to affect up to 80% of children with an autistic spectrum condition (ASC) and poor patterns can have a huge impact not only on the young person themselves, but on the whole family.
The science of sleep is complicated and getting the recommended seven or eight hours something of a national obsession. Recent media coverage has highlighted a direct link between sleep deprivation and long -term health issues including heart health and even a suggested link with Alzheimer’s disease, so it is a problem to be taken seriously.
Some families caring for children and young people on the spectrum can only dream of achieving that goal of a solid eight hours sleep a night as they battle to get their children to bed, fall asleep and stay asleep through the night.
Problems may arise from differences in neurology, medical or behavioural issues and some research also suggests there may be differences in the brain systems and hormones that regulate sleep.
Weary parents are only too familiar with the frustratingly long ritual of getting children into bed, creeping out of the room as their young ones finally nod off only to repeat the cycle throughout a long, exhausting night. So, what can we do to help? The National Autistic Society, www.autism.org.uk, recommends parents start by considering their expectations and suggests there is no fixed number of hours a child at various stages should sleep – the focus is on getting enough sleep.
The internet is awash with features, advice and products aimed at promoting good sleep and most agree on the need for the following:
· Bedtime routine
· Teach to sleep alone
· Sleep environment
· Sleep/wake schedule
· Diet and exercise
A number also point to the prolonged use of tech equipment in the lead up to the bedtime routine as another sleep stealing culprit. Anxiety, fear and worry about the day ahead may also be a factor in young people with ASC who continue to experience sleep problems well into young adulthood and those issues need to be acknowledged and where possible addressed alongside the sleep difficulties themselves.
What else helps? Some children with ASC may not fully understand the need for sleep or may have communication difficulties which stop them from picking up on cues that it’s time for sleep, or prevent them from expressing their thoughts and needs. Parents and carers may have to explain sleep as the introduction to a very clear, consistent bedtime routine which may include the following:
· A visual sequence of the bedtime routine
· Avoiding caffeine, fizzy drinks, chocolate and other stimulating foods before bedtime
· Sticking to the same structured routines each day
· Including physical exercise in the daily routine
· Making sleep comfortable and accommodating sensory issue –
Black out curtains
Reducing noise with thick carpet, closed doors, switching off appliances
Soft nightclothes with labels removed, soft bedding or weighted blankets
Reducing smells reaching the room / using scented oils if they soothe a child
Removing clutter, toys, and creating a calm clear space
As we approach the date for turning back the clocks, experts advise that we prepare in advance by sharing and showing when it is going to happen and what to expect. A week before the time change it may be useful to start shifting your child’s bedtime by ten minutes at a time until an adjustment of a full hour has been made by the time the clocks change.
When sleep problems persist despite the use of good sleep health routines it may be time to seek professional help. Medical interventions such as the use of melatonin supplements are regarded as last resort solutions and are only available on prescription. Other options include sleep training information and workshops, available across East and West Berkshire from the charity Parenting Special Children – see http://www.parentingspecialchildren.co.uk
Information from a one day conference on sleep disturbance from practitioners at Cerebra , a charity dedicated to supporting families with children with brain conditions, can be downloaded from their website http://w3.cerebra.org.uk/
As with almost everything else we do to provide the best possible support for our young people on the spectrum, planning and preparation is key – along with that most magical ingredient – patience. Night night everyone Zzzzzzzzzzzzz.