Ashwin Lewis
Sleep issues are common among autistic people and can have a significant impact on their functioning and quality of life. Research suggests that autistic children and adults experience sleep difficulties such as sleep-related anxiety, difficulty settling at bedtime, trouble falling asleep, and impaired breathing during sleep. These issues can persist into adulthood, affecting their overall health and well-being.
Autistic adults may require more sleep due to various factors, including insomnia, circadian rhythm disorders, sleep apnea, restless leg syndrome, and parasomnias such as sleep paralysis and sleepwalking. They also tend to spend less time in REM sleep, which is crucial for memory consolidation and cognitive function. Additionally, autistic individuals often have mutations in genes regulating melatonin, resulting in a flat melatonin curve, which disrupts their sleep-wake cycles.
Addressing sleep issues is essential for autistic adults as it can help manage sensory sensitivities and executive functioning challenges. Establishing a consistent bedtime routine, reducing screen time before bed, creating a comfortable and sensory-friendly bedroom environment, and practicing good sleep hygiene are some strategies that may improve sleep quality.
| Characteristics | Values |
|---|---|
| Prevalence of sleep issues | 50-80% of autistic children experience sleep disorders (compared to 9-50% of neurotypical children) |
| Circadian rhythm sleep-wake disorder (CRSWDs) | Autistics have a mutation within the CLOCK gene, which impacts circadian rhythm. |
| Melatonin levels | Autistics are more likely to have a mutation in genes regulating melatonin resulting in a "flat melatonin curve". |
| Time taken to fall asleep | On average, it takes autistics 11 minutes longer to fall asleep. |
| Insomnia | Autistics are more likely to experience insomnia which includes everything from difficulty falling asleep to night waking and early morning rising. |
| Parasomnias | Autistics are more likely to experience parasomnias, including sleep paralysis, sleepwalking, and night terrors. |
| REM sleep | Autistics spend roughly 15% of their time asleep in REM (while neurotypicals, on average, get 25%). |
| Repetitive behaviors & hyperactivity | Increase with poor sleep (which can make sleep more difficult). |
| Sensory sensitivities | Sleep deprivation can have a significant impact on sensory sensitivities. |
| Executive functioning | When Autism and sleep issues co-occur, this can amplify executive functioning difficulties. |
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What You'll Learn
- Autistic adults may need more sleep due to insomnia, which can be caused by anxiety or an inability to relax
- Autistic adults may have a mutation in genes regulating melatonin, resulting in a flat melatonin curve
- Autistic adults may experience parasomnias, including sleep paralysis, sleepwalking, and night terrors
- Autistic adults may have a mutation within the CLOCK gene, which impacts their circadian rhythm
- Autistic adults may have hypersomnia, caused by the additional stress they experience in social situations
Autistic adults may need more sleep due to insomnia, which can be caused by anxiety or an inability to relax
Sleep issues are common in autistic people and can have a significant impact on their functioning and quality of life. Research has found that sleep issues are more common in autistic children and adults than in their neurotypical counterparts.
Additionally, autistic people may have a mutation in genes regulating melatonin, resulting in a "flat melatonin curve". Melatonin is a hormone that regulates sleep patterns and helps us feel sleepy. A "flat melatonin curve" means that autistic individuals may not feel as tired at night and may feel sleepier during the day or upon waking. This can further contribute to insomnia and sleep difficulties.
To improve sleep, autistic adults can try establishing a bedtime routine and making their bedroom more comfortable by reducing light, noise, and smells. Relaxation techniques such as having a bath, massage, quiet time, or gentle exercise can also help to wind down before bedtime. Addressing food sensitivities or stomach discomfort with a GP or dietitian may also improve sleep.
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Autistic adults may have a mutation in genes regulating melatonin, resulting in a flat melatonin curve
The relationship between autism and sleep issues is an area of ongoing research. Studies have found that sleep issues are common in autistic children and adults, with 50-80% of autistic children experiencing sleep difficulties. Autistic people are more likely to experience insomnia, parasomnias such as sleep paralysis and sleepwalking, and circadian rhythm sleep-wake disorders (CRSWDs). They also tend to have longer sleep onset latencies and poorer sleep efficiency.
Addressing sleep issues is crucial for autistic individuals' overall health and well-being. Sleep deprivation can exacerbate sensory sensitivities and executive functioning difficulties, making daily tasks more challenging. Additionally, adequate sleep is essential for the brain to release neurotransmitters that regulate mood, learning, and attention. It also helps detoxify the brain and maintain a balance of hormones that promote mental well-being.
To improve sleep quality, autistic adults can establish a bedtime routine, reduce screen time before bed, create a comfortable and sensory-friendly bedroom environment, and practice good sleep hygiene. Seeking professional advice from a doctor or a sleep specialist is also recommended.
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Autistic adults may experience parasomnias, including sleep paralysis, sleepwalking, and night terrors
Sleep issues are common among autistic people, with studies suggesting that over half of autistic individuals experience significant sleep issues. These issues can lead to serious challenges for autistic people and their caregivers. Autistic adults may experience parasomnias, including sleep paralysis, sleepwalking, and night terrors. These conditions can be frightening and disruptive to sleep, impacting overall quality of life.
Sleep paralysis is a condition where an individual becomes conscious during REM sleep but is unable to move their body. It can be a terrifying experience, leaving the person feeling trapped and unable to react. Sleepwalking, also known as somnambulism, involves complex behaviours during sleep, such as walking or performing other activities while asleep. It can range from simple, such as sitting up in bed, to complex, such as walking around or even driving a car. Night terrors, on the other hand, are characterised by intense fear and screaming, with the individual appearing to be awake but still asleep. These episodes often occur during the first third of the sleep cycle when transitioning from deep sleep to light sleep.
The exact causes of parasomnias in autistic adults are not fully understood, but several factors may contribute to their occurrence. Sensory issues, for example, can play a role. Autistic individuals may be hyper-responsive to sensory input, making it difficult for them to block out light, noise, and other disruptions, increasing the likelihood of parasomnias. Additionally, physical or mental health conditions common in autistic adults, such as sleep apnea, post-traumatic stress disorder (PTSD), and high cortisol levels, can further disrupt sleep and trigger parasomnias.
To manage parasomnias and improve sleep, autistic adults can consider various strategies. Establishing a consistent bedtime routine that includes relaxing activities and minimising electronic device usage before sleep is essential. Creating a predictable transition from waking to sleeping hours by providing warnings before starting the bedtime routine can also help. Maintaining a cool, dark, and quiet bedroom environment is crucial to reducing sensory challenges. Seeking professional help from sleep specialists and considering cognitive behavioural therapy for insomnia (CBT-I) are also recommended approaches to improving sleep quality and reducing the occurrence of parasomnias.
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Autistic adults may have a mutation within the CLOCK gene, which impacts their circadian rhythm
Sleep issues are common in autistic people and can have a significant impact on their quality of life. Research has found that sleep issues are quite common in autistic children and adults. According to a 2021 article, roughly 50-80% of autistic children and adolescents experience sleep difficulties.
A 2022 review of research explored the effects of various genetic and neural factors on sleep quality in autistic children. The review found that various gene mutations were associated with sleep changes, such as prolonged awakening and disturbed REM sleep, in autistic children. The disruption of an essential clock gene in preclinical models can lead to autistic-like phenotypes. Specifically, the global or cerebellar deletion of the Bmal1 gene can cause severe impairments in sociability, social communication, and excessive repetitive behaviors.
The disruption of a circadian clock gene may be involved in the development of autism spectrum disorder (ASD). Circadian clock and melatonin pathway genes may play a role in the sleep-wake rhythms of autistic adults with intellectual disabilities. Normal and abnormal sleep-wake rhythms could be related to circadian clock (PER1) and melatonin pathway (ASMT) gene variants.
There is a need for further research to translate this data into clinical decisions or risk profiles.
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Autistic adults may have hypersomnia, caused by the additional stress they experience in social situations
Autistic adults may experience hypersomnia, or excessive sleepiness, as a result of the additional stress they face in social situations. This can lead to increased exhaustion and a need for more sleep.
Autistic individuals often have difficulty with social interactions and communication, which can be stressful and exhausting. This additional stress can contribute to hypersomnia, causing them to require more sleep than neurotypical individuals.
Research suggests that autistic people are more likely to experience insomnia, which can include difficulty falling asleep, night waking, and early morning rising. They may also have a harder time winding down and relaxing before sleep due to increased anxiety or sensory sensitivities.
Furthermore, autistic adults are more likely to have a mutation in genes regulating melatonin, resulting in a "flat melatonin curve". Melatonin is a hormone that regulates sleep patterns, and a disruption in its secretion can impact an individual's sleep-wake cycle.
The additional stress and exhaustion experienced by autistic adults in social situations can contribute to hypersomnia, making it challenging for them to get the restorative sleep they need.
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Frequently asked questions
Most adults, whether neurodivergent or not, generally need the same amount of sleep each night. According to the National Institutes of Health, the recommended amount of sleep for adults is between 7 and 9 hours each night. However, everyone has different needs when it comes to sleep.
Autistic adults are more likely to experience insomnia, circadian rhythm disorders, sleep apnea, restless legs syndrome, and parasomnias, including sleep paralysis and night terrors.
Some reasons could include difficulty settling, winding down, and going to sleep; waking up repeatedly during the night; increased anxiety or an inability to relax; social cueing problems; irregular secretion of the sleep hormone melatonin; neurological conditions such as epilepsy; and sensory differences, such as increased sensitivity to blue light from screens or certain sounds.
Autistic adults are more likely to have a mutation in genes regulating melatonin, resulting in a "flat melatonin curve." This means their bodies often do not feel tired or send the same level of tired cues at night, and they may feel sleepier during the day. On average, it takes autistic adults 11 minutes longer to fall asleep. Autistic adults also spend roughly 15% of their time asleep in REM sleep, while neurotypical adults spend 25% of their time in this sleep stage.
Sleep deprivation can cause increased sensory sensitivities and executive functioning struggles for autistic adults. Sensory sensitivities may be heightened, and executive functioning, including the ability to plan, organize, and break down complex tasks, may be more challenging due to poor sleep.
