New parents expect to be sleep deprived – but they expect the sleepless nights to eventually end. For parents of children with autism, though, they don’t always. A study in the March issue of the journal Pediatrics found that children with autism are more than twice as likely to have sleep problems as those without autism.
Jane Tavyev, M.D., director of pediatric neurology at Cedars-Sinai, offers some insight and advice.
What characteristics of autism are most likely to impact a child’s sleep?
Children with autism have lower natural melatonin production, and melatonin is the hormone that helps us to initiate and maintain quality sleep.
Also, a lot of the kids who have autism are really into screens, and we know that screentime reduces melatonin production. The bright light from the screen tricks the brain into thinking that it’s the noon sun. It’s seeing the bright light and thinking, I’m not going to make any melatonin. It’s the wrong time of day. So, if the kid is doing screens right before bedtime, their sleep is going to be impacted.
There’s also a neurobiological propensity to a more hyperactive state in most kids with autism, and it’s just a bit harder for them to settle down.
What are some of the basic effects of lack of sleep on a child?
For kids with autism, it’s going to impact their ability to learn in therapies the next day, and it’s going to make them look more hyper, which is going to lead to more challenging behaviors.
What is your advice for parents who have a child with autism who is not sleeping well?
Addressing the screen issue is the first thing to look at. Some studies suggest cutting off screens two hours before bedtime, others suggest turning off screens four hours before bedtime, but let’s start with at least one hour.
The other thing that helps melatonin production is to actually go outside in the evening. You’re getting the darkness signal coming in through the eyes. You’re doing the opposite of what you were doing with the screens.
Do you ever recommend melatonin supplements for these children?
I think any medications or supplements should be given under the direct supervision of a physician. I know a lot of families feel like it’s natural, they feel like it’s safe. But there are emerging safety concerns.
Do you feel like parents might tend to put the sleep issue on the back burner?
That can definitely happen. The important thing to remember is that if the child’s not sleeping, it is negatively impacting the child and it is also negatively impacting the parent, which is then going to negatively impact the child. The parents should really seek treatment and not be afraid to use medication, if necessary, to address the child’s sleep. I think sometimes parents feel selfish, thinking I don’t want to give my child a medication just so I can sleep better. There’s nothing selfish about it. They really should get treatment to address the sleep issues, which can be very, very challenging at times.