Sleep Baby Sleep: Bedtime Tips for Those with Autism

Chandra says bedtime routines for her son with autism go on forever. “My son seems to gain energy as the night wears on. Sometimes he’ll sleep from 11 p.m. until 1 a.m. and then is up again running around the house. He’s hyper and I’m exhausted and unable to deal with the demands of the day.”

“First he needs to see a certain video. Once that’s over then there’s some other routine that needs to be done before he can go to sleep. The worst part is I have to sleep with him every night. Night waking is still a problem and if he wakes up alone, he panics and it takes a long time for him to fall back a sleep. Night waking also wakes up my other children.”

Do these stories sound familiar?

Sleep deprivation can be harmful for both parents and children

My son Marc went to bed late every night and he had to be rocked into a deep sleep. Once that was accomplished, the night waking began every two hours. Marc was up an average of five times a night at a year old. I was nursing him each time I went in to see him. He was crying fitfully so I felt I couldn’t ignore him. I went into work everyday on four hours of sleep. Teaching music to elementary school children became a chore due to chronic sleep deprivation. I felt like screaming at my students when they were playing the xylophones or banging on drums. Mastitis, a breast infection, was a recurring problem too – probably related to fatigue. I was hitting the wall. Something had to change.

My best friend suggested I take a sleep course at an Infant Resource Centre. I was desperate enough to agree even though I was terrified at some person telling me I had to let my baby “cry it out”. Headaches, Ibuprofen, and poor judgement were taking over my life so I had to try the sleep course. It was the best money I ever spent. Here is what I learned from the instructor.

Sleep tips for those with babies and children who have ASD

1. A baby needs ten to twelve hours of sleep a night, not including naps
   If the baby is under a year, two naps are necessary – a one hour nap in the morning and a one to two hour nap in the afternoon. After a year of age, a baby needs a two-hour afternoon nap until age three. The best time for the afternoon nap is 1 or 1:30 p.m. The baby should sleep no later than 3:30 p.m. or it will interfere with bedtime. The optimum time for bed is 8 p.m.
2. The biggest no-no is nighttime feedings
   It takes approximately 2 ½ hours to digest a bowl of cereal. Babies sleep best on an empty stomach. If feeding occurs during the night, a baby does not fall into a deep sleep because the digestive system is continually working. Milk feedings should be limited to no more than 2 ½ cups a day after a year of age. Milk feeding from nipples should not be done close to bedtime or that becomes a crutch for sleep induction.
3. A strong, consistent bedtime routine needs to be established
   If your child is having a bath, it should happen by around 7:20 p.m. All milk feedings need to be done by 7 or 7:15 p.m. Do not do the feedings in their room. Get the child’s pajamas on, then read one or two stories maximum. Remember the longer the bedtime routine is, the harder it is to put your child to bed because they want you to stay with them.
4. At 7:55 p.m., instead of nursing or giving the child a drink, sing a song or say good night to main objects in the room such as the window, clock, lamp, dresser etc…
   I used the “Goodnight Moon” book by Margaret Wise Brown as a routine, taking Marc around the room in my arms allowing him to touch each object as we said good night to it. Now it is time for bed. Put some toys on the bed, say “It’s nighttime, I love you, I’ll see you in the morning”, close the door, and don’t come back for a bed check for 45 minutes. Make sure the non-nursing parent puts the child to bed if you are still night nursing.
5. Closing the bedroom door may seem cruel but there are two reasons for doing this
   One is to keep the focus in the child’s room. If the door is open even a crack, the light from the hall will pour in and the child will draw his/her attention towards the outside light. It is also better to have the door closed in case of a fire.
6. On the first night of this routine, you’ll experience some crying or objection from your child as it is a new routine with new expectations
   Let them protest for the first 45 minutes before you do your second bed check. At this time, open the door and say, “It’s nighttime, I love you, I’ll see you in the morning.” This should take five seconds. Don’t hang around in the room. Spending more than the five seconds becomes cruel for the child. Keep repeating this routine until they are asleep.
7. If the child wakes up again in the night, do a check after ten minutes of fussing or crying
   Say the bedtime phrase and leave. Start the checks every 45 minutes again until the child is back asleep. This process may sound cruel but by the morning, everything is fine.  The first night of this routine will be the worst night but hang tough. By the second night, the child will cry half of what they did the night before. By the third night, they might cry for five to ten minutes. If the child wakes up at all in the night, it will be for less than ten minutes.

I used this routine with Marc at thirteen months after a year of very little sleep for both of us. To my surprise, Marc was a much happier child on more sleep. I used to feed him cereal before bedtime and nurse him until he fell asleep; cutting those two things out made bedtime a breeze. Marc cried only a few minutes the first night at bedtime and by the second night he didn’t wake up at all. The interesting thing is after a year of this solid bedtime routine, going to bed became a pleasant, worry-free experience for us.

Sleeping routines for older children that can help

Marc is now 20 and is an excellent sleeper. There has been the odd waking relapse. When he turned 13, he started waking up at 4:30 am for the day. I gave him a travel alarm clock to take to bed with him. The alarm was broken so he couldn’t set it by accident. I told him the rule was to stay in bed until 7 am on a school day, 9 am on a weekend. Even though he was awake before those times on some days, he remained in his room. Marc likes having rules for a framework on how to live. He still takes the clock everywhere with him to refer to for snack and meal time and bedtime. To this day, Marc still adheres to this morning waking rule.

When I took the sleep course, Marc had not been diagnosed with autism yet. Knowing what I know now, I would recommend to try this sleep routine to any parent of a child with autism. Our children love routines and predictability.

• Use PECS symbols if they aid the process.
• Have special toys only for bedtime.
• Read a book that is only read at bedtime, which will make the book special.
• Be consistent and firm with your expectations.
• If your child is a night-waker, see if there is a disruption in a bedroom set- up such as a teddy bear positioned a certain way on the bed.
• Teach your child how to rearrange his things if they become dislodged in the night.
• Do not allow screens and tech toys to be played with in bed or right before bedtime as they are stimulating.
• Do not eat right before bedtime.

Remember: Wanting your child to sleep is not a cruel thing

It is a necessity for both you and your child in order to function at an optimum level the next day.

I did the sleep routine with my Julia when she was five months old and I’ve never looked back. She also has autism. She is 18 now and also an excellent sleeper. We had issues with her around the age of 2 getting up at 3 am for the day and that took some time to stop. Julia also wound up in our bed at age 6 for a year until we bought her bunk beds for her 7th birthday. She liked the idea of sleeping up high. She is still sleeping in the top bunk.

There are many books out there on the subject of sleep, but I found this sleep training method worked for us. Everyone needs a good night’s sleep to be at his or her best. Try the sleep routine, adapting it to make it personal for your child. Sweet dreams! See you in the morning…

Recommended Reading

Sleep Better! A Guide to Improving Sleep for Children with Special Needs

Solving Sleep Problems in Children with Autism Spectrum Disorders: A Guide for Frazzled Families

Sleep Well on the Autism Spectrum