Do you dream of the day when your child or adolescent goes to sleep without protest, falls asleep quickly and remains in bed throughout the night?
Sleep challenges for children and youth on the Autism Spectrum are more common than you may think. According to a study by Hanley & Colleagues (2018), 63-73% of children diagnosed with Autism may experience troubles getting ready for bed, falling asleep, and remaining asleep throughout the night. Without adequate sleep, these learners are more likely to be irritable, fatigued, and engage in a variety of challenging behaviours.
Did you know that 81% of consultations to a professional regarding sleep challenges results in prescription medication alone, without any environmental or behavioural changes suggested (Stojanovski & colleagues, 2007)? Not only do these medications not directly treat the cause of the sleep disturbances, they are a band-aid solution and not an option that will bring long-term changes. If medications are not long-term solutions, what is? This is where Behavioural Sleep Treatment enters the stage.
What is Behavioural Sleep Treatment?
Behavioural sleep treatment is an Evidence-Based, best practice for treating sleep challenges for children, youth and adults on the Autism Spectrum (Hanley & colleagues, 2018). It often involves working alongside a Behaviour Analyst to Assess a variety othat may be contributing to your childs’, teens’, or adults’ sleep challenges. Your behavioural clinician will conduct a sleep assessment and develop a sleep treatment plan alongside family members to ensure goals are achievable, realistic and individualized.
If your child is having difficulties with their sleep, try some of these Evidence-Based Behavioural & Environmental Modifications:
1. Determine an Appropriate Sleep Schedule
Make sure that you are putting your child to bed and waking them up at an ideal time and keep this time consistent. This is a delicate balancing act of making sure it's not too early and they are tired, or it's not too late and they are unable to wake up in the morning.
Sometimes to get your child back on track, you may need to wake them up when they have gotten less sleep, have them go about their day, and then put them to bed at an earlier time the next night to properly re-align their schedule.
It is important to know how long each age group should in fact be sleeping for, to ensure we are not requiring our loved ones to sleep longer than necessary – potentially causing sleep disturbances.
It is also important to factor in how long a child should be napping during the day or if they should be napping at all.
Take a look at the chart below to help determine how much sleep your loved one requires and at what ages naps are no longer recommended.
2. Create a Solid Bedtime Routine
Keep your routines consistent – visual schedules and audio reminders are great (utilize Amazon Alexa or similar technology).
Shortly before bedtime, ensure they experience a calm and quiet state, activities become more passive.
Remove screens when possible, from the bedtime routine as blue light disrupts our circadian rhythm and may contribute to sleep disturbances.
If the routine involves showering, complete this near the beginning of the routine so their internal temperature has time to return to normal and will not disrupt their sleep.
If this routine involves a snack, ensure it is a light snack as heavy meals near bedtime can contribute to sleep disturbances.
3. Optimize Their Bedroom Conditions
Ensure the bedroom is comfortable for them and the bed is large enough.
Black out curtains to prevent light coming in from outside.
Bedroom temperature should be cool – approximately 60-67 degrees Fahrenheit or 15-18 Celsius. A hot room will affect sleep.
Main lights should be off when your child enters their room, if you have a night light, we recommend one that provides indirect light (from below the bed).
A sound machine that plays white noise (or any non-undulating noise) that is on throughout the entire night, is highly recommended.
Removing favourite toys, electronics, or other items from the room prior to bedtime to minimize distractions after the bid goodnight.
4. General Sleep Hygiene Tips
Make sure that the bed is only for sleeping – not for watching TV, playing, doing homework or anything else. This will help the bed to invite sleep once they are in it!
Providing them a “sleep dependency” they can keep all night long – weighted blanket, stuffed animals, a body pillow – something easily portable that can be there all night long.
Avoid daytime naps whenever possible if your child is over 4 years old – If you see your child is getting tired, have them get up and engage in an activity that they enjoy, and put them to bed early that night. If despite your best efforts they fall asleep, allow them 15-20 minutes and then wake them up.
Do not drink caffeinated beverages within 6 hours before bedtime, and minimize eating sugary, greasy, or junk foods for at least 2 hours before bedtime.
Melatonin an hour before bedtime may be beneficial when paired with other environmental and behavioural techniques to help cause sleepiness before bedtime.
Ensure your loved one is getting adequate exercise and stimulation during the day - if they do not burn this energy during the day this will increase the likelihood of sleep disturbances at night.
I hope you found these Evidence-Based Environmental & Behavioural Modifications helpful, and you and your loved one’s are on your way to a better night’s sleep!
Is Your Child Still Struggling with Sleep Challenges?
For sleep challenges that persist despite implementing the environmental modifications outline above, it is highly recommended that you seek professional guidance to tackle these complex challenges.
Is your child still:
not falling asleep quickly,
leaving the bed,
waking up at night,
wetting the bed, or
engaging in any other behaviours that are interfering with sleep?
If so, the professionals at Progressive Steps Training and Consultation Inc. would be happy to conduct a sleep assessment and develop a collaborative sleep treatment plan with you that meets the needs of your family.
Implementing sleep interventions consistently can be tough! Espcecially when you're already sleep deprived. The behaviour consultants at Progressive Steps Training and Consultation Inc., will support you throughout the process and check in with you following each night to see how it went and help you troubleshoot things that may come up.
If you are interested in Behavioural Sleep Consultation Services please contact: firstname.lastname@example.org for more information.