Strategies to Help with Sleep for Autistic Adults

A good night’s sleep can be a huge difference maker in our mood, productivity, and well-being. Yet many autistic adults face challenges in getting a good night’s sleep for a variety of reasons. While every autistic person has a unique sleep experience, a few commonly reported issues include: 

• Only getting 4-5 hours of sleep each night.

• Having trouble falling asleep.

• Waking up in the middle of the night.

• Waking up early.

Autistic adults report a variety of reasons for experiencing these kinds of sleep issues, from anxiety over the day’s interactions to excessive environmental noise. For many autistic adults, this diminished sleep schedule directly impacts their quality of life.

It should be noted from the outset that some people are night owls, early birds, or have very short sleep schedules and do not feel that their quality of life is diminished at all. There is nothing inherently wrong with how anyone sleeps, only the question of whether or not your sleep schedule is contributing positively to your quality of life. If you are happy with your sleep schedule, you shouldn’t feel pressured to mess around with it!

If you do face some challenges in getting the rest that you feel you need, then some of the following strategies may help. Because autistic people can face a variety of different sleeping challenges, most people won’t relate to every single one of these strategies. You might also have already tried some of these and know whether or not they’re useful. 

Feel free to skip those strategies that you don’t think are worth your time and focus on the ones that seem the most promising or able to directly address your obstacles. 

We will do our best when discussing individual strategies to indicate what kinds of challenges they might help address.

Despite the variety of strategies, we can offer one universal pro tip before diving in: try one new sleeping strategy at a time! While sometimes sleeping strategies complement each other, they can also sometimes clash and mute each other’s effectiveness. Whether or not you do get a good night’s sleep when trying multiple strategies at once, it’s hard to know which thing is actually helping or not helping. 

Once you know a strategy is worth incorporating into your routine there’s nothing stopping you from trying some of those other strategies too!

Here we are talking about the parts of your sleep environment that are directly under your control. If it’s in your room or something that you can change in your home, it counts as your sleeping environment!

• Block out any light from entering your room.

  • For some people, seeing lots of visual contrasts, shadows, or little points of light can be hugely distracting and prevent sleep. Blocking out light, even if it’s seeping through something like a doorframe or window, can help minimize those pinpoints, shadows, and potential points of distraction.

• Experiment with different night lights to find the balance you need.

  • Other people cannot sleep in total darkness for a variety of reasons, and a night light can be a nice balance between having a soft light while keeping the room mostly dark. Night lights come in different varieties so if one feels nice but not quite right you may benefit from a different design.

• Adjust the temperature.

  • Sometimes temperature can play a surprising role in our ability to fall asleep! A room that’s a little bit too hot or cold can lead to quite a bit of tossing and turning at night. If you are able, try adjusting your thermostat by a couple of degrees in your preferred direction and see how you feel about it. 

There are a variety of sensory considerations when it comes to sleeping.  One might seek things like noise-canceling headphones or environmental changes to deal with negative sensory challenges, but what about sleep aids that could potentially make positive sensory contributions?

• Weighted blanket

  • A weighted blanket just feels right for some people, especially when it comes to sleep! According to Penn Medicine, weighted blankets help put your autonomic nervous system into “rest” mode, which can help with symptoms of anxiety such as stress or shivering.

• Soothing music or white noise

  • Although it can seem counterintuitive, one thing that helps some people cope with environmental noise beyond their control is a baseline level of white noise or a type of music they personally find soothing. For some people this baseline consistent level of noise is far preferable to random and intrusive noises.

• Swapping out pajamas or sheets for a more comfortable fabric

  • For people who just seem to have trouble getting comfortable no matter how they position themselves, sometimes the issue is the fabric itself! Are your sheets and blanket comfortable? Do they feel scratchy or uncomfortable when they make contact with your skin? How about your clothes? Even minor discomfort is worth noting - that feeling can be amplified when it’s distracting you from sleep!

  • Try shopping in person if you can - getting a sense of how the fabric feels at the store can be a great indicator of how you’ll feel about it when trying to sleep on it!

Please note that because we are not medical professionals we will not make any direct recommendations regarding medication related to sleep. Instead, our strategies will focus on communicating with medical professionals who can offer advice with a better understanding of your personal health. The following strategies are meant for doctors you trust and feel you can collaborate with when it comes to your health.

• Ask your doctor if any existing treatments may impact your sleep.

  • If you currently undergo treatment or take medication for reasons unrelated to sleep and are concerned they may be contributing to your sleep challenges, you should mention those issues to your doctor and ask if any of your treatments are typically associated with sleep issues. Your doctor can use their personalized knowledge about your help and medical interventions to provide an educated answer.

• Strategize about lifestyle changes you can make to help with your sleep schedule.

  • If you are worried that some of your personal habits are contributing to the challenges you are facing in your sleep schedule, talking about it with your doctor can help you both mutually plan some low-risk strategies that could potentially resolve your sleep issues without necessitating further intervention!

  • Doctors are often working at an information deficit when it comes to getting the full story of how their patients live their lives, so talking about some areas where you know you are concerned can prompt some answers they might not otherwise think to give.

• Ask your doctor about possible overlapping or co-occurring conditions.

  • In addition to the vigilance, doctors should have for any potential medical causes for sleep issues, there are some sleep disorders that have a higher occurrence among autistic adults including insomnia and sleep apnea. If you think there may be an underlying medical cause for your sleep issues it is worth asking your doctor and developing a plan to keep an eye on things.

• If you think it may become necessary or is necessary, ask your doctor about potential interventions to address sleep challenges.

  • As much as it would be nice to solve all sleep-related problems with lifestyle adjustments, sometimes and for some people these problems may eventually require medical intervention. If you think you need or think you may one day need medical intervention in relation to your sleep challenges then you should tell your doctor sooner rather than later so you can develop a plan of action that makes sense to you both.

Food and drink suggestions can be fraught, as everyone’s bodies are different! Instead, we will talk about a couple of general rules when it comes to eating and drinking and sleep - if you are looking for potential solutions and see room for adjustment with one of these strategies then that strategy may be right for you!

• No or limited food/drink 2 hours before bed.

  • Some people enjoy a good nightcap and find it helps them get to sleep more easily. Others might need to just eat a little something before bed to ensure they are not dealing with hunger pains while trying to fall asleep. But eating a significant meal close to bedtime does have the potential to disrupt your sleep. As a general rule, try to avoid anything resembling a full meal in the 2-3 hours before bed and try to make those bigger meals happen earlier in the day.

• Find your caffeine timer.

  • Caffeine is one of those substances that can be all over the map in how it affects different people’s sleep schedules. Some folks can drink caffeinated beverages all day and fall asleep right on schedule, while others can’t have a cup of coffee after lunch or they’re guaranteed to be up past their bedtime. If you’re a regular caffeine user and aren’t sure about your caffeine timer, it can help to try cutting off caffeine use a little earlier in the day each day and seeing how it impacts your overall sleep. You may find a sweet spot that’s right for you!

• Be mindful of alcohol use.

  • Much like caffeine the effects of alcohol can be all over the place, but should not be discounted in terms of how it can disrupt sleep! Whether you are a regular or occasional drinker, it’s worth making note of how well you sleep when you do enjoy a glass of wine or two in the evening and whether that affects how much or when you choose to drink.

Create a schedule.

• For some people following a schedule is already a challenge and adding one isn’t about to make their problems any easier. If you have not tried using a schedule to incorporate some of the lifestyle changes around your sleep schedule, it can serve as a helpful reminder of your current plan and something you can evaluate as a way of thinking about your progress.

• Schedules are not magical motivators but are wonderful tools as long as you feel that they are helping you!

Consult a mental health professional.

• Although medical professionals may be the exact people you need to help with a variety of sleep related problems, other sleep-related problems may be best addressed with the support of a mental health professional. If you feel that talking to someone about some of the problems that are keeping you from having a restful sleep is an appealing option, a mental health professional may be the perfect person to talk to!

• Consult a medical specialist.

  • Although consulting medical specialists compounds the challenge of finding a person who is autism friendly and that sleep treatments are not always successful for autistic adults, sometimes the severity of a given challenge related to sleep is enough that it is worth going to a doctor who specializes in sleep. It is the type of choice you can discuss with your general practitioner if you feel it may become necessary.

This is more generalized advice than a specific strategy. Using these tips to track your progress will help you remember what strategies you have already tried and most importantly how well they are working!

• Establish a baseline.

  • As tempting as it can be to dive into interventions right away, one of the most useful things you can do at the start of your journey is to establish a baseline of what you currently consider to be a “normal” night of sleep.

• Make a note of the interventions you have tried.

• Note how your sleep schedule has changed, if at all.

  • If your sleep schedule is changing for the better then you must be doing something right! Alternately if you are putting in a lot of effort for little return, it’s OK to reconsider whether a given strategy is worth your time.

Interested in more resources to help with sleep? Check out this excellent toolkit from Milestones or this more condensed guide from AutismCRC.

For those who struggle with sleep, getting it right can feel like an unstable alchemy that’s in danger of coming undone at any moment. For all the rest sleep is supposed to bring us, doing it “the right way” isn’t always so easy! We hope this post has offered some potentially helpful strategies and resources for helping you get the good night’s rest you deserve!