It is evident that how well you have slept that night may affect your entire day significantly. Nevertheless, when it comes to families raising a kid with autism spectrum disorder (ASD), then sleep disturbances become a regularity. The research demonstrates that 80% of children, usually still in their developmental years, having ASD encounter sleep disturbances including insomnia symptoms (e.g. refusal of going to bed, anxiety, and gastrointestinal distress). In accordance with the research from Frontiers in Psychiatry, these difficulties have a domino effect leading to problematic behavior on the part of children compared to those who have had a good sleep.
Bedtime habits:
In the research, the following is stated regarding children with autism: even though they sleep more, their sleep quality becomes lower. For example:
- Parasomnia — a sleep disorder, when there are certain actions and situations that affect sleep. They include confusional arousal, somnambulism, and sleep terrors.
- Bedtime defiance – your child is very lively, noisy, and energetic prior to sleeping.
- Consistent nighttime awakenings — for example, it is very hard for your kid to fall asleep in his or her bed if he or she is used to sleeping elsewhere, such as in the living room.
Even though the autistic child has slept 10 hours in his/her bed, fragmented sleep results in lack of deep sleep that is necessary for emotions regulation during the day.
The Ripple Effect: Daytime Behavior and Family Well-Being
If the sleep of a child is always disturbed, its effects extend to his daily life and family functioning:
- Exacerbated Behavioral Challenges Lack of sleep compromises neurocognitive control; therefore, children are less capable of controlling their emotions. It has been proved that there is a direct relationship between the severity of sleep disturbances and hyperactivity, irritability, and behavioral problems in the daytime.
- Lower Health-Related Quality of Life (HRQoL) The child's quality of life is affected not only because of the child's disease but also because of the severity of his sleep disturbances and maternal burnout.
- Elevated Maternal Burnout & Depression The raising of a child who requires many resources from his parents drains them of energy. Moreover, when it is accompanied by the parent's hypervigilance and sleep disorders, the risk of their burnout increases significantly. In this study, mothers of children with ASD had significantly higher levels of clinical depression and burnout than controls.
Sleep as the Critical "Bridge"
One of the main findings from the studies is that the quality of sleep functions as an intermediary factor between parental psychological state, children's behavior, and quality of life:
- 51.4% of the association between maternal depression and children's quality of life is explained by the intermediary factor – quality of sleep of the child.
- 36.6% of the association between maternal burnout and children's quality of life was mediated by the intermediary factor of sleep quality.
- 23.1% of difficulties with behavior during the day affects quality of life through the intermediary factor of disturbed sleep.
This means that sleep becomes the invisible "bridge" that connects this stress cycle in case of depression/burnout of a mother or meltdowns of a child
The Takeaway for Families and Caregivers
If your child with ASD is having difficulty sleeping, this isn't an unfortunate symptom of his or her condition but rather the critical health need that must be addressed. Since good sleep is so essential for the family, pursuing sleep assistance isn’t indulging yourself but rather essential family-centered care.
Steps for parents and clinicians to consider:
- Sleep screening from the start: Discuss sleep habits at regular clinical and therapy sessions.
- Find out what's causing the problem: Determine the causes both physiological (sensory difficulties, GI distress, sleep apnea) and behavioral.
- Help the parent: Improving the parent's mental well-being can be a critical step towards improving the child’s sleep environment.
With the right intervention, addressing the challenge of sleep can become a potent tool for happier lives and improved wellbeing.
Reference:
Xavier, S. D. (2021). The relationship between autism spectrum disorder and sleep. Sleep Science, 14(3), 193. https://doi.org/10.5935/1984-0063.20210050