Sleep difficulties are a highly prevalent concern for the autistic population, with studies showing that between 50% and 80% of individuals on the spectrum experience some form of sleep disturbance. The question of whether people with autism require a greater number of sleep hours is complex, as the primary challenge is less about a higher baseline quantity need and more about the quality of the sleep they achieve. Understanding the underlying factors that interfere with rest is the first step toward promoting better sleep health.
Sleep Disruption Versus Sleep Need
The core issue for many autistic individuals is not an inherent need for more total sleep time than their neurotypical peers, but rather significant difficulty initiating and maintaining sleep. This poor sleep quality often leads to excessive daytime fatigue, which can appear as a need for more sleep hours. The most common sleep problem reported is insomnia, manifesting as prolonged sleep onset latency and frequent night awakenings.
Other recognized sleep disorders, including restless legs syndrome and sleep-disordered breathing, are also found more frequently in this population. The frequent interruptions and inability to transition smoothly through sleep cycles mean that even an adequate number of hours may not be restorative. This chronic state of insufficient, non-restorative sleep necessitates focusing on improving the depth and consistency of rest.
Biological and Circadian Factors
Internal physiological differences often play a major role in the sleep challenges experienced by autistic individuals. The body’s internal clock, the circadian rhythm, can be significantly dysregulated. This system, which manages the sleep-wake cycle, may be genetically predisposed to run on an irregular schedule.
A significant finding relates to the sleep hormone melatonin, which signals the body that it is time to sleep. Many autistic people show lower-than-average levels of melatonin or experience a delayed release of the hormone in the evening. This hormonal difference can be linked to variations in genes, such as the ASMT gene, involved in melatonin synthesis. This delayed or reduced melatonin signal contributes directly to delayed sleep phase syndrome, making it difficult to fall asleep at a typical hour.
Furthermore, increased physiological arousal is common, reflected in higher levels of cortisol, a stress hormone. This state of hyperarousal makes relaxation and the transition into sleep more challenging. These biological factors create an internal environment that is less conducive to the natural, timely onset of sleep.
Sensory and Environmental Influences
Beyond internal biology, external factors related to sensory processing and environment can profoundly interfere with sleep. Autistic individuals frequently experience heightened sensory sensitivities, where ordinary stimuli are perceived as overwhelming or painful. Minor environmental details like a ticking clock, a distant siren, or light under the door can prevent sleep onset or cause awakenings.
Tactile sensitivities are also common, making the texture of sheets, blankets, or seams on pajamas a source of significant discomfort. The brain’s difficulty filtering out this sensory input leads to constant stimulation, making the transition to a relaxed state elusive. Furthermore, a preference for routine and predictability is a core feature of autism, and any deviation from a familiar bedtime ritual or sleeping environment can cause anxiety and resistance.
Co-occurring conditions frequently seen in the autistic population, such as anxiety, Attention-Deficit/Hyperactivity Disorder (ADHD), and gastrointestinal issues, also contribute to poor sleep. Anxiety and hyperarousal can maintain a state of wakefulness, while physical discomfort from conditions like acid reflux or constipation can cause frequent awakenings. Addressing these factors is crucial for managing sleep disturbance.
Practical Strategies for Better Sleep
Establishing a consistent and predictable sleep hygiene routine is one of the most effective interventions for improving sleep quality. This routine should be performed at the same time every night, even on weekends, to reinforce the body’s internal clock. The routine should incorporate calming activities, such as a warm bath or quiet reading, and utilize visual schedules to clearly communicate the steps of the bedtime process.
Environmental modifications are also necessary to accommodate sensory needs. Blackout curtains block external light, and white noise machines can mask sudden or inconsistent sounds. The bedroom temperature should be kept cool, ideally between 65 and 70 degrees Fahrenheit, as this range promotes better sleep.
Specific sensory accommodations can be incorporated into the sleeping arrangement. Weighted blankets provide deep pressure stimulation, offering a calming and secure feeling that promotes relaxation. Individuals should select bedding and sleepwear made from preferred soft or seamless fabrics to avoid tactile overstimulation. In some cases, medical professionals may recommend short-term melatonin supplementation to help adjust the timing of sleep onset, but any use of supplements must be managed under the supervision of a physician.