Overcoming Sleep Issues

The is post is part of Best of the Best, Edition 8: Sleep Issues & Bedtime and Special Needs Kids. If you check the above link on about July 14, you'll find a whole host of similar articles by other authors.

Sleep issues are very common for children and adults with Aspergers Sydnrome. I've talked about these before but last time it was a bit of a "scientific" post. This time, I want to be more practical. I want to look at why children with Aspergers Syndrome and Autism have sleep difficulties and what you as parents can do to improve their sleep.

Some Reasons for Sleep Issues

First of all, I want to look at some reasons why sleep may be difficult for children (and adults) with aspergers sydnrome;

The Sleep Ritual

Like many aspergers activities, sleep is a matter of ritual. If you get the ritual wrong, or out of order, then sleep can become much more difficult. The aspie can stress over the ritual instead of sleeping. A case in point is my youngest son (7.5). One part of his ritual concerns dessert and should a parent send him to bed without any, trouble is sure to follow.

My wife will often say; "You don't have dessert every night" but that's not true. In his mind, it's an accepted part of the ritual. In his mind, he DOES have dessert every night. Though at least we've mandated "eating your dinner" first. If we break this ritual, he will stress over the lack of dessert. It might seem like a small thing but it's enough to keep him awake.

This puts us into a positive parenting dilemma. Is giving him dessert really "giving in" to him? Sometimes it is but sometimes it's just a case of picking your battles. Is dessert unhealthy? Are we encouraging unhealthy rituals? Perhaps... but then, maybe if we could come up with a healthier dessert, such as fruit, it would be less of a problem. In any case, a small dessert is not as unhealthy as lack of sleep.

Constant Thinking (No brain quiet)

Aspies have a lot of trouble calming their brains. We tend to think over things, solve problems and allow our minds to wander into excessive detail on our special interests. When I was younger, I'd lie in bed and code computer programs. I'd wake up in the morning with reams of code and amazing solutions in my head but I'd suffer from lack of sleep. Talking to my older son (10.5), he designs lego creations in his head while he's attempting to fall asleep. Of course it's obvious - if you're using that much brainpower, you're not going to fall asleep. Aspie brains tend to seize quiet time and use it to its full potential.

If this is your issue, then you need to find a way of removing that quiet time. Have your child do a regular activity when going to bed. It needs to be something which can occupy their thoughts but must be in one direction only (ie: computer games are out). Watching television in bed is one option, though it's probably not the best habit. Listening to quiet music or audio books is better and reading books or comics is best of all.

If your child is concentrating on the story, they won't be stewing over other things. There's a good chance that they will fall asleep while reading. That's good. At least they've fallen asleep.

Reviewing

Even when aspies aren't actually dreaming up new concepts, they're busy reviewing the events and conundrums of the day. Some aspies are word-based, some are picture-based and some, like me, tend to be more events-based. I find that I play back whole conversations over and over again looking for hidden meanings, gestures, tones etc. All of the stuff that I didn't notice during the actual conversation. After all, I did "take it all in". I just couldn't process it during the conversation. Word and picture based aspies will also tend to review their day using their preferred mental facilities.

Again, the solution for this problem is to remove the quiet time. Don't let your aspie use sleep-time to reflect on their day. Give them a certain time for that before bed but make sure that once they're in bed, they are mentally occupied.

Compounding the problem

It's clear that sleep is a problem for people with aspergers on normal days but there are a few things which can really compound the problem;

Extraordinary Stress

A stressed child will find sleep even more difficult. Lots of things can cause stress, deviation from routine, sensory issues and day-to-day problems. You need to communicate with your child regularly to find what things stress them out.

Social Problems

The more social problems a person has, the more time they'll need to spend reviewing their day. Sometimes it's better as a parent to spend some time before bed putting their social problems to rest. Then, when it's time for them to sleep, distract them with a book.

Medications

Many stimulant medications (most notably ritalin/concerta) have side effects which reduce the patient's ability to sleep. If the medication is still active in a child's body, it will prevent sleep. Check the dose and the time it takes to wear off. If you've given your child a tablet later than usual, don't expect them to fall asleep at the normal time. In fact, if the medication is still in your child's body, don't send them to bed. You'll only make the bedroom into a place of frustration.

You can counter these medications with a natural product called Melatonin but don't automatically assume that "natural" means safe. Melatonin can cause irritability and may have other side-effects too.

Food

There are lots of side effects from food including allergies and discomfort. Some foods such as chocolate and soft drinks have a stimulant effect which keeps kids awake and some foods, particularly those which are high in carbohydrates will cause the body to spend the night processing it rather than relaxing.

The evening meal should really be consumed about four hours before bedtime but today's busy lifestyle means that it's often only a matter of minutes between the meal and sleep. Don't forget too that lying down after a big meal can create reflux problems (and the acid in reflux can damage a child's teeth while they are asleep).

Comfort

Children with Aspergers Syndrome often cite discomfort as a barrier to sleep. This can be a matter of temperature regulation or of difficulty getting comfortable due to bed linen. For example, most people love the feel of freshly laundered linen but many aspies will find the clean linen to be too "scratchy". Sometimes it's to do with the fabric softener you use and sometimes it's to do with specific scents within your detergent.

Distractions

Make sure that your child's room is free of distractions. Ideally, close the blinds against lights, remove toys and make the rest of the house reasonably quiet but not silent. Make sure that your child can't see the television from their doorway. In our case, we have to check the drawers of my son's bedside table regularly because he likes to sneak toys up into his room. If a distraction is present, your children will take advantage of it rather than sleep. Don't forget to check the stuffed animals in the bed as many modern toys will talk, laugh and writhe.

Anxiety and nightmares

Sometimes children won't sleep due to anxiety or nightmares. You might think that you're doing them a favour by not letting them watch scary television shows but you'll find that kids will quickly find alternative things to be scared of. Instead of dracula, they'll be scared of the count on Sesame street. Instead of some space alien, it will be the "spider in my room". Anxious children will always find something to be anxious about so instead of trying to block every experience from their sight, start trying to teach them about liklihood (how likely is it that a bad spider could get up here) and fiction (these things aren't real).

My mother always told me that a nightmare was just my body trying to wake me up to go to the toilet. I found that once I accepted this, I became much less disturbed. If all else fails, remember that you can provide younger children with night-lights and older children with lamps. My own nightmares mostly stopped once I had a bed lamp that I could turn on at any time to dispell the dark.

Things to do?

I've been dropping specific hints throughout this post but here are a few more general things you can try.

Return to Sender....

I think that most people are familiar with the supernanny's tactics and sometimes they work really well. It's always worth trying her tactics at the start of a new set of sleep issues, just to make sure that the issue is inability to sleep rather than sheer wilfulness.

Once you've figured out that your child can't rather than won't sleep, it's time to retire those supernanny tactics otherwise you'll start to exacerbate the bedroom issues. Instead of sleep, consider giving your child a chance to do some low thinking things (reading again). You might consider letting your child out of bed for a while too because sitting in a bed reading will make the bed linen feel too hot and could exacerbate any sensory issues.

Don't be tempted to lock your child's door (though many parents, myself included) will still try it. This won't help your child and may increase their sleep anxiety or simply, as was the case with us, result in the need to purchase a new door. We were certainly surprised that our child could throw things hard enough to put holes in the door.

Quiet before bed

It might seem like a no-brainer but having kids run around excitedly just before bed doesn't actually help them to sleep. It's a pity because "just before bed" is usually "dad time". It's the time when the "big toy" comes home from work and wants to play with the kids.

It's a shame to cut this time out because it's important bonding time so instead, make "dad time" an early priority. Dads should come home, and rumble with the kids for at least 30 minutes, then transition to slower and gentler play.

It's hard because mothers really want some "dad-time" of their own but if you can just get the kids out of the way first, you'll increase your chances.

The same goes for storybook time. Some dads like me are quite animated storytellers and give their characters all manner of accents and sound effects. This is fine but sometimes it stirs the kids up. If you can at least make rules to prevent your children from jumping around during storytime, you'll be able to make the story exciting without the consequences.