Any parent will know how much information is on the internet regarding getting better sleep. Despite the amount of sleep information, it can sometimes feel like information overload, leaving you trying to figure out the "right" strategy.

It can leave you experiencing decision fatigue. 

When it comes to caregivers with neurodivergent children, it can be even more challenging as often the mainstream sleep advice doesn't take into account sensory, behavioral, and developmental needs.

Sleep struggles are common for neurodivergent children; one study found that children with Autism Spectrum Disorder are twice as likely to have sleep difficulties in comparison to neurotypical children (Reynolds et al., 2019). Difficulties can include but are not limited to difficulty with relaxing their bodies, shorter REM cycles, anxiety, insomnia, sleep apnea, restless legs, difficulty with producing melatonin, and inconsistent length of sleep. However, mainstream sleep advice can leave a parent feeling lost or isolated. 

Let's dive into traditional sleep tips that we may need to shift to support all children to sleep.

Advice #1: White noise machines support children going to sleep quicker and staying asleep. 

The purpose of using white noise machines, sound machines or fans is to help provide a constant noise that can block out environmental sounds that could startle us awake. 

For children with Sensory Processing Disorders, ADHD/ADD, and ASD, for example, these traditional sounds can be aversive. The sound, for some, can even be painful. 

What to try instead?

Often, music is not recommended during sleep due to the highs and lows a song can have with tone; however, highly preferred songs on repeat can be exceptionally comforting when played as background noise. 

Additionally, research has shown that certain levels of constant background noise can help individuals with ADHD focus more on the task they are on (Söderlund, Sikström, & Smart, 2007). For sleep, this can look like supporting their concentration for staying on track during the routine and for relaxing their body.

Guided meditations can be a great resource to help relax their body and calm their mind. Our favorite ones are Goldminds and Zenimal. 

Advice #2: Ensure to keep them in their room throughout the entire night 

We want to pair their bedroom with sleep versus wakefulness or play. Sleep Stimulus Control can support the creation of new sleep pathways to help cue the brain to know what to do based on environmental cues. AKA we pair the room for sleep only. 

If we try to keep them in their room during long wakefulness periods, it can tell the brain that their room is a place for wakefulness versus relaxing or sleep. This also goes with encouraging them to play in their room across the day or keeping toys in their room; this can pair and signal that it is a place for fun and staying awake. 

What to do instead?

For long wakefulness periods across the night, I suggest a reset by taking them out of the room for a short time. The goal would be to allow them to release the energy they may have, but also to help maintain pairing the room as a place for sleep. 

Doing a reset can also help break the loop of thoughts they may be stuck on, resulting in feeling anxious and unable to relax. 

After 20-30 minutes of the reset, do a short routine and attempt to sleep again. 

Also, I would try to avoid any electronics in their room, such as the iPad or TV, to help strengthen the idea that their sleeping place is for sleep only.

Advice #3: Keep the routine calm and quiet 

While a calming routine can have many benefits, children with different sensory needs may need a more upbeat and movement style of routine.

This can include adding heavy work (I.e., pushing, pulling, hanging activities) into routines to help release energy and then grounding activities to help calm them (I.e., pressure, pulsating, movement). 

You may need to do swinging, jumping on a trampoline, pushing a laundry basket, hopping, yoga moves, pillow fit, dance party, being thrown into pillows then wrapping them up and releasing them, pulsating their body with a massage or a massager, deep hugs, stretching. 

The routine may need to start from dinner onward to help their bodies have enough time to unwind. Keeping it consistent can be greatly beneficial. 

Every child is unique and when trying to get better sleep, creating a sleep plan that is carefully tailored to meet their unique sleep needs while taking into consideration their unique developmental profile is key. 

Be open to trial and error and come back to strategies that may have not worked previously to see if they work in the moment. Thinking outside traditional sleep strategies can be beneficial to find the right mix of strategies that will work for your child. 

Written by: Kensey Butkevich, BCBA, Certified Sleep Consultant, owner of Sleep Easy Consulting 

Sources 

Corkum P, et al. Better nights/better days—distance intervention for insomnia in school-aged children with/without ADHD: A randomized controlled trial. Journal of Pediatric Psychology 2016;41:701-13.

Hiscock H, Sciberras E, et al. Impact of a behavioral sleep intervention on ADHD symptoms, child sleep and parent health: A randomized controlled trial. TheBMJ 2015;350:h68.

Neumeyer AM, Anixt J, Chan J, Perrin JM, Murray D, Coury DL, Bennett A, Farmer J, Parker RA. Identifying Associations Among Co-Occurring Medical Conditions in Children With Autism Spectrum Disorders. Acad Pediatr. 2019 Apr;19(3):300-306. doi: 10.1016/j.acap.2018.06.014. Epub 2018 Jul 24. PMID: 30053632.

Reynolds AM, Soke GN, Sabourin KR, Hepburn S, Katz T, Wiggins LD, Schieve LA, Levy SE. Sleep Problems in 2- to 5-Year-Olds With Autism Spectrum Disorder and Other Developmental Delays. Pediatrics. 2019 Mar;143(3):e20180492. doi: 10.1542/peds.2018-0492. Epub 2019 Feb 11. PMID: 30745433; PMCID: PMC6398427.

Sobanski, E., Schredl, M., Kettler, N., & Alm, B. (2008). Sleep in adults with attention deficit hyperactivity disorder (ADHD) before and during treatment with methylphenidate: A controlled polysomnographic study. Sleep: Journal of Sleep and Sleep Disorders Research, 31(3), 375–381. https://doi.org/10.1093/sleep/31.3.375

Söderlund G, Sikström S, Smart A. Listen to the noise: noise benefits cognitive performance in ADHD. J Child Psychol Psychiatry. 2007 Aug;48(8):840-7. doi: 10.1111/j.1469-7610.2007.01749.x. PMID: 17683456.

Wajszilber D, Santiseban JA, Gruber R. Sleep disorders in patients with ADHD: impact and management challenges. Nat Sci Sleep. 2018 Dec 14;10:453-480. doi: 10.2147/NSS.S163074. PMID: 30588139; PMCID: PMC6299464.