SLEEP 2026 | Guidance for managing sleep problems in children with autism/developmental disorders

The first important piece is identifying whether there’s a medical condition. For evidence-based approaches to treating sleep in autism and other developmental conditions, is there something that’s interfering with a child’s sleep? And that can be reflux. It can be seizures. It can be sleep apnea. It can also be depression, anxiety. These are all very common in autism and other developmental conditions. And then once you figure that out, also look at the medications a child may be on. They may have well-controlled depression, but they may be taking medicines that are very stimulating at night and interfere with sleep. So figuring out if there’s a medical cause is number one. And then once you’ve done that, I always try to start with behavioral approaches, meaning calming, soothing bedtime routine, consistent bedtime, making sure the bedtime isn’t too early because we know a slightly later bedtime promotes sleep, making sure that the screens, whether they be iPads or phones, are out of the child’s sleeping environment because the blue light and the content can interfere with sleep, making sure that there’s good interaction with the parents so that the child feels comforted, but also knows that it’s up to them to fall asleep and they can’t become dependent on the parent to fall asleep. Sometimes we use medications to jumpstart that process. We may use melatonin. We may use some other medications to help the child fall asleep or stay asleep with the idea that over time we can remove those medicines as the child learns healthy sleep habits. And sometimes we’ll use a medication that we can use to treat another condition like depression or anxiety, we can dual-purpose it for sleep.

Yeah, I would just say that a lot of people believe that autism can’t be treated with medications. I should say sleep problems and autism are really hard and really hard to treat. And I think if you take a simple approach and you really work with the parents and hear what their concerns are and try to address them, you can be very successful. And the other piece is that treating sleep, of course, is super important for health. It’s also really impactful in this population and in other disability populations for daytime behaviors to improve when you’re sleeping better. Family functioning improves when the child is sleeping better. And we all know how we feel, right? When we don’t sleep well, we feel grumpy and grouchy and more apt to send that snarky email. So, you know, if we can help our populations that are already sensitive to emotional regulation problems, right? We can help them by sleeping better. We can make a huge impact for the child and the family.

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