I often tell patients my wish would be to bottle up a ‘good night’s sleep’ and hand it out by the dozen! For my patients with autism, it’s no different. Sleep often, if not always, is quite disrupted in these little gems.
Importance of Sleep
If you think our brains are busy during the day, you can’t even imagine what they do at night! We need sleep to regulate neurotransmitters, detox the brain, and support prefrontal cortex functioning.
During sleep, neurotransmitters that are responsible for mood, memory consolidation, and attention are released. Melatonin which we all know as our sleep hormone is also released – it helps us get sleep, yet it’s also released when we sleep. Lastly our growth hormone which (you guessed it!) helps our body to grow and repair, is also released.
When we don’t get enough sleep, it causes an increased release of cortisol (a stress hormone) throughout the day which disrupts our normal circadian rhythm (how we wake gracefully and how we fall asleep easily).
Not only does our brain produce chemicals like neurotransmitters at night, it ‘mops’ others up! For example, our brain gets rid of glutamate. Although glutamate helps to build neurons, helps us learn and remember items, it also can be quite inflammatory. We want to get rid of this during the night so as to reduce inflammation in the brain.
Executive functioning – that is motor planning, memory, impulsivity – is impaired when sleep is low quality or abundant enough. Motor planning specifically is a big issue in autism so lack of sleep makes this worse.
Stats on Autism and Sleep: Did You Know?
50-80% of children with autism experience sleep disorders (vs 5- 50% of those that are neurotypical)
On average, children with autism spend 15% of their sleep time in REM (vs 25% of those that are neurotypical).
Causes of Sleep Disruption in Patients with Autism
So often I have parents coming in stating how terrible their child’s sleep is. This is probably the roughest part for my mighty autistic patients, imagine just being UP. FOR LONG PERIODS OF TIME. JUST NOT SLEEPING. It’s like torture for these little humans, really. And hard on the family who also need their sleep, right? So what is going ON? A number of factors may be playing a role, including the following:
Melatonin release is disrupted in patients with autism, be it the actual amount released from the pineal gland or an abnormal rhythm of release. This can be caused by a genetic mutation in the enzyme that governs the release. As well, often times in autism, neurotransmitters can be out of balance. This, in turn, can manipulate melatonin production.
Sometimes patients with autism can be hypersensitive to sounds, touch, and general stimuli. This can make it hard for their parasympathetic nervous system (ie the one responsible for the body to rest and to digest) to turn ‘on’ and enable them to fall asleep as well as stay asleep.
Other body systems can play a role in sleep disturbance such as digestion and immune system. Often times in patients with autism, digestive issues occur. This can look like dysbiosis, food sensitivities, and general inflammation in the gut track. Not only can these issues keep them up at night, it also can play a role in the production of melatonin via other neurotransmitters.
Treatment of Sleep
Treat the root cause of the issue. This is a pillar of naturopathic medicine, isn’t it? And it applies here! For example, often times with autism patients we will do dietary changes right off the bat. I’ll also look for an overlay of their dysbiosis picture. Treating this via herbs, bowel flush, nutrients and returning to homeostasis often times change sleep patterns
Supporting the body with exogenous melatonin when circadian rhythms are disrupted and/or production is lacking, is a great way to support sleep! There is a bit of debate around melatonin production and this debate, given ongoing research, will continue.
Just as important, using herbs and supplements to support the body’s parasympathetic nervous system is key to sleep latency.
Overall, when sleep quality and length of good, the neuro inflammation in autism patients can decrease, causing symptoms to reduce/eliminate and thriving brains to develop!
