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70% of autistic adults struggle to fall and stay asleep — we ask a sleep expert why
Autism is a lifelong neurodevelopmental condition that impacts a person's day-to-day life — including their sleep.
In fact, research indicates that as many as 50-80% of autistic individuals experience sleep issues, compared to 25-30% of neurotypical people.
Meanwhile, studies have found that sleep problems are the most common co-occurring conditions experienced by autistic individuals. But why exactly are sleep difficulties so prevalent within the autistic community?
To find out, we turned to sleep expert Dr Dagmara Dimitriou. Professor Dimitriou is an Academic Director at UCL's Sleep Education and Research Laboratory, which focuses on the relationship between sleep and neurodevelopmental disorders.
Ahead of Sleep Awareness Week 2025, we asked her how and why autism affects sleep and what can be done to alleviate these issues.
How does autism affect sleep?
According to Dimitriou, the most common sleep issues among autistic individuals are frequent or prolonged wakings, trouble falling asleep, shorter sleep duration, and nightmares.
Surveys have shown that 70% of autistic adults experience difficulty falling or staying asleep, 90% experience poor sleep quality and frequent nighttime awakenings, and 40% experience nightmares.
70% of autistic adults experience difficulty falling or staying asleep
"Nightmares are supposed to diminish with age, but many autistic adults still report them," Dimitriou tells us.
"In the general population, we don't see these reports as much as we do in autistic adults. We are also seeing nightmares more frequently in autistic children than non-autistic children."
While research has also found that 50% of autistic adults report being unable to stay asleep for long, Dimitriou says that shorter sleep duration isn't the only issue.
"In adults and children, it's not only about duration, but about frequent wakings," she says. "We know from our data that autistic individuals will be waking up for prolonged periods of time."
How does autism affect sleep?
Autism can affect sleep in a number of direct and indirect ways. Autistic people are a heterogeneous group, meaning that their needs, traits, and challenges can vary from individual to individual. However, here are some common ways autism can disrupt sleep:
1. Sensory issues and sleep environment
Research has found that many autistic adults associate their lack of sleep with sensory issues.
Autistic people experience sensory differences, meaning they can be under-sensitive or over-sensitive to certain things, such as sounds and textures in their sleep environment.
"I learned from autistic individuals that sometimes the environment that they sleep in is behind their sleep issues," explains Dimitriou.
"So, if you have bright lights or a buzzing sound from outside, it can make it far worse to fall asleep and can also cause frequent wakings. They may need different sensory aids to help them to sleep as well."
2. Unsuitable routines
At Tom's Guide, we frequently dispense advice on how to optimize your sleep routine, from going screen-free before bed to joining the 5am wake-up club.
However, Dimitriou has pointed out the guidelines for creating the perfect nighttime routine are set out for the general population, and are not compatible with lots of autistic individuals' needs.
"The advice I tend to gather from our data and speaking with autistic individuals is that bedtime routines have to be individualized," says the Professor of Sleep Education.
"The sleep hygiene that you're told to follow, such as brushing your teeth or putting on quiet music, doesn't work with a lot of autistic individuals and autistic children."
Likewise, recommended morning routines, such as early risings, can also cause a lack of sleep in autistic individuals.
An example that Dimitriou gives is a study conducted on autistic children in Singapore, which found that autistic children who went to a non-mainstream school with a later start time were less sleep deprived than autistic children who attended mainstream school.
"The children receiving mainstream schooling are not able to go back to bed after nighttime awakenings because they have to go to school, so that pressure causes shorter periods of sleep," she says.
3. Nighttime anxiety
Studies have shown that anxiety is a common co-existing condition in autistic individuals, and this can influence their sleep patterns.
Nighttime anxiety refers to feeling worried or fearful about past experiences or the future. Common symptoms include restlessness, a racing heart and tense muscles.
Dimitriou says that nighttime anxiety can play a huge role when autistic people experience sleep issues, with autistic children and adolescents experiencing school anxiety and autistic adults experiencing office anxiety.
"Interestingly, we carried out sleep research prior to COVID and then repeated the same sleep study during COVID lockdowns," the academic director tells us.
"During the lockdowns, most people slept worse than they did prior to the pandemic. Yet in autistic adults, we saw quite the opposite, because they didn't have those anxieties stemming from thinking about busy public transport and office work, concerns about being late, and the pressures of social interactions."
How does a lack of sleep affect autistic people?
While the challenges associated with autism can cause a lack of sleep, Dimitriou also points out a lack of sleep can also exacerbate those challenges.
This can lead to emotional deregulation, diminished daytime functioning and social interaction, and increased anxiety.
"If you have sensory problems and you have sleep problems, you will even see enhancement in sensory overload," she explains.
"If you wake at night frequently or for prolonged periods of time, that is definitely going to affect your sensory thresholds and increase sensitivity to certain textures, sounds, and tastes."
How can autistic people improve their sleep?
1. Build an ideal sleep environment
"Sometimes, autistic people may not feel that going to bed is a safe thing to do," says Dimitriou. "So, it's also about having a safe environment."
According to the sleep researcher, one way to create a safer sleep environment is through sleep aids.
While she notes that there's no magic sleep aid that will work for all autistic individuals, she has observed that autistic people can benefit from certain products, such as white noise machines to block out environmental sounds or black-out blinds to block out light.
Other sleep aids include weighted blankets, sleeping tunnels and tents, and even safety beds.
These beds define the edges of the bed through padded sidewalls or guard rails. "Sometimes children and adults need to feel the edge of the bed to feel more secure," she explains.
2. Tailor routines to fit you
From her research and speaking with autistic individuals, particularly adolescents, Dimitriou has found that a bedtime routines should feature something that calms the individual, such as a special interest.
"Some say that listening to loud music, which is against most sleep hygiene advice, helps them sleep," she tells us.
You have sensory and cognitive differences and this beautiful brain ticking in a different way. So you need to have your own ways of promoting sleep hygiene
"At the end of the day, you are an individual, you have sensory and cognitive differences and this beautiful brain ticking in a different way. So you need to have your own ways of promoting sleep hygiene."
Sometimes, creating an ideal routine can even mean allowing screen time before bed.
"I've been told, 'If I finish that particular game, I am calmer and can actually go to bed'. Being allowed to finish the day in your own way will absolutely work and be beneficial for sleep."
3. Breathing techniques
Sleep methods that Dimitriou has observed as effective are breathing techniques: "We have taught some individuals breathing relaxation, and they did amazingly well."
The sleep expert says it doesn't matter what breathing technique or mediation app you use, as long as it works for you. However, if you're looking for inspiration, checkout our guide to the seven best breathing exercises for sleep.
Tom's Guide created this content as part of a paid partnership with Helix Sleep. The contents of this article are independent and solely reflect the editorial opinion of Tom's Guide.
