Help: My Child Doesn’t Sleep

Dwaine asks: Is there any other thing apart from melatonin that could help my autistic daughter sleep? Please help.


Hi Dwaine! So many parents face this same issue, particularly parents of children with autism. There are so many reasons that may be causing her sleep disturbances but let’s look at a few things you can do.  It sounds obvious, but it’s important to create a quiet, comfortable environment for your daughter to sleep in.

  • Reduce noise as much as possible, or consider a white-noise machine or some other noise maker. (My brother can’t sleep without his sound-machine turned to the ocean noises!).
  • Make sure the room is properly lit, depending on her needs. She may need a pitch black room, or maybe she needs a nightlight. If you’re not sure what suits her best, try different options for a few days each and see if you notice a difference.
  • Be conscious of her napping patterns. If she’s sleeping during the day she may be less motivated to sleep at night.
  • Be aware of what she’s eating and drinking, and when she’s eating and drinking. Again, it sounds obvious, but limit her caffeine intake. Caffeine can be found in sodas, teas, chocolate, chocolate milk, and even some medications.
  • Limit the use of electronics before bed. The light and the stimulation from the TV, iPad, or computer may make it difficult for her to fall asleep.
  • Create a bedtime routine and stick to it. Pick a bedtime and create a schedule of events leading up to bedtime. If she enjoys books, have story time before bed. If your family is religious, pray together before bed. If she enjoys music, let her listen to a song before bed. Whatever it is, make sure it’s calming and not over-stimulating. We want bedtime to be relaxing and peaceful, not exciting and high-energy. Also, stay away from aversive tasks as part of the routine. If brushing teeth is usually a struggle consider doing that task earlier on in the night so it doesn’t affect the bedtime routine.

Another angle to consider is if her sleep issues are behaviorally related. For example, is she avoiding bedtime because she has a hard time separating from you? Is she trying to escape bed time because she would rather keep engaging in whatever preferred activity she was already doing? Is she refusing to go to bed because it gets her lots of attention when she runs around or cries? It’s common for children to use diversionary tactics when it comes to bedtime. As soon as it’s time to lay down they suddenly need a drink of water, or they forgot that they need to use the restroom, or can’t find their favorite stuffed animal. You can proactively combat these diversions by preparing ahead of time. Before you tell her it’s time to go to bed make sure she has already used the bathroom, had a drink of water, found her blanket/stuffed animal/etc. If separation from you guys is difficult or scary for her, or if she loves getting attention she gets for refusing to go to bed, working with a Behavior Analyst can help you set up a plan for exactly what to do.

Lastly, her sleep issues may have a biological etiology. If she is taking any other medications check to see if those have side-effects which could be hurting her sleeping. Also, consider if she has any other possible comorbid diagnoses. Epilepsy, sleep apnea, Bipolar Disorder, gastrointestinal issues, and other things could be contributing to the sleep issues. If you suspect any of these biological factors ask her doctor for a referral to a specialist.

Best of luck, and we wish you restful nights of sleep!

Angelina M.

Angelina M., MS, BCBA, LMFT works as a Board Certified Behavior Analyst, specializing in assessing and treating children and adolescents with autism, down-syndrome, and other developmental delays. She began her career in Applied Behavior Analysis in 2006, following her youngest brother’s autism diagnosis, and has since worked with dozens of children and families. She also writes a blog about her experiences as both a professional and a big sister. Her brother, Dylan, remains her most powerful inspiration for helping others who face similar challenges.  Learn more about Angelina and her blog, The Autism Onion, at or

  • Avatar Alondra Rogers says:

    My daughter had chronic severe insomnia until we learned she was anemic. We supplemented her iron and in just a couple of weeks, she started sleeping through the night. There could be a medical cause.

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