Cognitive Behavioral Therapy Reduces Insomnia in Kids with Austism

New research offers hope of sleeping through the night to children with autism and their exhausted parents.

By Andrea Pisani Babich

A new study published in the official journal of the International Society for Autism Research offers hope for sleep-deprived children with autism and their exhausted parents. Insomnia is the most common sleep disorder for children with Autism Spectrum Disorder (ASD).

As many as 86% of children on the autism spectrum struggle to fall asleep and stay asleep. In addition to the many negative impacts of sleep deprivation on neurotypical children, the severity of ASD-related symptoms in children with autism is strongly correlated with how well they sleep.

These symptoms include

  • Repetitive movements
  • Difficulty making friends
  • Impaired social interactions
  • Communication difficulties
  • Increased anxiety
  • Attention Deficit Hyperactivity Disorder

But now researchers are learning that cognitive behavioral therapy (CBT), a treatment used to treat insomnia in neurotypical children, may be an effective treatment for children with autism who struggle to sleep. And that gives researchers, parents, and children on the autism spectrum hope of finding a way to not only sleep through the night but to decrease the severity of ASD symptoms.

CBT for Treating Autism-Related Insomnia

The small study tracked the sleep of 17 children on the autism spectrum who were diagnosed with insomnia as well as at least one of their parents. A research team led by Christina McCrae, professor in the Department of Psychiatry at the University of Missouri School of Medicine, asked participants to keep sleep diaries to record how long it took them to fall asleep, their sleep duration, and other factors. They also wore wristbands that measure limb movement to provide an objective measure of sleep quality.

Baseline data was obtained for two weeks before eight, 50-minute cognitive behavioral therapy sessions that were specifically designed to target each family’s particular sleep concerns. After the CBT sessions, participants recorded their new sleep information in their diaries. The results were impressive.

After CBT, data collected from the wrist devices and diaries revealed that the children were sleeping much better, and their ASD-related behaviors improved. In fact, after one month, 85% of the children in the study no longer experienced insomnia. And their parents reported sleeping better and feeling less fatigued, an observation verified by their wrist monitors and their diaries.

How CBT Works

Cognitive behavioral therapy typically breaks down problematic behaviors and beliefs and replaces them with more logical approaches to troublesome situations, like trying to fall asleep. Patients identify the fears and behaviors that pose a problem for sleep onset by keeping sleep diaries. Here they might report that fear of the dark or feeling unsafe in their rooms keeps them from falling asleep. Then a therapist would work with the patient to challenge their irrational fears and replace them with more logical thought patterns.

But for children with autism who often struggle with communication, keeping sleep diaries and talking through irrational fears could pose a problem. Still, Dr. McCrae advocates CBT for disordered sleep. “In treating insomnia and other behavioral sleep issues among adults and children in general, I’ve found that there’s no substitute for cognitive behavioral therapy. Yet it’s still unclear how to best use such therapy for children with autism who struggle with communication.”

In her pilot study, McCrae was pleased to find that young participants were able to keep meaningful sleep diaries, and parents reported that the CBT was “helpful, age-appropriate, and autism-friendly.” The success of this study has encouraged Dr. McCrae to expand this first study into a randomized controlled trial with an active control group and a more diverse sample.

Be sure to bookmark Mattress Advisor Bedding Industry News to follow developments in Dr. McCrae’s follow-up work on CBT for insomnia related to autism. You can also find other suggestions for helping children with autism get the sleep they and their parents need at Autism and Sleep.


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