Frequent "Night Wakings" and Moodiness in Children on the Autism Spectrum

“My son wakes in a terrible, nasty mood. He goes to bed happy, laughing and loving. Nothing that I do can deter him from ruining his day and the day of those around him. I have tried everything to help him turn the day around - from being extra cheerful, music, ignoring, consequences, taking away privileges, talking about it, timeouts, etc... Although I do everything that I can to make sure that he gets adequate sleep (9pm-7am) he has been diagnosed with frequent night wakings. The doctors will not do anything about it. He was diagnosed with ADHD, age 5. However, I realized at age 7 that it was something much more complex than that. Finally, this past winter, he was diagnosed with mild-to-moderate ASD. We have provided countless hours of traditional and non-traditional therapy yet he still struggles a good portion of the time. His father passed away January '14 so that does not help matters -- and he has entered precocious puberty (being treated). Would you please be willing to give me suggestions to help get him off that path as quickly as possible so that everyone can go on about their day?”


I think the harder you try to fix this, the worse you may be making it. Sometimes you just have to let a child be angry and upset. Kids need to vent, too.

Let's try this: Stop trying to change it. I'm sure your efforts to "cheer him up" annoy him even further. Give him permission to be moody. You can even say something like this first thing in the morning: "Good morning, this is the time you have a mood, so go ahead and get started." [reverse psychology]

But first, tell him tonight, while he is in a good mood, that you are giving him permission to have a mood in the morning. Then remind him in the morning using the line I just mentioned. In addition, while he is disgruntled in the morning, you can say things like, "I know honey – it's hard to get up and get going in the morning, isn't it?" In this way, you aren't punishing, ignoring or cajoling -- rather you are validating his feelings. Try it!

==> How to Prevent Meltdowns and Tantrums in Asperger's and High-Functioning Autistic Children

Having said that, here are some common reasons for “night wakings” and tips for dealing with them:

1. Children may be awakened during the night due to an urge to urinate, thus your son should avoid drinking fluids before bedtime. Some kids may have urinary tract problems that awaken them even when their bladders aren’t full. If your son has frequent night wakings, try to find out if bathroom trips are contributing to the problem.

2. Children who suffer from heartburn may experience frequent night wakings. Heartburn is associated with sleep-disordered breathing, and can be dangerous in some cases. If you think your son may suffer from heartburn, consult your doctor for treatment options. Meanwhile, avoid acidic and hard-to-digest foods before bedtime.

3. Children who suffer from headaches are more likely to suffer from frequent night wakings. It’s not clear if headaches cause sleep problems, or sleep problems are causing the headaches. Either way, it’s a good idea to have your youngster’s headaches checked by a doctor.

4. Night terrors are distressing, disruptive, and cause night wakings. But night terrors differ from nightmares. A youngster may move (even sleep walk) during a night terror, which puts him at risk of hurting himself. Have you ever noticed your son sleep walking?

5. Nightmares are associated with REM sleep, and they are more likely to occur after a youngster has been sleeping for several hours. When a youngster wakes up immediately after a nightmare, he is likely to remember it. Triggers for nightmares include anxiety and medications that interfere with REM sleep. Children who awaken from nightmares need to be reassured that their dreams are not real. Also, check to see if any of your son’s medications are contributing to sleep problems.

6. Worried, frightened children have more sleep problems. Research suggests that ignoring a youngster’s fears may lead to nightmares and emotional problems. Thus, it’s important to take an active role in teaching your son to overcome his fears.

7. When children are overtired, their sleep may become more restless – and they suffer more frequent night wakings. If your son is overtired, he needs more sleep. An earlier bedtime may help.

8. Children often learn to associate falling asleep with certain forms of comforting stimulation (e.g., parental soothing, a particular sleep environment, etc.). These sleep aids may be very effective, but if your child becomes dependent on them, he fails to learn how to fall asleep on his own. Thus, if your son is used to falling asleep in your presence, but wakes up alone, he may not be able to settle himself back to sleep. If you want your son to develop self-soothing skills, you may want to consider sleep training.

==> How to Prevent Meltdowns and Tantrums in Asperger's and High-Functioning Autistic Children

9. “Sleep disordered breathing” includes interrupted breathing (i.e., sleep apnea), loud breathing, snoring, and troubled breathing during sleep. Sleep disordered breathing can restrict the oxygen supply to a youngster’s brain and cause serious health problems. It is also associated with attention problems, daytime sleepiness, frequent night wakings, hyperactivity, nighttime crying, and poor sleep quality. If you suspect your son suffers from sleep-disordered breathing, consult your doctor.

10. Kids who have experienced traumatic events are likely to suffer from night wakings and other sleep disturbances (and you did say his father passed away recently --- BIG FACTOR THERE!). Even everyday stressors disturb sleep. Children experiencing family stress suffer more night wakings and get less sleep overall. These sleep problems are associated with elevated stress hormone levels. Check to see if your son is experiencing an inordinate amount of stress for some (perhaps hidden) reason. Grief counseling may be in order as well.

Morning moodiness is associated with the "sleep inertia" phase, which is a transitional period of fatigue that usually lasts between 5 and 20 minutes after a child first wakes, though it can go on for a longer time in some cases. The process of waking up is slow – it’s not like a light switch. Feeling excessively grouchy in the morning is not enjoyable, but does not necessarily indicate having had a poor night of sleep.

Why some kids are able to cheerfully connect their sleep inertia phase with the rest of their day is much more specific and individualized. Moodiness might be associated with not getting enough rest and being tired, but it might also be symptomatic of having a bad attitude about the day. For some children though, chronic morning moodiness is simply a symptom of an over-scheduled life, with too little sleep, and not enough things that bring them joy on a day-to-day basis.

Resources for parents of children and teens on the autism spectrum:

==> Videos for Parents of Children and Teens with ASD

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