Why do autistics have trouble sleeping?
Updated: Jun 18, 2019
Difficulty sleeping is a very common, and very frustrating, symptom of autism. I regularly see posts in autism groups from parents about this. They'll have difficulty getting their child to fall asleep, or stay asleep. They'll be up late, up early, and awake multiple times in the night.
For years I had difficulty sleeping. I would lie awake in bed for hours trying to fall asleep, or I would be awake until 2 or 3 in the morning to avoid that. I couldn't shut my brain off so that I could sleep.
Where are the sleep issues coming from? The biggest culprit I have found is an overactive fight-or-flight response.
The fight-or-flight response is meant to keep us alert and ready to respond to things, like dangers or sources of stress. So one of the things it does is suppress the production of melatonin in order to keep us awake. So when the fight-or-flight is overactive, it makes it really hard to sleep.
Some reading this may be thinking that since the body is having trouble making melatonin, the answer then is to give the child melatonin to make up for it. I don't personally recommend this. For some parents it works, for others it doesn't.
In some cases, it helps for a while and then stops. And many parents are concerned that they're drugging their child sleep. There is some legitimate concern here - melatonin is a hormone. Regularly supplementing melatonin in a high enough dose will cause the body to stop making its own.
I have recommendations for what to do instead - supplementing vitamin D, magnesium, and zinc. I'll explain where the overactive fight-or-flight is coming from, and why these supplements can help.
The fight-or-flight response is overactive because of excess norepinephrine and adrenaline in the body, which are the neurotransmitters (chemical messengers) that cause the fight-or-flight response. This is due too much dopamine (the reward neurotransmitter), which they're both made from, and due to the consequences of a vitamin D deficiency that is commonly found in autism.
First, due to a genetic defect common in autism with something called the dopamine transporter, there tends to be excess dopamine in the system. I go more into detail about why this is in my article about Fixation. Dopamine is made into norepinephrine, and then norephinephrine and made into adrenaline. So having excess dopamine causes an excess of all three.
Zinc has been found to correct the defect in the dopamine transporter, reducing the excess dopamine, and making less of it available to make into norepinephrine and adrenaline.
This has a number of consequences, because of all the things vitamin D does in the body. One of the things it does is allow the body to absorb, among others, magnesium and zinc. When vitamin D is deficient, the body has trouble absorbing absorbing these. As a result, magnesium and zinc have both been found to be deficient in autism.
A zinc deficiency means the body has trouble correcting that issue with the dopamine transporter.
So why does magnesium matter? I've seen many parents mention that they give their child magnesium to help them sleep. Here's why it helps.
The body gets rid of the dopamine, norepinephrine, and adrenaline that it doesn't need by breaking them down using an enzyme called COMT. Magnesium helps COMT function and get rid of them. With a magnesium deficiency, COMT can't properly do its job to clear out the excess.
Magnesium also helps with nerve function and is a muscle relaxant.
In my case, I get a double-whammy on this. I found out through genetic testing that due to a genetic defect, my COMT enyzmes are less efficient, in addition to the magnesium deficiency caused by vitamin D deficiency.
So, with the help vitamin D, magnesium, and zinc, we've helped the body calm down that overactive fight-or-flight response.
Now, we need the body to make the melatonin so that we can sleep. As it turns out, D, magnesium, and zinc also work together to help with this too.
You see, vitamin D also helps the body make serotonin. Known as the happy hormone, serotonin is the neurotransmitter that helps regulate mood - not enough of it leads to anxiety and depression. Serotonin is also made into melatonin, with the help of magnesium and zinc, unless blue light hits the eyes (many electronic devices have a blue light filter as an option for this reason). So deficiency of vitamin D, therefore also of magnesium and zinc, makes it harder to make serotonin and melatonin, making more troubles with sleep.
I take all three (vitamin D, magnesium, and zinc) both morning and night, to help with stress and sleep. They have helped me. I have little trouble trouble falling asleep now.
Additionally, as I've talked about in the past, the combination of taking vitamin D, magnesium and zinc can also help a number of autism issues, including social learning, anxiety, appetite, aggression, digestion, and fixation.
Note: I'm always learning, and many of the blog posts I've linked above were written before I knew about the role of magnesium, and therefore don't talk about it. But if I talk about reducing dopamine, norepinephrine or adrenaline (also called epinephrine), magnesium will help.
If you're interested in supplementing these, be aware it will take some time to take full effect, since it takes the body ten days to turn vitamin D into its active form. But with time, it will make a difference.
And as always, I recommend talking to a doctor about proper dosage.