Sleep differences are often significant for people with FASD and sleep deprivation can make symptoms associated with FASD more severe.  While you may not be able to fully cure this problem because it is in part due to the organic brain differences, there are many strategies that help.  We have listed some ideas to try when working on a sleep routine, but as with everything FASD, each person is different and what calms one, may excite the next. Observe and modify based on reactions.

 

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Medication and diet:

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• Talk with your doctor about medications that are being administered and the timing of the medications.

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• Melatonin supplementation after checking with your doctor - start slow - 1/2 mg 

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• Chamomile tea is safe for all ages

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• Check magnesium and potassium levels

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• Reduce sugar intake and consider dessert after lunch and not dinner, particularly if waking in the night occurs

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• Probiotics

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Circadian Rhythm:

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• Stay off  screens 1-2 hours before bedtime or wear blue light glasses

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• Lower lights in the home in the evening and consider incandescent bulbs - the blue and green light waves in fluorescent and LED lights trigger cortisol and stop melatonin production

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• Go to sleep and wake up at the same time as best you can

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• Fresh air, sunlight and exercise during the day - bright natural light upon wake-up promotes cortisol, reduces grogginess and strengthens circadian rhythm  

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• Daylight Savings: proactively change routine slowly over time

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Fear and anxiety:

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• Reduce demands and expectations by changing the bedtime routine and make it enjoyable ​

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• Enjoy relaxing with your loved one until they fall asleep - the keyword is enjoy, they know when you are faking.

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• Have a pet that can stay with them at bedtime 

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• Visualizations can be very powerful, particularly if they are guided towards reducing fear and creating safety.  Youtube is a good free source.

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• White noise machine

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• Massage

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• Practice deep breathing 

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• Tented sleep area

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Bedtime routines are filled with transitions, which generally cause anxiety. Create a relaxing environment that your child will look forward to. By observing and talking about what is hard, adjust expectations. What's the worst that can happen if your child sleeps in their clothes?  Can teeth be brushed after dinner? Would it be easier if you brought the toothbrush to your child so they don't have to stop what they are doing? 

If the last hour before sleep is peaceful, doing favorite activities (not screens), preferably together, the nervous system will stop anticipating the difficult transitions often associated with bedtime and may calm down, opening up the possibility for sleep. For families with children who outnumber the adults where one on one isn't possible, finding quiet activities that everyone will participate in might be challenging.  Reading out-loud or listening to calm music together, while each child has an individual preferred activity can work, especially once there is a routine that everyone looks forward to. Drawing, fidgets, slime, watching a fish tank or petting the dog are just a few ideas. Having both mind and hands occupied may alleviate sibling bickering. 

 

If your child is fearful of the dark or sleep itself, consider staying with them while they fall asleep. Professionals might argue against this, but keeping their overreactive nervous systems from pumping out cortisol, the primary stress-response hormone produced by the adrenal glands is paramount for sleep. For the same reason, having the child in the place they will be sleeping for a last preferred activity will alleviate another transition.  

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Sleep for people with FASD is a challenge. Helping them learn what works can make a big difference in daily functioning. Make changes slowly so it's not too overwhelming.  Keeping a journal and noting how your child does during the day with respect to how well they fell asleep and stayed asleep, may help you stay on track.  Identifying patterns and improvements can help maintain motivation.

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Sleep is such an important and difficult subject for families affected by FASD. Please share your experiences and strategies that work!  

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