Neurodivergent sleep support

Why sleep feels different for neurodivergent brains?

Sensory processing differences can impact a person’s ability to recognise and feel the signs of tiredness (Interoception), and common activities in the nightime routine such as dressing and toothbrushing can cause dysregulation. Differences in sensory processing can also make achieving the optimal sleep environment more challenging.

The process of transitioning into sleep also requires high level thinking skills (executive function) for example stopping a task, transitioning to a new environment and remembering and carrying out the steps in a routine e.g. dressing, brushing teeth.

Neurodivergent individuals can also find it more challenging to ‘switch off’ and can experience racing thoughts or anxiety when not engaged in activity.

Sensory processing and sleep

Neurodivergent individuals often process sensory information differently. For some senses they can process the information very intensely and therefore perceive information that others might not notice (e.g. the humming of a light). For other senses they may need more information to notice (e.g. not hearing background music). This can impact on the sleep routine and environment.

The sleep environment

There is not a single correct sleep environment for everyone but generally it should be calm and low arousal. A person’s individual sensory processing should be taken into account when creating this environment, below are some suggestions to try:

If sensory information is processed intensely try:

• Sight: Black out blinds, an eye mask, lights outside the bedroom switched off, a clear floor without visual clutter (e.g. toys on the floor)

• Sound: White noise machine or soft consistent sound (e.g. rain) to cover background noise, earplugs, all unnecessary noises (e.g. ticking clocks) removed.

• Touch: Soft bedding with no textured design, chosen pillow, trying different pyjamas (e.g. shorts, trousers, night dress), cut out pyjama labels

• Smell: Use consistent laundry detergent, air out bedroom during the day, avoid strong smells like perfumed diffusers in the bedroom

If sensory information is processed less intensely try:

• Sight: A brighter night light or a lamp left on at a comfortable brightness, keeping lights outside the room on

• Sound: Background noise (e.g. white noise, music, or a fan)

The sleep routine

Many neurodivergent individuals can find it difficult to process the internal senses within their body (this is called interoception) this can impact their ability to know when they are tired. Having a consistent nighttime routine is important in supporting this. This includes a set bedtime that varies a maximum of 1 hour (on weekends and holidays for example).

When creating an individual routine, it is important to consider sensory preferences. Typical nighttime routines such as dressing and brushing teeth can be dysregulating. Therefore, it would be important for these to happen more than 1 hour before bed. This provides space to regulate before bedtime.

It would also be helpful to add in some sensory calming activities to do within the hour before bed. Examples of these activities are calm proprioceptive activities (putting weight through the joints) e.g. yoga, Pilates, wall pushes, TheraBand pulls, helping to make the bed; using weighted blankets or lap pads before bed, massage, a warm bath.

Have a selection of other non-alerting activities that can be completed within this hour (e.g. Lego, crafting, reading, puzzles, knitting, crochet, journaling, magnetic tiles, drawing, listening to music, podcasts or audiobooks, if watching TV choose a calm predicable show e.g. rewatching a previously seen episode). Set a visual timer for these activities so that it is clear when they will end or have a reminder 10 and then 5 minutes before.

Keeping the routine consistent and predictable will help to signal to the body that it is time to sleep. Having a visual schedule of this routine can increase the ease of following it.

Switching off when in bed

Neurodivergent individuals can often find it difficult to ‘switch off’ and can experience racing thoughts and anxiety when in bed. Some of the strategies below can help:

• Listening to an audiobook

• Playing sleep inducing mind games, for example:

o Naming animals, places etc… A to Z

o Naming a word that starts with the last letter of the word you just thought (e.g. Apple, Egg, Geese etc)

o Counting backwards in 2s, 3s, 4s etc

o Replaying a familiar calming memory (e.g. a day on holiday)

Imagine other thoughts floating away or tell yourself I can think about this tomorrow and return to the audiobook or game. This is mindfulness.

Sleep differences are common in neurodivergent communities and require an individualised approach. This information sheet has given you a starting point to put together your own individualised sleep routine. This will likely need changing and tweaking over time. However, once you have agreed your routine give it a go for at least 3 weeks before making any changes. It takes time for something to become a routine and for bodies to make sleep associations.

Key points

• Consider sensory processing when setting up the sleep environment

• Make a set bedtime that varies a maximum of 1 hour

• Create a bedtime routine for the 1 hour before bed

• Include sensory calming activities in this routine

• Include a choice of activities that are calming and use a visual timer

• Avoid including activities that are dysregulating in this hour (e.g. toothbrushing)

• Create a visual schedule of the routine

• Use distraction and mental tools to support your mind to drift off to sleep