Seeking Advice - Teenager Sleep issues

Welcome, Minidonk.

I've not been active here for quite a while, but when I saw your post, I felt that I had to reply, as what you've described is so familiar to me. Your description of your son could so easily be a description of a teenager with whom I'm extremely familiar - that is, my younger self! (I was diagnosed with ASD, including likely PDA traits, a few years ago in my forties).

There may be a few things in play here, and I think that you're correct not to jump to the conclusion that depression is the cause (or at the very least, not the only cause).

Firstly, there does appear to be a high occurrence of sleep disorders amongst autistic people ("sleep disorders" is maybe a slightly contentious term, but I use it for convenience). In particular, what is known as "delayed sleep phase" seems to be particularly common - where a person's body-clock just won't synchronise with normal daylight hours, so that getting to sleep and feeling ready to wake are several hours behind what's normally expected. This can affect other things, too; such as when one feels hungry or is best able to concentrate. My own experience is that my brain simply won't "shut up" until it's good and ready to at about 3-4am, and trying to get to sleep any earlier simply leaves me staring at the ceiling, my head buzzing with thoughts (not necessarily anxious ones), getting ever more frustrated that my brain won't just turn off and let me rest. Such frustration doesn't exactly help, either, of course!

So I would ask you - when he is allowed to follow his current sleep patterns, does he get enough sleep, and does he feel rested from it? I find that I usually do, so long as I'm not forced to fit myself around other time pressures. I have come to expect that, when I have school or work to attend, I will simply have to turn up after only 2-3 hour's sleep, or even none at all, pretty much every day. One sign of delayed sleep phase is that the sleep deprivation from this makes little difference - you might expect that it would lead to simply keeling over from exhaustion, but I don't get to sleep any easier no matter how many days this goes on for (and an incredibly long "catch up" sleep at the weekend isn't always enough to recover fully). The sleep deprivation does, of course, make dealing with other people and situations much harder, and can compound whatever other difficulties autism might cause - I was always rather prone to running away and hiding, as you've described of your son, because it lowered the threshold at which my brain would say "that's enough now". Giving up and going "around the clock" is also well known to me; I still kid myself that it might "reset" my body clock, but in reality, it rarely achieves very much.

Delayed sleep phase might be made much worse during the teenage years. It's pretty much accepted now by the scientists who study these things that nearly all teenagers experience a lag in sleep phase due to hormonal changes etc. Don't discount that he may have always had a sleep disorder, but that's he has been able to cope with it until puberty tipped the balance. As a young child, I became extremely good at concealing the fact that I was awake when I wasn't "supposed" to be (within a couple of weeks of moving into a new house, I know exactly where all the squeaky floorboards are!) The "masking" by which we attempt to hide our autistic traits isn't always for daylight hours only.

However, the problem may not be entirely a physical thing. The night-time is very appealing to some autistic people with PDA or who have extreme sensory sensitivies. It is peaceful and quiet, no-one will be making demands, the phone will not ring, there will be no visitors, and so on. I have been a keen programmer since childhood, and I write all of my best code in the early hours, when there is nothing to disturb my concentration (I am very sound sensitive) - and better still, there's not even the slightest threat of being disturbed playing at the back my mind. I have spoken with many autistic people who are "night owls" at least, if not outright nocturnal (I have been nicknamed "the vampire" by relatives of my landlady!)

Dealing with this may not be easy, I'm afraid to say. As you may have guessed by now, the situation is much the same for me in middle age as it was when I was a teenager (likewise for my Mum, who is in her 70's, with whom I share many traits). I have had a little success with the atypical anti-depressant Mirtazapine, and some people respond to the "jet lag" medication Melatonin. Of course, the usual caveats about only doing this with a doctor's advice apply, and everyone reacts to these medications differently; but I would certainly consider a visit to the GP if your son is willing to try this approach. However, other effects of such medication may be less welcome (I stopped the Mirtazapine because it messed with my concentration).

The ideal approach, from my experience, would be to allow your son to simply follow what comes naturally. However, the demands of the outside world don't exactly make this easy - one has to shop when the shops are open, and work the hours demanded by one's employer unless free-lance work from home is a possibility. There is some evidence that in other societies, this is accepted as perfectly normal (Bediouin sheep-herders much appreciate someone who gladly stays up all night to watch the flocks) - but sadly, the modern, Western world is rarely so accomodating, so a compromise of some sort must be found. Most important of course, is that you continue your compassionate, loving acceptance of his differences, as amply shown in your post - accusations of laziness or indolence will do nothing to make a sleep disorder any easier to live with.

Best regards to you and your son.

Hi Trog, just want to say thanks for writing this, as it has helped me feel so much better about my 16 year old's sleep pattern which is the same as yours and Mini's son He tends to go in cycles though and sleeps or doesn't, so that there is no set routine from one day to the next, rather a weekly cycle if that makes sense. He says he has always found it difficult to sleep a normal routine and when he was in primary school was constantly tired, but still couldn't get to sleep til 2am? He loves coding as well though and has been teaching himself since he was 8. I suspect he also finds it easier when it's quiet at night because he has a complex sensory profile across all his senses. He has acute hearing and sense of smell and touch and vision, so the world can be very overwhelming for him. As a result he started home schooling 3 years ago and teaches himself, and doesn't go out much. Do you have any suggestions as to how this may be overcome, as exercise is something that I worry he doesn't get enough of, even though he exercises at home and walks around his room a lot  

Hi Trog, just want to say thanks for writing this, as it has helped me feel so much better about my 16 year old's sleep pattern which is the same as yours and Mini's son He tends to go in cycles though and sleeps or doesn't, so that there is no set routine from one day to the next, rather a weekly cycle if that makes sense. He says he has always found it difficult to sleep a normal routine and when he was in primary school was constantly tired, but still couldn't get to sleep til 2am? He loves coding as well though and has been teaching himself since he was 8. I suspect he also finds it easier when it's quiet at night because he has a complex sensory profile across all his senses. He has acute hearing and sense of smell and touch and vision, so the world can be very overwhelming for him. As a result he started home schooling 3 years ago and teaches himself, and doesn't go out much. Do you have any suggestions as to how this may be overcome, as exercise is something that I worry he doesn't get enough of, even though he exercises at home and walks around his room a lot