Autism: The Nightmare of Life Without Sleep

This month our blog focuses on the torment of sleep deprivation in individuals with severe autism, and their families

By Jill Escher

There are various ways to torture a person. There’s whipping, “the rack,” painful electric shocks, needles, beatings, and so many other horrific methods. But another classic torture device is less bloody but plenty damaging: sleep deprivation.

Humans need sleep much like they need food and water, it’s a physiological necessity for both mental and physical health. Chronic sleep deprivation can cause high blood pressure, diabetes, heart attack, heart failure or stroke. It increases the risk for obesity, depression, confusion, memory impairment, reduced immune system function, lower sex drive, and even psychotic episodes. Because sleep is vital the daily processes of DNA repair, lack of sleep leads to increased risk of cancer. Lack of sleep is a serious medical issue that can be ruinous.

So we should be concerned about the epidemic of sleep deprivation affecting individuals with severe autism and their families. It’s estimated that sleep disturbance affects 40-80% of children with autism. Desperate families seek all sorts of interventions, from behavioral “sleep hygiene” practices, to special beds, to supplements like melatonin, to pharmaceuticals like trazodone. But in many cases, nothing seems to regulate the haywire circadian rhythm of the child or adult with autism.

This month we shine a light on the autism insomnia crisis by sharing the lack-of-sleep stories of five autism families. I certainly can relate to all of them. While my 16 year-old ASD daughter has always been a pretty good sleeper, my 23 year-old ASD son, from the day he was born, was highly dysregulated and just could not sleep through the night. I would often awake to crashing sounds at 2am, finding him throwing furniture or whatnot around or outside the house, or to the sounds of water flowing in various sinks, or to the shaking of an energized jumping. I would often (barely) function on 3 or 4 hours of sleep a night and then spend several hours cleaning up whatever mess was made overnight. It was a torment for all of us.

For my son, though I was very reluctant to use medications initially, the drug trazodone, which we started with him a few years ago, helped immensely. Combined with other treatments he has, more or less, been able to sleep most nights. It’s a … dream come true.

But others are not so fortunate. Please look out for our NCSA blog this month and we un-celebrate sleeplessness in severe autism.

Jill Escher is president of National Council on Severe Autism.

#KickedOut: Too Autistic for Local Programs, but Finding Help, at a Distance

“He needed me for every aspect of his well-being and most importantly, he just needed me to be there.”

 
 

Third in a series of commentaries about the disparate treatment of individuals and families affected by severe autism

By Laura

My firstborn went off to college after I had done all I could do to pave the way for her independence and set her up for success. It was the next step. It was normal. It was typical. It was a part of growing up. 

When my son T, who has severe autism, was the same age, I couldn’t imagine sending him off to live somewhere else. I felt he needed my care, he depended on my care, and no one else could possibly care for him the way I did. He needed me to shower him, wash his hair, shave his face, clean his bottom, to ensure he used deodorant and brushed his teeth. He needed me to clean his ears, trim his toenails, and help him dress. He needed me for every aspect of his well-being and most importantly, he just needed me to be there. 

When T turned 21, his Dad and I decided we would look at what type of assisted living opportunities might become available at some point in time. We still weren’t ready but we were curious. We toured a couple of homes in the county, but even if we would have been ready, there was no availability. I decided that I wanted to be able to help him have a successful transition to living away from home and make it as easy as possible for him. I did not want there to be an emergency placement (as is so often what happens) and have him put somewhere with no preparation on his end or for the staff in the home. 

We found out about an amazing development being created in our county with opportunities for a dozen individuals. There was a church, a barn, and homes with an amazing layout. Each individual had their own bedroom, living area and bathroom. I cried when I walked in and saw the space. The residents also shared a large gathering space, dining room and kitchen. 

We worked hard to show that T had made progress with the behavioral issues that the development had an issue with prior. He was more patient and tolerant of others and with support from our case manager, T was given one of the last four spots that were available. We were overjoyed and began our preparation. 

It was a 6-month process from learning that T would attend this amazing place to his actual placement. Social stories were written to help prepare him. We made new symbols for his schedule book, we added pictures of staff to the book, we created countdown calendars and marked the days until T’s new house became a reality! 

When the time arrived, we went to set up his place, we made sure that ALL of his stuff was there because this “stuff” (including 100’s of VHS tapes) mattered. He would know if things were missing and we wanted him to feel 100% at home. 

The philosophy of this particular organization was to not allow parents to visit for several weeks. This made the goodbyes on that moving day even more difficult. After all, in 26 years, T and I had never been apart for more than a week. 

We had supplied the staff with a book about T’s behaviors. When he says this, it means this, calming techniques for when he becomes anxious, what makes him happy, when to give him space etc. It can be like learning a new language in a way, but once you figure him out, and use his schedule book, the system usually runs very smoothly.

Weeks went by and another roommate was added to T’s house. This young man was very verbal and persistent. One night T was upset and missing his family. He was lying on the ground asking for us. No one implemented the plan that we had outlined when T’s anxiety began to rise. T pushed his new roommate down, hit him and then hit a staff member as they tried to intervene. We were called and rushed over. By the time we arrived it was 10 p.m. and he was on the floor crying. We were told he had to leave the next day. 

We knew and understood that his behavior was wrong, but we also believe that had we been able to visit and spend time with the staff and show them how to best interact with T, it could have had a more positive outcome. Now everything we worked for was gone.

T’s school years were ending in just weeks and that meant T would be at home full time. He had nowhere to go and no one to care for him while I worked. No day programs available, at all. We were about to fall off the cliff - together. 

I knew I had to work fast to try and make arrangements, and that was a full-time job in itself. I also knew that any future placement for him was very unlikely after his incident. 

A year passed, and we assembled a new normal without school, found some caregiving support, and had a meeting with Community Mental Health. We said we were willing to look outside of our county to see what options might be available. An option was presented 161 miles away from our home. We felt we had to look, or we might never be presented with future opportunities. 

T’s dad and I drove there believing we would leave and say it was just too far from home and it wouldn’t work for him. Instead, we both somehow felt this was an environment he might do well in. It was a grade school converted into a group home for 24 residents. He would have his own large room and half bath. It was large enough to hold his belongings and still give him some space. It was new and fresh and we felt like it might work.

We drove home thinking about the long drive but knew T’s well being was what ultimately mattered. We chose to move forward. This may not be his forever home as I am also trying to figure out a better solution, but it works for now and that has to be enough. 

Laura was born and raised in Wisconsin but has lived the last 30 years in West Michigan. She is a mother to A and T and wife to Bill. She graduated from the University of Wisconsin Madison and has a successful 35-year sales career selling wine and liquor, pharmaceuticals and currently real estate. She is an advocate for all things T and autism related, fan of her daughter’s photography career and also enjoys quilting and gardening. 


Disclaimer: Blogposts on the NCSA blog represent the opinions of the individual authors and not necessarily the views or positions of the NCSA or its board of directors. Inclusion of any product or service in a blogpost is not an advertisement, is not made for any compensation, and does not represent an official endorsement.

#KickedOut: When Severe Autism Makes You Too Disabled for Disability Programs 

Her son was asked to leave nearly every disability activity he tried

(First in a series of commentaries about the disparate treatment of individuals and families affected by severe autism)

By Deborah Lane

I am a mom to a 31-year-old son B who has autism and intellectual disabilities. He has my entire heart and keeps me entertained with his ridiculous sense of humor and repetition of movie lines used for every situation. He has a childlike faith that teaches me every day, especially when he says his blessing over dinner “thank you Jesus for a very bad day and please help me wait for the live-action Little Mermaid.” Or when he doesn’t leave the house without me putting my hand on his head and saying “Jesus over you today”. In all of these joyful moments, he is also my biggest challenge as his behaviors can escalate in an instant and cause injury and destruction.

When he was around 8 years old, we participated in Special Olympics. During our first several years we chose swimming because he was a water bug and loved it; however, soon after, a new instructor was hired and said that my son was not a good fit for Special Olympics any longer as he was not able to “cooperate appropriately”. We continued to participate in open swim time at the high school most weekends, but I no longer loved Special Olympics or believed in their program. 

Several years later, we were encouraged to try the Special Olympics bowling. I was hesitant but at the same time wanted him to be part of some kind of community. We were not able to even finish the first round because he displayed significant behavioral issues. It was noisy, and the environment was too much for him which resulted in rage and him needing to be restrained by one of the other parents. We were not allowed to attend again.  

A few years after this traumatic incident, we took him to a sleepover camp for special needs children. He did well for a couple of years which made us confident in leaving town to enjoy a vacation. On the first night away from home, we received a call from the camp. Our son had attacked his roommate, and we had to pick him up immediately. The funny thing (not actually funny at all), we paid extra for one-to-one support to safeguard against something like this happening.

When he aged out of school at 21, we entered the world of day programs. We chose to leave the first one because the staff was horrifying in their treatment of the individuals. The second option could have worked if they had given him a one-to-one like we repeatedly begged for but never received. Long story short, the director eventually asked us to leave because his behaviors were too intense. I was devastated and not sure how we were going to proceed.  

After a lot of research, contemplation, and prayer, I decided to start my own day program for him. Honestly, It’s a 24/7 bureaucratic nightmare, especially with the lack of staff and funding, and I never know what tomorrow will bring, but at least I know he won’t be kicked out of this one. At least I know I’m doing my best to provide purpose and community for my son and others like him. At least I know I did everything in my power to help my son feel like he belongs.  

Deborah Lane is a mom who lives in Glastonbury, Connecticut. B is the youngest of her five children. Everyone else is grown and flown and busy giving her grandbabies. Needless to say, they bring her joy without measure. She hasn’t been able to work for many years now as B’s needs became too intense. She loves movement of any kind and needs it! She calls out the name of Jesus all day and night as her source to get through every moment.

Disclaimer: Blogposts on the NCSA blog represent the opinions of the individual authors and not necessarily the views or positions of the NCSA or its board of directors. Inclusion of any product or service in a blogpost is not an advertisement, is not made for any compensation, and does not represent an official endorsement.

Recovery from a Marriage in Crisis

“No one sees the chaos that autism does to a family or to marriage. No one sees because we are often isolated and just ‘dealing with it.’”

Fourth in our series on the impact of severe autism on marriage

By KE

“You have never been kind.“ 

As soon as the words left my mouth, I felt a huge weight lifted off my chest that had been pressing for years. 

My husband and I have 3 children and 2 of them are on the autism spectrum. 

I made a choice to homeschool them when the world fell into chaos due to a global pandemic, and I regret that choice. The pressure of being a mother, a caregiver, a wife, and a teacher all at the same time became crippling to my marriage. I began to push my husband away — push him away to focus on the kids and their needs. I reasoned that he was a grown man and could take care of himself, and my absence caused him depression. This depression led to excessive drinking, but honestly, it didn’t phase me because I was too busy being a mom and a teacher and a caregiver to my two sons on the autism spectrum — all the things except for being a wife, and it almost cost me my marriage. 

In hindsight, part of the problem was not having an ounce of energy to even care about his depression. I didn't have time to care because I was trying to survive the aggression, lack of sleep, and the emotional stress our sons were putting me through. 

They weren't putting my husband through this trauma because he checked out. He went to work, quickly ate dinner, and then headed out to the garage where he engulfed a case of beer until it was bedtime. 

My husband never directly said autism was part of the problem in our life, marriage or even some of the cause of his depression or drinking, and truth be told, he probably never will, but I believe wholeheartedly that if autism wasn't part of our life, we would have been different. He would have been different. 

Last December my husband demanded a divorce, and to be honest, I saw it coming as I watched him unravel and quickly become someone I didn't love anymore. Someone I wasn’t willing to fight for anyone.  

I hated him for not loving me more. 

I hated him for not fighting for us. 

I hated him for wrecking Christmas. 

I hated him for days and then something strange occurred. 

We started to talk one night. We enjoyed one another’s company and didn’t try to fix any of our problems. We didn’t strategize about this meltdown or how we were going to get our kids to sleep, we just talked. We both had a lot we needed to get off our chests. 

We talked for days which turned into weeks which slipped into months which quickly turned into “let's be better” — together. 

The divorce was removed from our conversations. 

My husband became a better version of himself and so did I. 

When the world went into chaos, our chaos was simply amplified. The problem was no one could see it except for us. No one sees the chaos that autism does to a family or to marriage.  No one sees because we are often isolated and just ‘dealing with it’; dealing with depression through coping strategies like checking out and drinking. No one sees and that became a huge part of the problem. 

This past year has been a journey of new; a new home routine and educational plan for our three children and new for me and my husband because now we actually talk about our feelings without becoming combative with our words. We talk through our pain and chaos rather than using numbing strategies and that’s a win not only for our family but for our marriage. 

About: KE lives in Canada with her husband and three kids. She spends her time advocating for better resources, support, and funding for the individuals who are diagnosed with cognitive disability or physical disability. K has a love for helping people and sharing her story through blogging online about being a mother raising two boys both diagnosed on the autism spectrum.