Sleep is one of the most important foundations for a child’s learning, behaviour, and emotional wellbeing — yet many neurodiverse children struggle with sleep. If your child has autism, ADHD, anxiety, or sensory processing differences, bedtime might feel stressful, unpredictable, or exhausting. You are not alone. And there are supportive, neuro-affirming strategies that can help.

As an Occupational Therapist (OT), I work with families every day who want their child to fall asleep more easily, stay asleep longer, and feel calmer at night. This guide explains why sleep can be difficult for neurodiverse children and what you can do to create a sleep routine that truly works for your child’s unique brain.

1. Sensory Processing Differences

Many neurodiverse children experience sensory input more intensely or more subtly than others. This can make bedtime harder because they may be:

Sensory seekers who need movement, pressure, or sound to feel calm

Sensory avoiders who find certain lights, textures, or noises overwhelming

Sensitive to internal sensations, like temperature, hunger, or body movement

These sensory needs can affect their ability to wind down or stay asleep through the night.

2. Emotional Regulation Challenges

Children with ADHD, autism, anxiety, or PDA profiles often find it harder to regulate emotions, especially at night. When everything finally gets quiet, the brain may get busier. This can show up as:

Restlessness or difficulty switching off

Racing thoughts

Feeling “on alert” at bedtime

Big emotions right before sleep

This isn’t misbehaviour — it’s neurological.

3. Need for Predictability and Routine

Many neurodiverse children rely on structure to feel safe. Small changes — a late dinner, different pyjamas, someone new putting them to bed — can disrupt their sense of control and lead to sleep struggles.

4. Co-Occurring Conditions

Sleep can also be affected by things like:

• Anxiety

• Gut issues or food sensitivities

• Hypermobility or low muscle tone

• Restless legs

• Sleep apnoea

Because sleep is influenced by the whole body, OTs take a holistic view of what might be contributing.

Sleep is considered an occupation — a meaningful daily activity that supports a child’s health and wellbeing. OTs focus on understanding your child’s sensory profile, emotional needs, and environment to make sleep more achievable.

1. Creating a Sensory-Safe Bedroom

An OT looks at how to set up a calming, predictable space. This might include:

• Weighted blankets or compression sheets

• Blackout curtains

• Warm or red-toned lighting

• White noise or sound machines

• A tidy, low-clutter environment

• Sensory tools to wind down

The goal is to help the bedroom feel safe, cosy, and regulating.

2. Designing a Bedtime Routine That Works for Your Child

Traditional routines don’t always work for neurodiverse children. OTs help families find routines that match how their child’s nervous system works. This may include:

• Movement or deep-pressure input before bed

• Warm baths for sensory regulation

• Visual schedules for predictability

• Short, supported choices to give a sense of control

• Gradual wind-down rather than sudden transitions

• Bedtime doesn’t have to be silent and still — it just has to be regulating.

3. Supporting Emotional Regulation

OTs teach children and parents simple, gentle ways to manage big feelings around bedtime:

• Identifying body cues

• Co-regulation strategies

• Calming scripts

• Breathing and proprioceptive techniques

• Social stories about sleep

This helps your child feel safe and understood.

4. Understanding Behaviour Through a Neuro-Affirming Lens

Instead of asking “How do I fix this behaviour?”, OTs ask:

What is my child trying to communicate?

Are they overstimulated or under-stimulated?

Are they anxious? Hungry? Uncomfortable?

Does the routine move too fast? Is it too quiet? Too unpredictable?

When we understand the WHY, we can change the HOW.

5. Supporting the Whole Family

Parents matter. Your energy, capacity, stress level, and needs are part of the plan.

An OT helps make routines realistic for your family — not just ideal on paper.

⭐ Do a Sensory Check-In

Ask yourself:

“What does my child’s body need to feel calm right now?”

Movement? Deep pressure? Warmth? Quiet?

⭐ Create a Simple Visual Sleep Routine

Something like:

1. Movement or bath

2. Pyjamas

3. Snack or drink

4. Story or quiet activity

5. In bed

Predictability lowers anxiety.

⭐ Reduce Hidden Sleep Disruptors

Consider removing or adjusting:

• Bright LED lights

• Clutter

• Itchy or scratchy bedding

• Strong smells

• Screens before bedtime

• Small changes can make a big difference.

⭐ Use Co-Regulation

Children borrow your calm.

A slow voice, gentle rhythm, and predictable presence can set the tone.

⭐ Build In Slow Transitions

Rushing dysregulates the nervous system.

Move gradually from busy activities to quiet ones.

Neurodiverse children aren’t “bad sleepers”. They simply have different nervous systems — and when we understand those differences, sleep becomes much easier to navigate.

With the right tools, environment, and support, your child can sleep more peacefully, and your family can enjoy calmer, more predictable nights.

If you ever feel unsure where to begin, an Occupational Therapist specialising in sleep and sensory needs can help guide you and your child toward a routine that truly works. This is where Dream Sleep OT can help you!

You both deserve rest — and it is possible.