Sleep Problems in Kids: What You Need to Know

In this post, we’re addressing sleep problems in kids. Sleep problems in children are extremely common for neurodivergent families (ADHD, Autism, etc). Understanding your child’s unique sensory needs will help you better navigate sleepless nights.

Please welcome Robin Abbott, MS, OTR/L as she explores different sensory profiles of kids who struggle with sleep.

drawing of a boy sleeping.  He's wearing yellow pajamas and his snuggled under a blue blanket with white stars on it.  His pillow is in the same blue pattern with white stars.  A collection of yellow letter "Z"s are trailing from his mind as he sleeps.

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When Sleep Doesn’t Come Naturally

Sleep is a complex neurological process that requires the body to shut down and surrender to fall asleep. It must feel safe enough to stay in this suspended state long enough to do its work.

During sleep, the body:

  • Mends cells,
  • Processes new emotions and thoughts,
  • Dreams 

During sleep, the mind is active, even though the body is not. Problems arise, however, when there’s a disruption between the activity of the brain and the body.

The Reticular Activating System (RAS)

The relationship between the brain and body during sleep is related to the Reticular Activating System (RAS). The Reticular Activating System is a network within the brain that regulates processes related to what we see and feel.

"Reticular Activating System" in blue text above a drawing of a yellow profile of a head with the brain shown as a white cloud shape. There is a dark blue arrow at the brainstem extending upward throughout the entire brain as multiple blue arrows.

Regulation of Mental Energy

The RAS balances our levels of mental energy. For example, getting out of bed in the morning leads to an increase in arousal (alertness) levels. The RAS regulates that process of awareness or alertness.

On the other hand, the RAS also slows conscious thinking to allow the unconscious state of deep sleep.

Message Mediator

In the end, the RAS decides which messages get from the body to the brain and vice-versa. It keeps us from acting out our dreams physically. And in a perfect world, it allows us to sleep through expected noises during the night.

Sensory Systems and the Reticular Activating System

During sleep, two sensory systems continually send information to the RAS.

  1. Auditory
    • Hearing
  2. Vestibular
    • Balance and sensing movement

The RAS must “decide” whether to let input from these systems wake us from our sleep. To complicate matters, the RAS also connects to the limbic system. The limbic system is considered the emotional center of our brain and is a key player in certain types of ADHD.

A child might have trouble sleeping because the RAS has deemed new information a potential threat. (This is related to the fight-flight-freeze response.) Why else would the body want to sacrifice needed sleep? 

Sensory Thresholds

We all have different thresholds for attention to our various sensory systems. For example, some kids are more sensitive to sound than others. On the other hand, some cannot tolerate as much movement as others.

Check out this brief tutorial about the Reticular Activating System (RAS) and its relationship to sleep.

4 Reasons Behind Sleep Problems in Kids

Let’s dive into four potential reasons behind sleep problems in children. The following is a gross oversimplification. However, these four categories can offer you direction to support your child.

1. Vestibular Hyposensitivity

We often help babies fall asleep by rocking or bouncing them. However, some continue to need this movement beyond infancy to “calm down” enough to sleep.

These children need to be in motion much of the time to feel normal. They lose their sense of orientation when made to stand or sit still. Additionally, these kids may be labeled as “hyperactive.”

How to Help a Vestibularly Insensitive Child Sleep

A child like this will need as much movement as possible during the day. They often do well at playgrounds and can play for hours. A backyard playset or a trampoline can be a great investment for kids who need extra vestibular input.

drawing of a blue, green, red, and yellow playset with a slide, rings, ropes, and ladder.  All against a white background.

Further, these kids may benefit from an indoor sensory swing to provide much-needed sensory input. A lycra swing, net swing, or hammock suspended from the ceiling is a good choice.

2. Vestibularly Hypersensitive

On the other hand, some children struggle with vestibular hypersensitivity. These children don’t like being moved and may be very light sleepers.

They may be unable to fall asleep unless with a trusted person. These children tend to like sedentary play activities and may be easily carsick.

drawing of a little girl with long blue hair.  She's sitting cross legged on the floor hugging a pillow in exhaustion.  White fluffy sheep are passing over her head.

How to Help a Vestibularly Hypersensitive Child Sleep

Children with vestibular hypersensitivity may do well with calming proprioceptive input. A weighted blanket or side bolsters in their bed may help these children feel more secure through the night.

3. Auditory Hyposensitivity

A child with auditory hyposensitivity is less sensitive to noise. They’re less likely to get distracted by noises and may struggle with focusing on auditory input.

They may have challenges with speech and language such as the following.

On the surface, it can be difficult to understand why this child has trouble sleeping.

Illustration of a boy with dark pinkish-brownish skin wearing a pink and blue striped shirt.  His eyes are closed and on either side of his head there are blue sound speakers shouting noises at him.  The noises are bouncing off his ears to indicate he can't hear.

An Offline Warning System

Wouldn’t they be able to sleep better, because noises in the house shouldn’t wake them?

However, the sleep issue is the child’s inability to hear WHERE sounds are coming from. Not knowing how far away a sound is triggers the brain’s “early warning system.”

This child might innately know that their warning system doesn’t work well enough to allow them to relax. They may insist on a parent staying until they fall asleep or sharing a room with a sibling.

How to Help the Auditory-Insensitive Child Sleep

A child with auditory insensitivity may benefit from soft instrumental music playing in the background during sleep. This could help their brain compare sound distances and locations more easily.

If your child is struggling with a dysfunctional auditory system, they may simply need your presence in their room.

4. Auditorily Hypersensitive

An auditorily hypersensitive child is sound-sensitive. A hypersensitivity to noise translates into hearing sounds in a way that others don’t.

As such, these kids can often have difficulties falling or staying asleep. Further, these kids can easily develop anxiety about bedtime for fear of a night of disrupted (or non-existent sleep).

Often a parent will know that their child is a light sleeper because they wake upon hearing any noise in the house.

How to Help the Sound-Sensitive Child Sleep

An auditorily hypersensitive child may benefit from using an ambient noise machine at night. A mechanical one is best, as some people can hear the “loop” of sound in an electronic one.

Many Autistic children struggle with sleep. Further, they often struggle with sound hypersensitivity that can hurt their sleep cycles.

Recap: Sleep Problems in Kids

Hopefully, the above descriptions of reasons behind sleep problems in kids are helpful. If you’re still having problems determining which issue might affect your child, here’s a suggestion. In my clinic, I use the following rule of thumb.

In general, children with vestibular differences need physical contact to fall asleep, stay asleep, or return to sleep.

Sometimes they’ll need a LOT of it. You’ll notice them lying on you or under your limbs. This combined with assurance that everything is OK can make a huge difference.

Robin Abbott, MS, OTR/L.  A caucasian women with short light brown hair and blue eyes.  She's staring into the camera and wearing a blue and white shirt with diamond shapes throughout.

Robin Abbott, MS OTR/L is an occupational therapist with 15 years of experience in pediatrics, the former owner of Dovetail Pediatric Therapy. She’s the author of Sound Advice: How to Help Your Child with SPD, Autism, and ADHD from the Inside Out. Contact her at

Drawing of a little boy sleeping under a blue blanket.  Above him are clouds of blue and yellow.  There are more white clouds with the words, "Sensory, Sound-sensitive, and Vestibular" above him. At the top of the image are the words, "Sleep Problems in Neurodivergent Kids".
Sleep Problems in Kids in dark blue text above a light blue overlay.  Below that is a drawing of a little girl with purple hair wearing a sleep mask.  She's staring at the clock and there are three white sheep over her head.

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