Sleep plays an essential role in every child’s health and development, but for children with autism, bedtime can often feel like one of the biggest challenges of the day. Many families struggle with issues such as difficulty falling asleep, frequent night wakings, or early rising. 

Research suggests that up to 80% of children with autism experience sleep difficulties at some point. While there are many contributing factors, from sensory sensitivities to anxiety, one often overlooked aspect is a child’s preferred sleeping position.

Parents sometimes notice their child chooses very specific positions at night, or they may wonder whether encouraging one position over another could help with comfort and rest. 

Understanding how sleeping positions affect children with autism can offer valuable insight into better bedtime routines and improved sleep quality.

Common Sleep Challenges in Autism

Sleep struggles in autism are common, and they can look different for each child. Some may have trouble winding down due to high energy levels or difficulty with transitions. Others may wake up frequently throughout the night or seem restless even after hours of sleep.

A few common reasons children with autism struggle with sleep include:

• Sensory sensitivities – Textures, pajamas, or bedding can feel uncomfortable.
• Overstimulation before bed – Screen time, loud noises, or unpredictable routines make it hard to relax.
• Co-occurring conditions – ADHD, anxiety, and gastrointestinal discomfort can disrupt sleep.
• Difficulty with melatonin production – Some studies suggest children with autism may produce less of this sleep-regulating hormone.

Since sleep is closely tied to behavior, mood, and learning, finding strategies that improve rest is incredibly important.

Do Sleeping Positions Matter for Children with Autism?

The position a child chooses to sleep in may not seem significant at first, but for children with autism, it can play a role in overall comfort. Certain postures can provide a sense of security or calming pressure, which helps regulate the nervous system.

For example, children who are sensory-seeking may prefer positions that apply gentle pressure to their body, while others may want to feel open and unconfined. That said, it’s important to balance comfort with safety, especially in younger children.

Most Common Sleeping Positions Among Children with Autism

Fetal Position

Curled up on the side with knees drawn in, this position is one of the most common in both neurotypical and autistic children. It provides a sense of security and can be especially soothing for children who crave a “cocoon-like” feeling.

Stomach Sleeping (Prone)

Many parents notice their child prefers sleeping on their stomach. This position can provide deep pressure against the body, which helps regulate sensory input and creates a calming effect. 

However, for infants and very young children, stomach sleeping may increase the risk of suffocation or sudden infant death syndrome (SIDS), so safety guidelines should always be considered.

Back Sleeping (Supine)

Sleeping on the back is widely recommended for babies because of its safety. For older children, it can be comfortable and reduce the risk of breathing difficulties. However, some children with autism may find it less grounding than side or stomach positions.

Side Sleeping

This position offers both safety and comfort. It’s often a middle ground between pressure and openness, making it a common choice for children with autism. Parents can also use body pillows or weighted blankets to enhance the calming effect of this posture.

How Sensory Needs Affect Sleep Position

Children with autism often have unique sensory preferences that influence how they feel comfortable in bed. For instance:

• Weighted blankets or body pillows can provide the extra deep pressure a child craves.
• Tight, curled-up positions may reflect a need for security and proprioceptive input.
• Sprawled or spread-out positions might indicate a need for freedom and avoidance of touch.

Understanding your child’s sensory profile can help you identify why they prefer certain sleeping positions and how you can support better sleep without forcing a change.

Strategies to Improve Sleep Quality (Beyond Position)

While sleeping position is one piece of the puzzle, parents can also support healthier sleep by creating a sensory-friendly environment. Helpful strategies include:

• Establish a consistent bedtime routine – Predictability reduces anxiety and helps signal the brain it’s time for sleep.
• Choose sensory-friendly bedding – Soft, tag-free pajamas and breathable sheets can make a big difference.
• Adjust lighting and sound – Blackout curtains, white noise machines, or calming music help children relax.
• Limit screen time before bed – The blue light from screens can interfere with melatonin production.
• Consider occupational therapy – Professionals can recommend sensory-based sleep tools, like compression sheets or weighted vests.

When to Seek Professional Support

If your child’s sleep struggles are frequent and significantly affect their daily life, it may be time to seek professional help. Warning signs include:

• Persistent insomnia or difficulty staying asleep.
• Snoring, gasping, or signs of sleep apnea.
• Daytime fatigue, irritability, or behavioral regressions linked to poor rest.

A combination of medical professionals, occupational therapists, and ABA therapists can work together to create strategies tailored to your child’s needs.

Conclusion

Every child with autism is unique, and there is no single “best” sleeping position that works for all. Some children find comfort curled up on their side, while others sleep best on their stomach or back. What matters most is finding a balance between comfort, safety, and sensory needs.

If sleep challenges are impacting your child’s well-being, you don’t have to navigate it alone. Intellaplay ABA, an ABA therapy in Maryland, is here to provide personalized strategies that support better sleep, healthier routines, and improved quality of life for your child and family.

Contact us today to book a consultation or speak with our ABA therapists.