this post was submitted on 17 Jun 2025
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Autism
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There is a high comorbidity of sleep issues with Autism, 60-80% vs 20-30% of neurotypical pop that has sleep disturbances
Melatonin system differences is the main neurological causal factor. Tends to be lower production overall and abnormal secretion schedule. Supplementation with melatonin is cheap, relatively safe, and easy place to start. Consult a doctor if you have an autoimmune disorder or are epileptic as melatonin can mess with immune activity and lower seizure threshold. like all things it is possible to be allergic to it but that’s astoundingly rare. Can also interact with other meds like SSRIs and birth control to increase melatonin levels more than you’d want or meds like warfarin to increase bleeding. Basically if you’re healthy it’s very safe but if you’re already taking a bunch of meds, diabetic, etc just ask a doctor. It’s probably fine but never hurts to be sure
Other potential causal factors are what you’d expect: sensory issues, anxiety, etc. managing these ranges from not that bad to extremely difficult. Sleep masks, ear plugs, medications, white noise, etc
Apneas are also more common in autism and are more difficult to treat. CPAPs are poorly tolerated by everyone. there’s a reason insurance companies have pushed to have metrics built into them. You last had one a decade ago so it was potentially before this but modern ones snitch on you: they take usage statistics and if you don’t use them the required amount the insurance co demands you return it or they stop paying for it (this may have been the case 10 years ago even, definitely how it works now).
Outside of CPAP your options for treating apneas are fairly limited and depend on how the apnea presents. If you’re overweight losing weight is the biggest factor in management of an apnea. If your tonsils or adenoids are enlarged surgeries to reduce or remove them can reduce or fix the apnea. If you have narrow jaw issues that can be similarly corrected and reduce apnea. Steroids and such can be used if you have bad allergies but this generally is only an intervention for fairly mild apneas and then you have to deal with side effects of steroids
Otherwise it’s best to find a way to desensitize yourself to the mask if possible. I know it sounds impossible but I’ve worked with many people on doing this and it can be quite a significant positive impact on quality of life. Apnea ultimately means that while you are sleeping and even sleeping excessively you likely aren’t getting much restorative sleep. There’s unfortunately not much to do for that aside from getting oxygen into you while you sleep (or correcting the issues that prevent your airway from becoming obstructed)
Ugh little rant bc I got my hopes up: when multiple counter indications apply (for me here: autoimmune disease, antidepressants, birth control), doctors tend to be so unhelpful. They'll give you the ok for the issue they're trained for, like a psych would potentially give the ok for the SSRIs. But even if you get the separate OKs for all the separate issues, there might be some intersectional issues that only occur for those who have a combination of the counter indications. If you ask a doctor about that, all of them will say they honestly don't know because it doesn't fall within their discipline. Can't even blame them, but it's so frustrating.
Autoimmune disease throws everything off, generally
Advice with a big caveat: you can consider seeing a multisystem doctor. In some hospital systems this is a called care coordinator, multisystem doctor, etc. the big caveat is there is also what are called integrative or functional medicine doctors. These are not inherently bad but you have to do your homework as some will move into pseudoscience bullshit. But there are many that stay to evidence based practice.
The point of all these practitioners though is to counteract the issue you mentioned. They are supposed to have a holistic view and coordinate care for complex cases. You may want to ask for a referral at rheumatology, in my experience they tend to know these doctors the most (bc again autoimmune is the worst)