Exercise boosts sleep quality for autistic children
Activities like swimming, karate and yoga appear to promote better sleep among autistic youth, in the first research study of its type
Key Findings
- Exercise helps autistic children aged 7-11 sleep better.
- Parents report their children can fall and stay asleep more easily, and devices show they sleep longer.
- Activities like yoga, karate, and swimming seem particularly helpful, but researchers aren’t sure why.
- More research is needed to find out if exercising in the morning or afternoon is more beneficial.
Source*
Liang, X., Haegele, J. A., Tse, A. C. Y. et al. The impact of the physical activity intervention on sleep in children and adolescents with autism spectrum disorder: A systematic review and meta-analysis. Sleep Medicine Reviews, 101913. (2024) https://doi.org/10.1016/j.smrv.2024.101913
*All evidence briefs are informed by one or more peer reviewed research studies. All study publications used to inform this article are listed at the bottom of this brief with links.
What's this about?
Sleep issues can be managed with medication and therapy, but these strategies have downsides. Exercise could be a cheaper and healthier solution.
A multi-country study reveals that exercise can help improve sleep in autistic children. The research highlights improvements in falling asleep, staying asleep, and overall sleep quality.
Sleep problems are very common among autistic children,1 often affecting their quality of life and wellbeing.2 Whilst sleep problems can be managed with medication or professional therapy, these options have drawbacks.
For instance, melatonin supplements are commonly used, but their long-term effects on children remain unknown. Professional sleep or behavioural therapy can be expensive, or difficult to access due to long waiting times.
Exercise emerges as a promising alternative, offering a more enjoyable and accessible option than specialist therapies.
For the first time, a global team of researchers, led by academics from The Hong Kong Polytechnic University, looked at international studies to understand what we know about how exercise impacts sleep for autistic youth. They found 8 relevant studies spanning 6 countries.3
In discussing their findings, the researchers say that exercise may aid sleep by regulating the body’s internal clock. Many autistic children have lower melatonin levels,4 a hormone involved in the sleep-wake cycle. They suggest exercise could help improve sleep by raising melatonin levels.
Activities like martial arts and swimming emerge as particularly promising options. However, the authors warn more studies are needed to confirm this, understand why, and explore whether other factors like timing (e.g., morning versus evening exercise) make a difference.
They also say conclusions are based on a small number of studies and mostly parent-reported data, which can sometimes be inaccurate. Additionally, some studies lacked control groups, which makes it harder to be confident in the findings.
The NHS recommends children get 8-12 hours of sleep each night, with younger children needing more.5 They also advise at least 60 minutes of physical activity every day and encourage minimising sitting time.
Research Toolkit
Researchers analyse international studies on exercise as a sleep aid for autistic children. Here’s what we know:
Key insights
- EXERCISE EASES SLEEP DIFFICULTIES
- Exercise makes it easier for autistic kids to fall asleep, stay asleep, and get better quality sleep. This is based on what parents say and data from wrist-worn sleep trackers.
- BEST ACTIVITIES FOR SHUT EYE
- Karate, yoga, and swimming seem to help with sleep, but more research is needed on this. In the meantime, it’s best to let kids try out different activities to see what they like so that they stay engaged.
- IT’S NOT JUST ABOUT SLEEP
- Regular physical activity offers many physical and mental benefits beyond just better sleep. Since autistic children are often less active than their peers,6 helping them to become more active can bring a wide range of benefits.
- WIDER FACTORS
- Sleep problems in autistic children may be influenced by a mix of neurobiological, psychological, social, environmental, and family behavioural factors. What works for one child, may not work for another.
What Else:
- Inclusive movement environments
- Creating opportunities throughout the week to encourage all students to sit less and move more could maximise efforts. We report how to create inclusive school environments to support autistic students here.7
- Engage parents
- Sharing the benefits of exercise with parents could help — researchers say parents often prefer behavioural interventions over medication for mild to moderate sleep issues in autistic children.
- Multiple diagnoses
- This research study excluded autistic children with other conditions, such as children with a dual diagnosis of ADHD and autism. More research is needed to understand how to promote sleep in neurodivergent children with multiple conditions.
- WHAT ABOUT TEENS?
- The current findings are based on young people aged 7-11. We don’t know yet how exercise affects older teens, but regular physical activity and consistent sleep are recommended for all young people.
Related Topics
- Autism spectrum condition (ASC)
- Autism
- Neurodiversity
- Inclusion
- Sleep
- Exercise
- Physical education
- Sport
- Primary school
Research Sources
Note. We use identity-first language (i.e., autistic children) throughout this article over person-first language (i.e., child with autism) in recognition of stated preferences of autistic people.a,b
a 'How to talk and write about autism', National Autistic Society
b Taboas et al., 2023
1. Mannion et al., 2014; 2. Deserno et al., 2019; 3. Liang et al., 2024; 4. Tordjman et al., 2005; 5. Sleep and Young Children. NHS. (2020); 6. Liang et al., 2023; 7. Breaking barriers for autistic children, School Health Pulse (2024)