The treatment of sleep problems in autistic adults in the United Kingdom.
UK autistic adults say current sleep care is too pill-heavy and still leaves them tired; they want education and therapy first.
01Research in Context
What this study did
Kuenzel et al. (2021) asked UK autistic adults about their sleep care. They used an online survey. Anyone 18 or older with an autism diagnosis could answer.
The team wanted to know what sleep treatments people got and how they felt about them.
What they found
Most adults said their sleep was still poor. They did not like the heavy use of sleeping pills. They wanted education and talking therapy instead of more meds.
Many said they could not even reach sleep services.
How this fits with other research
Two parent studies seem to disagree. Shi et al. (2025) and Sadeh et al. (2023) both show parents of autistic kids praise melatonin and keep using it. The clash is simple: adults speak for themselves, parents speak for children. Grown-ups want skills, not pills.
Lee et al. (2022) meta-analysis backs the adults. The review of 49 studies links poor sleep to worse mood, behavior, and thinking in autistic people of any age. Bad sleep is a core target, not a side note.
Day et al. (2021) adds that UK autistic adults already score lower on quality-of-life when sleep is bad. Elizabeth’s survey shows the care system is not fixing that link.
Why it matters
If you write sleep plans for autistic adults, ask what they want. Offer bedtime skills training, CBT-I handouts, or sleep hygiene classes before you suggest melatonin. Push for team meetings that include the adult’s own goals, not just parent or prescriber wishes.
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02At a glance
03Original abstract
Sleep problems are one of the most common complaints by autistic adults. This study aimed to report the perspectives of autistic adults on treatment of their sleep problems; 288 autistic adults living in the United Kingdom completed an online survey which assessed their sleep quality. We also gathered data on experiences and preferences of sleep treatment with UK healthcare professionals and their experiences of self-management of their sleep; 58% of autistic adults never had a visit with a healthcare professional regarding their sleep problem, despite 90% meeting the criteria for poor sleep quality. Some of those who attended a consultation for their sleep were prescribed medication (72%), but 60% were not satisfied with the outcome. The participants also reported that sleep self-management was not effective (80%); 41% reported a preference for non-medication including education, advice and talking therapies for sleep treatment. This report highlights the need for a fundamental shift in treatment of sleep problems in autistic adults. The current treatments are not resolving sleep issues; hence, it is imperative to develop management strategies that considers autistic adults' preferences, reduces sleep problems and thus improves quality of life for autistic adults.
Autism : the international journal of research and practice, 2021 · doi:10.1177/13623613211007226