Our neurologist told us to give our anxious, sleep deprived son with ASD 3mg of melatonin at 5pm. Ever since then, our sleep routine has been much easier.

For now, it seems like camping out in DS's room is the only thing that will work. For now, stay there until he falls asleep. Once he is feeling more comfortable, start leaving a bit at a time. Stay until he is very sleepy then leave to "go get something" or "use the bathroom". Return in 5 minutes. It's a pain to deal with, but I always try to think that eventually they won't want us to hold their hands and snuggle them to bed.

You could try writing a social story about going to sleep. How about re-planning bedtime routine together? Maybe reading in the dark, listening to calming music, or using an aromatherapy diffuser with lavender? New sheets? blankets? A weighted blanket? Usually if I can get my son to participate in decision making, some novelty helps us through hard times. The good news is this can't last too long (although I'm sure it already feels like too long). Tiredness will get the best of your kiddo eventually.

Sorry you are going through this. Good luck.

My 10 year old ASD son went through this for a really long time and the lack of sleep only exacerbated his OCD-like perseveration. He has been in skills therapy and has had cbt for quite awhile now, but like many other people on the spectrum, his body doesn't shut down at night and he struggled with both sleep onset delay as well as intermittent waking. We consulted a psychiatrist, who prescribed Vistaril to help him sleep and it does wonders. One of the difficulties of using meds on ASD children (and I have two) is that it often does not work as expected. The pp is correct in that psychiatrists are reluctant to prescribe Xanax or any other type of benzodiazepine because they are highly addictive and often cause a paradoxical effect in children (my son was first prescribed klonopin for extreme insomnia and all it did was make him agitated). Vistaril, however, is basically a very heavy antihistamine (hospitals use it to relax patients before surgery). It's non-addictive and the only side effects have been sedation, which is why we only give it at night. No one likes to medicate their kid (and I went for years resisting medicating either of my kids for their severe anxiety), but sleep is crucial and if your child has been awake that long then it's all about picking the lesser of the two evils. Good luck and I hope it works out.

They don't give kids xanax, but melatonin might help make him sleepy.

OP - Time to get him into his PCP to start with and then perhaps to a doctor who would have advice if needed on therapy or medication as two days of no sleep just about is a great stress on his body and can lead to other conditions if not treated. And if the doctor can prescribe something just to break the chain of no sleeping perhaps that will help break the cycle, too.

How old is DS?

Can you try benadryl for one night?

What about melatonin or something like Xanax or sleeping medication? This sounds serious and I hope you find help.

My DD has OCD which causes terrible nightmares. She takes anxiety meds and does CBT which mostly keeps it under control, but when it gets bad, I sleep in her room. (Otherwise she'd wake the whole house up). Could you try therapy? Everyone has occasional nightmares, but persistent nightmares are often caused by anxiety.

Good luck.

DS with ASD has developed a sudden fear after having a bad dream. This has caused him to basically stop sleeping entirely and refuse to be alone for even a minute. He's having massive meltdowns at night and at nap time if we leave his room. He's already sleeping with the lights on and I've offered for him to sleep in other places like the guest room (even the hallway if he wants) but all he does is scream. I finally temporarily moved DH into his room just to get some rest because I was worried when DS had only slept a total of about 3 hours in a 48 hour period. We've been through nighttime regressions with our other DC but the ASD traits seem to be making everything worse. He's constantly perseverating on the fear and can't be reassured by anything he or we come up with. I feel terrible but I'm also getting really frustrated with him because it's so disruptive and instead of coming to get us, he'll just start screaming his head off the second anyone leaves the room. Part of me also wonders if it's somewhat for attention but other times I think he's genuinely afraid. Please help DCUM, I'm losing it over here.