This study adopted a descriptive phenomenological qualitative design, guided by Colaizzi’s (1978) method [17], to explore the lived experiences of mothers of children with ASD who manage sleep problems. A phenomenological approach was selected as the aim of the study was to understand mothers’ lived experiences in dealing with sleep issues in children with ASD.

The design enabled the exploration of mothers’ experiential progression in managing sleep problems, including initial recognition, emotional responses, help-seeking behavior, strategy implementation, and subsequent adaptation. As data collection occurred within a defined period, participants were encouraged to reflect retrospectively on their past and ongoing experiences, allowing them to express the experiential journey related to sleep issues.

Colaizzi’s method facilitated rigorous inquiry by documenting key statements, deriving meanings, and developing themes from participants’ narratives. This method ensured that findings remained closely aligned with participants’ lived experiences while maintaining methodological rigor.

The study was conducted at the Autism Center of Excellence, SRM Medical College Hospital & Research Center. Participants were selected using purposive sampling, focusing on mothers who had relevant experience managing sleep problems in children with ASD. The presence of sleep disturbances in the child was an initial eligibility criterion. Purposive sampling was used to select mothers who could provide experience-driven insights. There were also efforts to include mothers from different age groups, children of different ages, and people from different socio-demographic backgrounds to get a wider range of views and make the findings more meaningful.

The data collection period was August 2025 to October 2025. Mothers of Children aged 3–12 years diagnosed with ASD for more than 6 months, self- reported sleep problems in their child, willing to participate in an in-depth interview about their experiences, and able to communicate in Tamil, Hindi, or English were the inclusion criteria. Mothers of children with multiple severe comorbid conditions (e.g., severe intellectual disability, genetic syndromes), and mothers with physical and mental illness were exclusion criteria of the study.

Requirements of Participants and in-depth interviews continued until repetition of themes occurred, and no new information was evident (i.e., data saturation was achieved). Seventeen mothers were approached during data collection; four were excluded as their children did not meet the eligibility criterion of having sleep disturbances. The final sample included 13 mothers, which was considered sufficient, as data saturation was achieved and no new themes emerged in later interviews.

Lincoln and Guba’s standards for assessing the trustworthiness of the study ensured this by addressing Credibility, transferability, dependability, and confirmability throughout the research process.

The interview guideline had two parts. The first part collected socio-demographic information of the mothers, fathers, and children, along with autism-related information about the child. Researchers developed the semi- structured interview guideline by reviewing relevant literature and consulting experts. To enhance clarity and relevance, pre-interviews were conducted with two mothers, who were not included in the final sample, and their data were not used in the analysis. The interview guideline consisted of open-ended questions designed to encourage mothers to freely describe their experiences, while probes were used only to clarify responses and deepen understanding. Care was taken to ensure that the questions were non-leading and exploratory, minimizing the risk of bias or self-reinforcement of expected findings. Respondents were asked using the seven questions with more probing questions, i.e., (1) Can you describe the sleep problems your child experiences, including how often they occur and what they look like during the day or night, (2) Can you describe your child’s usual sleep patterns and the sleep difficulties you observe, (3) How do these sleep problems affect ?, (4) In what ways do your child’s sleep difficulties influence your family routine and family members?, (5) What strategies have you used to manage your child’s sleep problems?, (6) What types of support have you received, and how helpful have they been? And (7) What additional support or changes do you think would help mothers manage sleep problems in children with ASD more effectively? These queries aimed to explore the in-depth experiences, emotions, and strategies used by mothers to deal with sleep disorders in their children.

Data were collected between August 2025 and October 2025. All respondents provided written informed consent before participation. The interviews were conducted by the first author(BK), who holds a Master’s degree in Nursing and has received formal training in qualitative research methodology, with experience in qualitative research. Socio-demographic and clinical characteristics were collected from the respondents using the Structure questionnaire to provide a comprehensive contextual background. Socio Reflexivity was maintained through journaling and peer debriefing to minimize bias. Semi-structured face-to-face in-depth interviews were conducted using Tamil, Hindi, or English, based on participants’ preference, in a private and comfortable setting, and at that time their children were taken by therapists. Each interview lasted approximately 25 to 30 min. Most participants were interviewed once; however, in a few cases, interviews were temporarily interrupted due to caregiving responsibilities, particularly attending to the child, and were subsequently rescheduled and completed in a second session. These follow-up interviews were conducted solely to ensure completeness and continuity of data, rather than to generate new or separate data points.

Mothers were encouraged to reflect on both their past and ongoing experiences, including the onset and progression of sleep problems, the strategies they used, and the perceived outcomes. This approach enabled the researchers to explore the experiential journey of managing sleep disturbances despite the interviews being conducted within a limited time frame.

All interviews were audio-recorded with permission and transcribed verbatim. Mothers who showed emotional pain during the interview were withheld, and appropriate psychological support was provided to reduce further emotional burden. Field notes were maintained to capture non-verbal cues and contextual details.

After the interviews were completed, the audio recordings were transcribed by the first and second authors within 24 h in conjunction with the interview scenarios. The audio transcriptions were carefully checked and verified to ensure their authenticity and accuracy. Information inquiry based on Colaizzi’s seven-step method: adaptation with transcripts, withdrawal of significant declarations, preparation of meanings, grouping into clusters of themes, comprehensive explanation, documentation of the important structure, and respondents’ validation. Manual coding was done using a Microsoft Excel sheet. Two researchers independently coded and transcribed to enhance analytical rigor. Differences in coding and theme development were discussed and resolved through consensus with the research team. Manual coding was performed using Microsoft Excel to organize and manage the data systematically.

To enhance credibility, member checking was conducted with four participants, who were selected based on their availability and willingness to provide feedback. These participants represented a range of experiences within the sample. Feedback confirmed that the findings accurately reflected their lived experiences.

Mothers describe their children’s irregular and disrupted sleep patterns as a major challenge. They shared that their child continued to be wakeful till early morning or had very rough sleep patterns, and frequently awakened. These disorders produced considerable emotional exhaustion, with mothers reporting anger, irritations, powerlessness, and frustration due to constant sleep deprivation. Its impact on family life, such as interrupted timetables and the need for one parent to continue awake, affected the well-being of the entire family. Based on the exploration of data, this theme was supported by the following subthemes:

Mothers described a process of continually seeking explanations, direction, and support to address their child’s sleep problems. Initial doubt was followed by seeking professional guidance and adopting everyday strategies.

Some mothers described the use of therapeutic interventions, including medication and home-based practices, as part of managing their children’s sleep difficulties. Some reported that medication prescribed by specialists, particularly managing hyperactivity and behavioral concerns, was associated with improvements in their children’s sleep. Some of the mothers said that they went for short-term homeopathic remedies to resolve sleep problems. These approaches were often used alongside maintaining a regular sleep routine.

Respondent 1:‘’ Initially, she had severe sleep disturbances and unpredictable behavior. Following medical consultation, medication was initiated and is ongoing. Her sleep has improved; she slept around 11 PM, with occasional delays. A consistent routine is also maintained. Although she continues to experience occasional sleep difficulties, there is overall improvement with continued medication and routine care.”

Respondent 2: “The doctor gave medicine for a few weeks to help cope with his hyperactivity, and it helps to settle down and sleep issues.”

Respondent 9: “We also used home remedies like giving him a banana or warm water before sleep, and these helped him relax and fall asleep more comfortably.”

Mothers described their journey of adapting to their child’s sleep pattern and the strategies they implemented. While some mentioned improvements in sleep routines after consistent effort, others continued to experience occasional sleep difficulties. Even so, many mothers reported having developed acceptance of these challenges. This adaptation was reflected in more consistent routines, reduced stress in some cases, and increased confidence in handling their child’s sleep-related behaviors—the extent of improvement and coping varied across children.

As sleep improved, some mothers described feeling foremost emotional relief and a better ability to manage their daily responsibilities. Many described a revived sense of hope and emotional stability after months or years of suffering. However, these experiences varied among participants and were not universal.

Respondent 7:” I can sleep quietly at night now, and I feel more undisturbed because I no longer have to awaken due to his sleep.”

Respondent 3: “We are getting sufficient rest after his sleep improved. Our tension significantly diminished, and we are more patient with him now.”

Respondent 10: “Observing him sleeping peacefully and remaining calm gives hope and enhances satisfaction with our efforts.”

Mothers described a gradual adaptation to their child’s sleep patterns and behavior. They reported increased confidence in managing sleep-related challenges, a better understanding of their child’s disorder, and greater optimism about tackling these challenges with experience. They expressed self-esteem in their ability to manage initial fear, frustration, and misperceptions, turning their experiences into sources of strength and self-assurance.

Respondent 9: “I have accepted his condition completely and have gradually learned how to handle his sleep issues more calmly and confidently, even though he sometimes does not sleep adequately.”

Respondent 6: “This entire journey has taught me a great deal of patience and strength; I have grown emotionally while dealing with his sleep difficulties.”

Respondent 13: “I now feel genuinely proud that I can manage his sleep routine on my own, without the fear, anxiety, or frustration I used to feel before.”

Based on these study results, parents need early information, guidance, and support to help their child get a good night’s sleep. This study demonstrates the significance of teamwork among healthcare providers in supporting both the parents and the children with ASD. Future research with longitudinal designs is recommended to understand further the sleep problems and management strategies in children with ASD.

The study was conducted at a single autism care center, which may have limited the generalizability of its findings. Only mothers of children with mild to moderate ASD were included in the study; as a result, perspectives of fathers, caregivers, and cases of severe Autism Spectrum Disorder were not explored. The findings were derived from self-reported experiences; they may have been influenced by social interest or recall bias.