For the parent

This isn’t for the child. This is for you.

The parent of an autistic child carries a weight nobody sees and that doesn’t stop at night. You sleep badly, you’ve stopped moving, you’ve stopped thinking about yourself because there’s no room. After a year that isn’t called tiredness any more, it’s called depletion, and it reaches the child faster than any supplement does.

Here are thirteen tools. None of them is a miracle. Each one works if you use it and none works if you only read it. So every page is short and has the same shape:

What it is: three sentences.
Why it helps: what the science actually says, without inflation. Where the evidence is strong it says strong; where it’s thin it says thin.
How: steps you can do tonight.
When: where this fits into the day of a parent with no spare hour.
When not: safety. Read this part.

How to start: not with all thirteen. Take the first page (“When you’re about to break”) and the second (“The physiological sigh”). That’s enough for two weeks. The rest comes once those two are a habit.

When this isn’t enough

These tools help with weight. They don’t treat depression, they don’t treat an anxiety disorder, they don’t replace a person who listens to you. If for more than two weeks you can’t feel anything good, if you’re not sleeping at all, if the thought passes through that everyone would be better off without you, that isn’t something breathing fixes. That’s the sign to talk to a doctor, now, not next week. In Australia: Lifeline 13 11 14, any hour.

There’s nothing weak in that. Weak is staying silent until you break, because then the family breaks too.

When you’re about to break: 90 seconds

What it is

A protocol for the moment when the child has been screaming for twenty minutes, the baby is crying, and you feel something climbing up your neck. Ninety seconds, three steps, done on the spot. It isn’t relaxation, it isn’t meditation. It’s a brake.

Why it helps

By that moment the body is already in alarm: pulse up, breathing shallow and fast, muscles clenched. You can’t ask the body to calm down by thinking, because thought is the weakest thing you have right then. But breathing is the one automatic function you can take over by hand, and a long exhale is the fastest known way to bring the pulse down. It’s the same reflex the body uses on its own when it sighs. A Stanford study in 2023 (108 people, one month) showed that this kind of exhale lowers breathing rate and improves mood more than meditation does, at five minutes a day. Ninety seconds doesn’t fix the day, but it puts you back in the room.

How

Two inhales through the nose, one long exhale through the mouth. Breathe in through the nose, and when you think you’re full, take in a little more: short, on top. Then let it out through the mouth slowly, as if cooling soup, until it’s all gone. Three times.
Feet. Feel where your feet touch the floor. Press them into it a little. It sounds stupid and it works: a brain thinking about feet isn’t thinking about running.
Name it. To yourself, one sentence, no prettiness: “I’m angry and tired and this is the third time today.” A named feeling is smaller than an unnamed one.

If you can step out of the room for a minute, step out. If you can’t, this works in the room too.

When

Only when needed. But it isn’t learned in that moment. It’s learned earlier, two or three times while calm, so the hand knows what to do when the head doesn’t.

When not

There’s no when-not. This is safe for everyone. Only this: if you’re about to break several times a day, every day, for weeks, that isn’t a moment. It’s a state, and then read the end of the introduction.

The physiological sigh: five minutes a day

What it is

The same double inhale and long exhale from the previous page, but as a daily practice: five minutes, repeated. The body does this by itself a few times an hour without you noticing, whenever the lungs partly collapse. That’s why it’s called physiological. You’re just doing it on purpose.

Why it helps

This is the tool with the best evidence-to-effort ratio on the whole list. In the study by Balban and colleagues (Stanford, Cell Reports Medicine, 2023), 108 people spent five minutes a day for a month doing one of four things: this sigh, box breathing, a Wim Hof-style cyclic hyperventilation, or mindfulness meditation. All four groups had less anxiety. But the physiological sigh improved mood the most and lowered resting breathing rate the most, and the effect grew the more people practised. The mechanism is simple: the second inhale reopens collapsed air sacs, the long exhale drives the parasympathetic side through the vagus nerve, and the pulse drops. No device, no app, no cost.

Honestly: the study was small and lasted four weeks. Ten percent of participants reported something unpleasant (dizziness, discomfort). But for five minutes a day, this is the best that science currently offers.

How

Sit or lie down. It doesn’t need silence: the car in the driveway before you walk into the house is fine.
Inhale through the nose to roughly full lungs, then a short extra inhale on top.
Slow, long exhale through the mouth. Let the exhale take about twice as long as the inhale.
Repeat for five minutes. The pace finds itself, roughly six to eight cycles a minute.
If you feel dizzy, slow the exhale or stop. Dizziness means you’re exhaling too hard.

When

Best at the same time every day, so you don’t have to decide each time. Candidates: the moment the child falls asleep; in the car before walking in after work; before you open the email from the therapist. One of those, every day, for a month. Then see.

When not

Safe for almost everyone. Don’t do it while driving, because a long exhale can make you drowsy. If you have serious lung disease, ask your doctor. Dizziness is a sign to slow down, not push through.

Box breathing: before the appointment, before the hard conversation

What it is

Four sides of a square, all the same length: inhale for four seconds, hold four, exhale four, hold empty four. Soldiers use it before an operation, surgeons before surgery, and people sitting in the paediatrician’s waiting room with a list of questions in their hand.

Why it helps

Slow, even breathing (around six breaths a minute) is one of the best-studied ways to raise heart-rate variability and lower anxiety in the moment; a 2018 systematic review (Zaccaro and colleagues, Frontiers in Human Neuroscience) gathers that evidence. Box breathing is one form of it. In the 2023 Stanford study it did slightly less for daily mood than the physiological sigh, but it has one advantage the sigh doesn’t: counting. When you count to four, four times over, there’s no room in the mind for “what if she says he’s regressing”. That’s what you need before an appointment: not calm, but presence.

How

Sit upright, feet on the floor.
Exhale everything.
Inhale through the nose: count 1, 2, 3, 4.
Hold: 1, 2, 3, 4.
Exhale through nose or mouth: 1, 2, 3, 4.
Hold empty: 1, 2, 3, 4.
Four to six rounds. Two or three minutes.

If four seconds is too long, do three. Evenness matters more than length.

When

Before the doctor’s appointment, in the waiting room. Before the meeting at daycare. Before the conversation with your partner you’ve been putting off for a week. When the results arrive in the post and you can’t bring yourself to open them.

When not

Holding on empty lungs can be unpleasant if you have blood pressure problems or are pregnant. Then skip the fourth side and do only inhale–hold–exhale. Don’t do it in water. If dizziness appears, shorten the count.

Breathing rounds and holds: mornings, when you need a jolt

What it is

Three or four rounds: thirty to forty deep, fast breaths, then an exhale and a hold on empty for as long as you comfortably can, then one inhale held for fifteen seconds. It takes ten to fifteen minutes. It isn’t calming. It’s the opposite of calming. It’s a controlled stress that wakes you up and afterwards leaves you strangely quiet. Its best-known modern form is the Wim Hof Method, and that is where the instructions below come from.

Why it helps

Honesty is needed here. The most famous study (Kox, PNAS, 2014) showed that people trained in this method could blunt the inflammatory response to an injected bacterial toxin. Impressive, but not the same as “helps parents”. A 2024 systematic review (PLOS One) found eight small trials, all at high risk of bias, mostly on men; the overall conclusion was that the method probably lowers inflammatory markers, and that the psychological effects (more energy, less fatigue) were reported but poorly measured. In the 2023 Stanford study this style of breathing came third of four for mood.

So: you don’t do it for the inflammation science. You do it because in ten minutes it moves you from “I can’t get up” to “let’s go”, without coffee, and because people who do it say the cold shower and the hard day are easier to take afterwards. That’s reason enough. Just don’t call it medicine.

How

Lie down or sit leaning back. Never standing. People faint from this. Not often, but it happens, and a fall from standing height is dangerous.
Thirty deep breaths: inhale fully through nose or mouth, exhale relaxed, not forced. A rhythm like a wave. Tingling in the hands and lightness in the head are normal.
After the last breath, exhale and don’t inhale. Hold the lungs empty until you feel a clear need for air, usually one to two minutes after a couple of weeks. Don’t compete.
Inhale deeply, hold fifteen seconds, release.
That’s one round. Three rounds. Then lie there for a minute and do nothing.

When

In the morning, before the house wakes, or right after. Not in the evening: it will keep you up. Not before driving.

When not

This is the one page where “when not” is not a formality.

Never in or near water. Not in the bath, not in a pool, not in the sea. Holding your breath after hyperventilating switches off the alarm that tells you to breathe, and people have drowned without ever feeling the need for air.
Never at the wheel, or right before driving.
Not in pregnancy. The method’s own authors say they don’t know how the adrenaline surge affects the baby.
Not with epilepsy, heart disease, a history of stroke, high blood pressure treated with medication, kidney disease, Raynaud’s syndrome, or recent surgery.
If you take psychiatric medication or get panic attacks, ask a doctor. Hyperventilation can trigger an attack.
If you faint lying down, no harm done, but it means you overdid it. Next time fewer breaths, shorter hold.

Cold shower: thirty seconds at the end

What it is

You shower normally, warm, and at the end you turn it to cold and stand there for thirty seconds. Not an icy lake, not an ice bath, not morning heroism. Thirty seconds of cold water from an ordinary tap.

Why it helps

The largest study (Buijze, PLOS One, 2016, 3,018 people in the Netherlands) compared 30, 60 and 90 seconds of cold at the end of a shower against ordinary showering, for a month. Result: 29% fewer days off work sick. What’s interesting is what wasn’t found: people weren’t ill less often. They were ill just as often, but stayed home less. And there was no difference between 30 and 90 seconds. The authors read it as: a cold shower doesn’t boost immunity, but it does something to the sense of energy and the ability to push through a day. Two-thirds of participants kept going on their own after the study, which for any habit is an unusually high number.

For mood: cold water triggers a surge of noradrenaline and people consistently report alertness and a better mood for a few hours afterwards, but there are no large studies for that, only small ones. Take it as “probably, and it’s cheap to try”, not as proof.

For a parent it means: thirty seconds that move the day from “I dragged myself through” to “I got through”. That isn’t nothing.

How

Shower warm as usual.
At the end, turn it to cold. Not lukewarm: cold. Legs and arms first, then torso, then back. Head if you want.
Breathe normally. For the first five seconds the body wants to gasp and clench. Let out a long exhale through the mouth and drop your shoulders. That’s the whole skill.
Thirty seconds. Count. Then get out.
The first week is awful. The second is bearable. By the third it’s something you miss when you skip it.

When

Morning, if you want alertness. Not before bed: it will wake you. If you shower in the evening, do the cold finish earlier in the day or skip it that day.

When not

Heart disease, arrhythmia, high blood pressure that isn’t under control: cold water clamps the blood vessels suddenly and blood pressure spikes. Ask a doctor before trying.
Raynaud’s syndrome, cold urticaria (hives from cold).
Pregnancy: a short cold shower is probably not a problem, but ask.
Never the breathing rounds in the shower or bath. They are two different things and don’t combine with water.
If you’re still shivering more than a few minutes after, it was too long or too cold.

Ten minutes of sitting

What it is

You sit, close your eyes, follow your breath. When you notice you’ve drifted into thought (and you will, fifty times), you come back to the breath. That’s the whole meditation. No mantra, no app with a voice, no “empty your mind”. The mind doesn’t empty; it wanders, and you bring it back. The bringing back is the exercise, not the stillness.

Why it helps

The evidence for mindfulness is broad but modest: dozens of studies, meta-analyses showing a moderate effect on anxiety and mood, similar to other active techniques, not greater. In the 2023 Stanford study, meditation came last of the four for daily mood. Breathing beat it. So why is it here?

Because breathing changes the body in five minutes, and sitting changes something else, more slowly: you notice earlier that you’re tense. A parent who meditates for a month doesn’t become calm. They become someone who notices their jaw has clenched before they shout, not after. That two-second gap is everything. The physiological sigh fits inside it.

And one more thing that isn’t measured: ten minutes a day in which nobody wants anything from you. For a parent who is on call from six in the morning to ten at night, that’s worth something on its own.

How

Sit on a chair, back upright, not leaning. Hands on your thighs. Eyes closed or lowered.
Timer for ten minutes. Without a timer you’ll keep checking the clock.
Breathe normally. Follow wherever you feel the breath most clearly: nostrils, chest, belly. Stay there.
When you realise you’re thinking about the Nystatin, the bills, what the daycare teacher said, that’s the moment of practice. Don’t be annoyed. Note “thought” and return to the breath.
When the timer goes, stay for one more breath. Then get up.

A bad day of meditation (a hundred thoughts, zero peace) counts exactly as much as a good one. You count days, not quality.

When

The same time every day, or it doesn’t happen. Realistic candidates: the moment the child is asleep in the evening, before you turn on your phone. Or in the morning, before everyone, if you’re that type. Ten minutes; if ten is too many, five. But every day.

When not

Safe for everyone, with one warning: in people with trauma or severe depression, sitting in silence sometimes amplifies what’s inside rather than settling it. If you consistently come out of sitting worse, not better, this isn’t for you right now, and that’s fine. Take the breathing and a walk instead.

The dichotomy of control: Epictetus for a parent

What it is

The first sentence of Epictetus’s Handbook, written two thousand years ago by a former slave: some things are within our power, and some are not. Within our power are our judgements, our intentions, our actions. Not within our power are our body, our reputation, other people’s actions and, the parent adds, our child’s brain.

Everything else in Stoicism follows from this. You don’t need the book; you need this one division applied every day.

Why it helps

The parent of an autistic child lives in a permanent attempt to control what can’t be controlled: will he speak, when, how much, is this protocol the one. All the energy goes into an outcome you don’t directly influence, and every evening is either a defeat or a hope deferred. That’s a recipe for burnout, and it isn’t weakness. It’s strength pointed the wrong way.

The division puts the energy back where it works. You don’t control whether he speaks. You control whether you sat on the floor with him for twenty minutes today, whether he got the capsule, whether you wrote down what you saw. Those three things are your entire power, and they are enormous, and they get done today.

Cognitive behavioural therapy, the best-studied psychotherapy there is, is built on the same idea: not changing the circumstances, but changing the judgement about them. The Stoics knew it without the studies.

How

When fear or anger grabs you, ask one thing: “Is this within my power?”
If not (the outcome, someone’s opinion, the past, the child’s brain), let go. Not “don’t worry”, but: take your hands off it, because hands do nothing there.
If yes (the next action), do it. Just that one.
In the evening, on paper, two columns: “Wasn’t mine” and “Was mine, and I did it”. Read the second column twice.

An example you’ll recognise: “Will the low-dose leucovorin be enough?” Not yours. “Will I notice and write it down if he regresses in the first two weeks?” Yours. That second sentence is the only one worth losing sleep over.

When

In the moment, when the question asks itself. And in the evening, as part of the day’s review (next page).

When not

One trap: the dichotomy is not an excuse for passivity. “Not within my power” doesn’t mean “not my concern”. It means you push to the edge of your power, and stop there. The Stoics were generals and emperors, not spectators.

And another: don’t use it on your partner. “That’s not within your power” said to a wife who is crying isn’t philosophy, it’s rudeness. This is practised on yourself.

The evening review: Seneca, ten minutes

What it is

Every evening, once the house went quiet, Seneca went through his day: what did I do, where did I go wrong, what will I do differently tomorrow. Without self-flagellation: he wrote that he talked to himself like a friend who judges gently but doesn’t lie. Marcus Aurelius did the same thing in a notebook he never meant to publish; today it’s called Meditations.

For a parent: three questions, paper, ten minutes, after bedtime.

Why it helps

The day of an autistic child’s parent has no end. It flows into the next one, without a full stop. You never get to “done for today”, so you never put the weight down, so you carry it into sleep and sleep badly. The review makes a full stop. Ten minutes in which the day becomes something that was, not something still going on.

Second: your memory is your enemy. Without a record, after a month you remember only the bad days, because they hurt, and you conclude that “nothing is working”. A record of thirty days shows five good days you don’t remember. That’s the same reason you keep a journey for Maxi at all, and the same reason to keep one for yourself.

Science: writing about your day (expressive writing, Pennebaker) has decades of modest but consistent evidence for mood and sleep. Not large. Consistent.

How

Three questions, two or three sentences each, by hand if you can:

What was good today? One thing. It can be tiny: he looked at me when I came in. He ate the beans. I didn’t shout.
Where did I go wrong, and what will I do differently tomorrow? One thing, no drama. “I shouted at 6:40 because I was hungry. Tomorrow I eat at 5:30.” Concrete, not “I’ll be more patient”.
What wasn’t within my power, so I let it go? One thing. Write it down and close the notebook on it.

Then don’t open your phone. That’s the condition. The review followed by Instagram cancels the review.

When

After bedtime, before screens. Ten minutes, no more. If it runs to half an hour it’s become rumination, which is the opposite of the goal.

Once a week, read the seven entries in one go. That’s the moment you see what day-by-day you can’t.

When not

If the second question (“where did I go wrong”) turns every evening into a charge sheet against yourself, skip it for a month and do only the first and third. Seneca judged gently. If you don’t know how to judge gently yet, learn that first.

The weight carried for years

Every previous page is a tool for a day. This one is for years, because this isn’t a sprint, and nobody tells you that at the diagnosis.

Sleep comes first, not last

Everything else (patience, judgement, the marriage) stands on sleep. A parent who has slept five hours a night for three months isn’t tired, they are clinically impaired in judgement, and they don’t notice because the impairment is in the judgement. If the child doesn’t sleep, the two of you alternate nights; you don’t split every night. One full night’s sleep twice a week is worth more than six half-nights.

The body has to move, but not at a gym

You don’t have an hour. You have twenty minutes of walking with the pram, ten squats while the water heats, stairs instead of the lift. The science on movement and mood is as strong as for any antidepressant in mild depression, but only if it happens. Twenty minutes of walking a day, outside, in daylight, is the minimum that works. Don’t plan more until that’s automatic.

Say it out loud

Parents of autistic children stay silent about the hardest part, because who would understand. Then it grows. One person (not your partner, a third person) to whom once a week you say how it really is. A friend, a brother, a parents’ group, a therapist. It doesn’t matter who; it matters that it’s said aloud to someone who listens. A weight that has been named out loud is lighter; this isn’t a metaphor, it’s one of the most consistent findings in psychology.

The two of you are the system

The child gets the protocol, the therapy, the attention. The marriage gets what’s left, and nothing is left. After two years, two people who are perfect parents and strangers to each other. One hour a week that isn’t about the child: not a “date night”, but an hour in which saying “Maxi” is forbidden. If there’s nobody to babysit, an hour on the balcony once he’s asleep. This is the only item here that you can’t make up for later.

There won’t be one moment

You’re waiting for the day he speaks, when everything changes, when you can breathe out. That day probably won’t exist as a day. There will be five hundred small days, each moving things a millimetre, and you’ll only notice when you look back through the journey. That’s why the journey is kept: not for the doctor, for you, so you can see the millimetres the eye doesn’t.

When this isn’t enough

Everything here is for weight. If what you’re carrying has crossed from weight into illness (you feel nothing for weeks, you don’t sleep at all, you drink more than you used to just to get through, you think it would be easier if you weren’t here), that isn’t solved with breathing and Seneca. A doctor, now. In Australia: Lifeline 13 11 14, any hour; Beyond Blue 1300 22 4636. There’s no weakness in it. Weakness would be breaking in silence, because then the thing you kept silent for breaks too.

Okinaga: the long breath

What it is

The Japanese okinaga (息長) means, literally, “long breath”. The slowest breathing on this list: inhale through the nose for six to eight seconds, exhale through the nose or half-open mouth for twelve to twenty, no holding, no strain. Three or four breaths a minute. There is no technique except one: the exhale is longer than the inhale, and everything is slower than you think it should be.

This is what remains when you strip away everything else. The physiological sigh is first aid, box breathing is for before the appointment, the breathing rounds are the morning jolt. Okinaga is what you do when you have twenty minutes and want to come all the way down.

Why it helps

The same mechanism as every slow technique, taken to its end: a long exhale drives the vagus nerve, the pulse drops, heart-rate variability rises, and at three or four breaths a minute the body enters a state it otherwise reaches only on the edge of sleep. The systematic review by Zaccaro and colleagues (2018) collects the evidence for slow breathing in general: less anxiety, better sleep, higher heart-rate variability; most studies used six breaths a minute, and slower breathing is less studied but goes the same way. Honestly: there are no studies of this exact form. There are two thousand years of practice in Japan and a physiology that agrees.

The difference you’ll feel compared with the shorter techniques: it doesn’t calm you in a minute, but after fifteen minutes you’re somewhere nothing else on this list gets you.

How

Lie down, or sit leaning back. This isn’t done upright and tense.
For the first minute just breathe normally and notice how long one breath takes. Change nothing.
Then lengthen the inhale: through the nose, six seconds, quietly, as if you didn’t want anyone to hear.
Exhale twice as long: twelve seconds, through the nose or barely open lips. Let it trickle out, don’t push it. At the end of the exhale don’t squeeze. Just let the next inhale arrive on its own.
When twelve becomes easy, lengthen to fifteen, then twenty. Never to the limit; always one step below what you can do.
Fifteen to twenty minutes. Set a timer, then forget it.

If counting gets in the way, don’t count. Just let the exhale be long, until it’s all out, and then a little more.

When

In the evening, in bed, instead of the phone. This is the only technique here where it’s fine to fall asleep in the middle. Or on a Sunday afternoon when someone else has the child and you have an hour to yourself.

When not

Safe for almost everyone. Not at the wheel. If you feel dizzy, the exhale is too long for now, so shorten it. If you have lung disease, start with a shorter exhale and ask a doctor. This isn’t breath-holding, so there’s no risk of fainting. But if you’re pushing it to the limit, it has stopped being okinaga.

Practising kindness: towards others, and towards yourself

What it is

Two exercises that go together. The first is simple: one deliberate good deed a day, small, concrete, expecting nothing back: a coffee for the neighbour, a message to a friend you haven’t heard from in months, a sentence to the daycare teacher that the way she works with your child matters to you. The second is harder: the same tone towards yourself. The parent of an autistic child is enormously kind to the child and enormously harsh on themselves, and those two don’t go together for long.

Why it helps

For kindness towards others there’s a meta-analysis of 27 studies and 4,045 people (Curry and colleagues, Journal of Experimental Social Psychology, 2018): people who deliberately do good deeds feel measurably better. The effect is small to moderate, consistent across age and sex, with no sign of being inflated. Small, but for something that costs five minutes and zero dollars, that’s a good ratio.

For kindness towards yourself (self-compassion, Kristin Neff): in parents of autistic children, self-compassion is consistently linked to less stress and depression and more life satisfaction, independently of how affected the child is. The mechanism is plain: self-criticism in a moment of exhaustion adds a second weight on top of the first. “I shouted, I’m a bad father” is two weights. “I shouted, I’m tired, this is hard for anyone” is one.

And one thing studies don’t measure, but you know: the child sees. Not what you say, but how you treat yourself when things go wrong. That gets learned.

How

Towards others, one a day: 1. Decide who in the morning. Don’t wait for an opportunity; it doesn’t come on a day like this. 2. Small and concrete. Not “I’ll be kinder”, but “I’ll message Marko”. 3. No report. Don’t talk about it, don’t post it. Part of the effect comes precisely from it being quiet.

Towards yourself, when you catch the self-criticism: 1. Notice the sentence. “I’m useless”, “anyone else would do this better”, “I ruined the day”. 2. Ask: would I say this to a friend with an autistic child and three hours of sleep? No. 3. Say to yourself what you’d say to him. Out loud if you’re alone. It sounds stupid the first ten times. The eleventh time it doesn’t.

In the evening review, one of the three questions is already “what was good today”, and the good deed you did counts there.

When

The good deed in the morning, while there’s still energy. Kindness towards yourself in the moment, when the sentence appears, usually around 6:30 pm, when it’s hardest.

When not

Kindness to others is not the same as not being able to say no. If you already give everything to everyone, you don’t need this exercise. You need the opposite one: one “no” a day. A parent who can’t refuse ends up empty, and then isn’t good to anyone.

Greasing the groove: strength without a workout

What it is

Pavel Tsatsouline’s method, a former Soviet special-forces instructor: instead of one workout to exhaustion, many small sets of the same movement scattered through the day, always far from your maximum. If you can do ten push-ups, you do five at a time, six or eight times a day. Never to failure, never out of breath, never sweaty. A pull-up bar in the hallway doorway and one rule: every time you walk through, three pull-ups.

A parent with no hour for the gym has twenty lots of thirty seconds. This is the only strength method built for that kind of day.

Why it helps

Tsatsouline himself explains it as learning: strength is a skill, and skills are learned by frequent, quality repetition, not by exhaustion. That matches what’s known about motor learning: spaced practice beats crammed practice. For the method under this name there are no clinical trials; there are thirty years of people whose pull-up count doubled without a workout. Take that as experience, not proof.

But for the principle (“a little, often, through the day”) the evidence exists, and it’s strong. A study of 25,241 people who don’t exercise (Stamatakis and colleagues, Nature Medicine, 2022, followed for seven years with wrist trackers) found that three or four vigorous bursts of one or two minutes a day (stairs, carrying shopping, running after a child) went with roughly 40% lower all-cause mortality and nearly 50% lower cardiovascular mortality, compared with people with no such bursts. About four and a half minutes a day in total. These aren’t people who train; they’re people whose day contains such bursts. The parent of an autistic child is exactly that person, now doing it on purpose.

And something unmeasured: five squats while the pasta water heats is a moment when the body does something for itself. Ten such moments a day change how you feel in a body that otherwise only carries, lifts and runs.

How

One movement. Pull-ups if you have a bar, push-ups if not, squats if not even that. One, not a programme.
Find your maximum once. How many you can do in one clean set. Say eight.
Do half. Four. Never more than 60% of your max, never to the edge. If the last rep was hard, it was too many.
Scattered through the day. Six to ten times. Tied to something you do anyway: every time you enter the kitchen, before every meal, when the child falls asleep, when you cross the threshold. At least fifteen minutes apart.
Every day. No “rest days”: since you never go to the limit, there’s nothing to rest from. If you’re ill or in pain, skip.
Every two weeks re-test the max. When it goes up, raise the set.

Example for a beginner with no equipment: squats, max 15, set of 7, ten times a day = 70 squats without a single minute of “training”.

When

All day; that’s the point. Not before bed if it wakes you.

When not

Joint or back pain: stop, don’t “push through”. This is done for decades, not weeks.
If you have a heart or lung condition, short bursts are exactly what those studies link to benefit, but ask a doctor how much.
The trap: turning this into a workout. The day you’re out of breath and sweating, it stopped being greasing the groove, and tomorrow you won’t want to.

Sleep: the one thing everything else stands on

What it is

Not “sleep more”: you can’t, the child decides. Rather: get the most out of the night you have, and organise the week so that at least twice you sleep it whole. These are the rules from cognitive behavioural therapy for insomnia (CBT-I), adapted for someone who gets woken at two.

Why it helps

CBT-I is the best-proven treatment for bad sleep there is: better than pills over the long run, and not marginally; it’s first choice in every guideline, including the Australian ones. You don’t need a therapist to apply half of it.

And why sleep comes first: everything else on these pages (patience, judgement, kindness, the marriage) draws on the same reserve, and that reserve is refilled only by sleep. A parent who has slept five hours a night for three months doesn’t feel tired; they feel normal and make worse decisions, and can’t see it, because the damage is in the very faculty they’d see it with. No breathing makes up for that.

How

Same wake-up time, every day. The one rule that works on its own. Not bedtime (the child sets that) but getting up, weekends included. The body arranges itself around a fixed point.

Light in the morning, dark in the evening. Ten minutes outside in the first hour after waking, no sunglasses. Dim in the evening, screen away at least half an hour before bed. Cheaper than melatonin and works better.

Caffeine until noon. Its half-life is five to six hours; a coffee at 4 pm is a quarter of a coffee at midnight.

The bed is for sleeping. Not the phone, not worrying, not planning tomorrow’s appointment. If you lie awake longer than twenty minutes, get up, sit in another room in low light until you’re sleepy, then back. It sounds cruel; it’s the strongest part of CBT-I.

Worries on paper, before bed. The evening review (page 8) is for this too: what’s written down doesn’t have to spin in your head at three in the morning.

The two of you: alternate nights, not wake-ups. A night where you both get up twice is a night where nobody slept. A night where one gets up four times and the other sleeps with earplugs is half the family rested. Twice a week a whole night, each of you. That’s what’s possible, and it’s worth more than everything else on this page.

Naps: twenty minutes or ninety. Twenty refreshes, ninety is a full cycle. In between is a groggy hour. Not after 3 pm.

Alcohol puts you to sleep and wakes you up. You fall asleep faster and wake at three; the sleep is shallower. If you drink “to get to sleep”, that’s a sign, not a solution.

When

The wake-up rule from tomorrow. Add the rest one at a time, weekly.

When not

The “get up if you’re not sleeping” rule assumes you’ll catch up the next day. If you’ve been sleeping four hours for weeks because of the child, don’t do it. Lie down and rest, and resting counts. Classic CBT-I also has “sleep restriction”; that isn’t for you until the child sleeps through.

If you snore, wake with headaches, or your partner says you stop breathing, that’s sleep apnoea, not poor sleep hygiene, and it’s sorted out with a doctor. If you’re not sleeping at all for weeks, or sleep won’t come even when there’s the chance: a doctor, not a page.