Little things are bothersome in bed

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I don't think that I am particularly sensitive to clothing and things touching my skin (though I may be wrong about that because I only wear t-shirts and sweaters and am bothered by button-down shirts because they don't stretch...) but when I am in bed trying to get to sleep, I notice the slightest thing, like if there's a small fold of fabric that is touching my foot or ankle in some weird way. I have to sleep in long sleeved t-shirts because I can't stand it if I can feel my own breath on my arm. And I'll get these itches that are just in one single spot and I have to scratch them or they just keep nagging me. But mostly it has to do with folds in the blanket that don't sit right, or sometimes with wrinkles in my pillow case. Is this an autistic thing?

quite likely!

Sensory processing problems are common in almost all autistic individuals but might not show up in the same sense or the same way.

Sense of touch is a biggie for many people, too hot, too cold, too smooth, too hard, too rough, too fuzzy, too much! Texture, temperature, the feel of something against our skin, the clothes we wear, our furniture, our bedding, the towels we use, etc etc etc can all be an issue for somebody with sensitive sense of touch. ( and more)

Others of us might not be sensitive to touch at all. Look up "sensory processing and autism" for more info.

If I'm not particularly tired, the slightest little sensory issue like that can stop me getting to sleep.

I can't wear things in bed. I feel the slightest crumb so I don't like breakfast in bed!

I can only wear a t-shirt and my special underpants to bed. I like to have blankets over top of me, though.

I find that when I'm tired, little noises and crumbs on the bed don't stop me from falling asleep.
Maybe the sports will help you.

Lights, noise, and temperature . . . gotta be dark, quiet, and cold for me to sleep through the night.

Even my processing issues are inconsistent.

When I can tolerate but overwhelmed, when I am never overwhelmed and beyond tolerant, when I'm intolerant but able to process, when I can handle but not process, etc...

This includes bedtime.

And when it came to sleep, it's not only the external but also internal.
I have more issues with internal than external; I can have the most comfortable room and bed, but that's nothing if I'm dealing with stomach issues or headaches or not breathing well...
Sometimes I can make do with that, sometimes I cannot.

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I sleep in my birthday suit.