Illustration by Federica Bordoni
Children with autism-related syndromes often are unable to fall or stay asleep. This condition, called insomnia, can negatively affect cognitive, social, and communication problems and exacerbate behavioral challenges and anxiety. Treatments such as behavioral interventions and medications can improve sleep patterns, however, there is no blanket model. Each treatment needs to be custom-made for each child.
In the general population, approximately 20 percent of children experience sleep problems in comparison to 70 percent of children with autism.1,2 In addition, children who have genetic syndromes associated with autism are more likely to experience severe sleep problems. For example, studies have shown that some children with CHD8 mutations can have such difficulty sleeping that they remain awake for days on end.3
Shafali Jeste, an associate professor at UC Los Angeles, runs a clinic where she attempts to improve sleeping patterns of children with various genetic syndromes associated with autism. In her article, Jeste mentions that her first course of action is to identify modifiable factors such as the child’s evening routine, sensory sensitivities, medications such as antiepileptic drugs or mood stabilizers, and hunger or gastrointestinal distress. Addressing these modifiable factors can be greatly beneficial but may not always be sufficient. In this case, medications, such as melatonin, can help regulate the sleep-wake cycle.
In order to collect more information about the effects of poor sleep Jeste often asks parents to keep sleep diaries for their children. These diaries help pinpoint triggers for insomnia and monitor the efficiency of interventions. Standardized questionnaires given to the general population have provided important data regarding sleep however, modifications need to be made before they can be applied to this case. Jeste calls for the adaptation of these questionnaires for children with significant intellectual disability, developmental delay, or language impairment.
Improving and increasing data collection will lead to more focused clinical trials as there would be more information on what stage of development should be targeted and sleep characteristics need to be improved. These trials will, in turn, improve interventions and thus improve the quality of sleep in children with autism.
For more information on sleep problems in children with autism visit: https://spectrumnews.org/news/sleep-problems-autism-explained/
1. Malow B.A. et al. Pediatrics 137, S98-S104 (2016) PubMed
2. Calhoun S.L. et al. Sleep Med. 15, 91-95 (2014) PubMed
3. Bernier R. et al. Cell 158, 263-276 (2014) PubMed