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Sleep in children with autistic spectrum disorder: a questionnaire and polysomnographic study
Silvia Miano1, Oliviero Bruni, Maurizio Elia
1Department of Neurology, Sleep Research Centre, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via C. Ruggero 73, 94018 Troina, Italy.
Insights
Children with autism spectrum disorder (ASD) experience more sleep problems, including difficulty falling asleep and daytime sleepiness. Polysomnography revealed subtle NREM sleep alterations, particularly reduced cyclic alternating pattern (CAP) A1 subtypes during slow-wave sleep (SWS).
Area of Science:
- Neuroscience
- Developmental Psychology
- Sleep Medicine
Background:
- Autistic spectrum disorder (ASD) is a neurodevelopmental condition often associated with sleep disturbances.
- Understanding sleep patterns in ASD is crucial for improving quality of life and cognitive function.
Purpose of the Study:
- To comprehensively evaluate sleep in children with ASD using questionnaires and polysomnography.
- To analyze the cyclic alternating pattern (CAP) during sleep in ASD.
Main Methods:
- Thirty-one children with ASD and age-matched controls underwent sleep evaluation.
- Methods included a 45-item sleep questionnaire and overnight polysomnography in a sleep laboratory.
Main Results:
- Questionnaires indicated high rates of sleep-onset difficulties, enuresis, and daytime sleepiness in ASD children.
- Polysomnography revealed reduced total sleep time, REM latency, and a lower CAP rate during slow-wave sleep (SWS) in ASD subjects.
- A lower percentage of A1 subtypes during SWS was observed in ASD children compared to controls.
Conclusions:
- While questionnaires highlighted significant sleep issues in ASD, sleep staging provided partial confirmation.
- Cyclic alternating pattern (CAP) analysis revealed subtle NREM sleep alterations in ASD.
- Reduced CAP A1 subtypes during SWS may impact cognitive functioning in children with ASD.
Objective:
To evaluate sleep in children with autistic spectrum disorder (ASD) by means of sleep questionnaires and polysomnography; moreover, to analyze their cyclic alternating pattern (CAP).
Methods:
Thirty-one patients with ASD (28 males, 3 females, aged 3.7-19 years) and age-matched normal controls were included. ASD children were evaluated by a standard sleep questionnaire that consisted of 45 items in a Likert-type scale covering several areas of sleep disorders and by overnight polysomnography in the sleep laboratory after one adaptation night.
Results:
The questionnaire results showed that parents of ASD children reported a high prevalence of disorders of initiating and maintaining sleep, enuresis, repetitive behavior when falling asleep, and daytime sleepiness. Polysomnographically, ASD children showed reduced time in bed, total sleep time, sleep period time and rapid eye movement (REM) latency. ASD subjects had a CAP rate during slow-wave sleep (SWS) lower than normal controls, together with a lower percentage of A1 subtypes.
Conclusions:
ASD children questionnaires showed a higher percentage of disorders of initiating and maintaining sleep than normal controls; this was not completely confirmed by sleep staging. CAP measures showed subtle alterations of NREM sleep which could be detected with an appropriate methodology of analysis. The reduction of A1 subtypes during SWS might play a role in the impairment of cognitive functioning in these subjects.
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