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Published on: July 31, 2017
Effectiveness of Sleep-Based Interventions for Children with Autism Spectrum Disorder: A Meta-Synthesis
Belinda M Cuomo1, Sharmila Vaz1, Elinda Ai Lim Lee1,2
1School of Occupational Therapy & Social Work, Curtin University, Perth, Western Australia, Australia.
Insights
Sleep interventions for children with autism spectrum disorder (ASD) show varied results. Melatonin, behavioral strategies, and parent education are most effective for multiple sleep issues in ASD.
Area of Science:
- Pediatric Sleep Medicine
- Autism Spectrum Disorder Research
- Evidence-Based Interventions
Background:
- Sleep disturbances are prevalent in children with autism spectrum disorder (ASD).
- A wide range of interventions are explored for pediatric ASD sleep issues.
- Understanding intervention efficacy is crucial for clinical practice.
Purpose of the Study:
- To synthesize findings from multiple systematic reviews on sleep interventions for children with ASD.
- To analyze the effectiveness of different intervention categories across various sleep problems.
- To identify the most promising interventions for improving sleep in pediatric ASD populations.
Main Methods:
- Meta-synthesis of eight systematic reviews focusing on sleep interventions in children with ASD.
- Inclusion of 38 original studies covering five intervention categories: melatonin, other pharmacologics, behavioral, parent education, and alternative therapies.
- Analysis of intervention efficacy across 17 distinct sleep problem domains.
Main Results:
- No single intervention effectively addresses all sleep problems in children with ASD.
- Melatonin therapy, behavioral interventions, and parent education programs demonstrate significant efficacy across multiple sleep domains.
- Other pharmacologic treatments and alternative therapies showed less consistent effectiveness.
Conclusions:
- Current evidence supports melatonin, behavioral interventions, and parent education as primary strategies for ASD-related sleep problems.
- Future research should investigate interventions for specific phenotypic subgroups and polytherapeutic approaches.
- This meta-synthesis provides valuable guidance for clinicians managing sleep issues in children with ASD.
Abstract:
Sleep problems are common in children with autism spectrum disorder (ASD). This meta-synthesis collated eight previously published systematic reviews examining the efficacy of sleep interventions in children with ASD in an attempt to present a clear analysis of trialed interventions. The collated reviews consider five major groups of sleep interventions for children with ASD: melatonin therapy, pharmacologic treatments other than melatonin, behavioral interventions, parent education/education programs, and alternative therapies (massage therapy, aromatherapy, and multivitamin and iron supplementation). These eight reviews were based on 38 original studies and address the efficacy of interventions across 17 sleep problem domains. The results of this meta-synthesis suggest that no single intervention is effective across all sleep problems in children with ASD. However, melatonin, behavioral interventions, and parent education/education program interventions appear the most effective at ameliorating multiple domains of sleep problems compared with other interventions. Due to the heterogeneous causative factors and presentations of disordered sleep, further research into the effectiveness of sleep interventions may target specific phenotypic subgroups rather than a broad analysis across the general ASD population. Similarly, future research needs to consider the efficacy of different polytherapeutic approaches in order to provide clinicians with evidence to inform best practice. In the meantime, this review supports clinicians' decision making for a majority of the identified sleep problems in the ASD population.
