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Insomnia subtypes and clinical impairment in hospitalized children with autism spectrum disorder

Briana J Taylor1, Charles F Reynolds1,2, Matthew Siegel1,3

  • 1Maine Medical Center Research Institute, USA.

Autism : the International Journal of Research and Practice
|October 27, 2020
PubMed

Insights

In children with autism spectrum disorder (ASD), specific insomnia subtypes like difficulty staying asleep and early morning awakenings are linked to longer hospital stays and more severe behavioral issues. Understanding these subtypes is crucial for better care.

Area of Science:

  • Pediatric Psychiatry
  • Neurodevelopmental Disorders
  • Sleep Medicine

Background:

  • Insomnia subtypes are poorly understood in children with severe autism spectrum disorder (ASD).
  • Sleep disturbances are common in ASD, impacting overall functioning.
  • Characterizing insomnia is vital for targeted interventions.

Purpose of the Study:

  • To investigate the prevalence and impact of different insomnia subtypes in psychiatrically hospitalized children with ASD.
  • To examine associations between insomnia subtypes and clinical outcomes, including hospital stay duration, autism severity, and behavioral functioning.

Main Methods:

  • A cohort of 427 psychiatrically hospitalized children with ASD (mean age 12.8 years, 81.3% male) was assessed.
  • Parental reports were used to identify insomnia subtypes: difficulty falling asleep, difficulty staying asleep, early morning awakening, and multiple symptoms.
  • Data collected included length of hospital stay, autism severity, nonverbal IQ, and adaptive/maladaptive behaviors.

Main Results:

  • 60% of children experienced at least one insomnia subtype.
  • Difficulty staying asleep and early morning awakenings correlated with longer hospital stays.
  • Early morning awakenings were associated with higher autism symptom severity.
  • Difficulty staying asleep and multiple insomnia symptoms were linked to poorer adaptive behaviors and increased maladaptive behaviors.

Conclusions:

  • Insomnia subtypes present distinct patterns in severely affected children with ASD.
  • Difficulty staying asleep and multiple symptoms significantly impair behavioral functioning.
  • Early morning awakenings may reflect core ASD symptomatology.
  • Further research is needed to understand and manage insomnia subtypes in this population.
Abstract

Keywords:
adaptive behaviorautism spectrum disordersdepressionpsychiatric comorbiditysleep

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