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Sleep Disturbances in Children Affected by Autism Spectrum Disorder

Jessica Galli^1,2, Erika Loi^2,3, Lucrezia Maria Visconti¹

¹Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.

Frontiers in Psychiatry

|March 7, 2022

Insights

Sleep disturbances are prevalent in children with Autism Spectrum Disorder (ASD), often linked to developmental delays and behavioral issues. Melatonin intake correlated with improved sleep, highlighting the need for integrated sleep interventions.

Area of Science:

Pediatric Neurology
Developmental Psychology
Sleep Medicine

Background:

Sleep disturbances are frequently observed in children diagnosed with Autism Spectrum Disorder (ASD).
Understanding sleep patterns and associated factors in ASD is crucial for intervention.
Parental stress related to sleep issues in ASD requires careful evaluation.

Purpose of the Study:

To characterize sleep patterns and disturbances in children with ASD.
To identify factors associated with sleep disturbances in this population.
To assess the impact of sleep disturbances on parental stress levels.

Main Methods:

A cohort of 100 children diagnosed with ASD (mean age 66.7 months) was studied.
Data collected included sociodemographic, clinical, genetic, and comorbidity information.
Validated questionnaires assessed sleep behavior, sleep disorders, and parenting stress.

Main Results:

Insomnia criteria were met by 57% of the children.
Sleep disorders correlated with developmental delay, emotional/behavioral problems, and lack of sleep-inducing strategies.
No correlation was found between sleep disturbances and family stress or epilepsy; melatonin use was linked to insomnia resolution.

Conclusions:

Insomnia in children with ASD is multifactorial and can impact behavior.
Clinicians should screen for sleep disturbances in ASD.
Integrating sleep interventions into ASD treatment plans is recommended.

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Abstract

Background:

Sleep disturbances are common in children affected by Autism Spectrum Disorder (ASD). The aim of our study was to describe sleep characteristics and disturbances in children with ASD, to evaluate possible related factors, and to assess parental stress.

Methods:

Hundred children with a diagnosis of ASD (mean age: 66.7 months, SD: 27.4, range: 24.7-152.1 months, n = 79 males) were included in the study. We collected data on sociodemographic, clinical, genetic and instrumental variables as well as comorbid conditions. Parents filled out the Questionnaire on sleep behavior in the first years of life, the BEARS questionnaire, and the Parenting Stress Index Short Form. From the analysis on sleep characteristics, we excluded 25 children treated with melatonin.

Results:

Fifty-seven (57%) out of 100 children met the criteria for insomnia. Sleep disorders were associated with developmental or cognitive delay, emotional and behavioral problems (such as anxiety problems and aggressive behaviors) and absence of strategies for inducing sleep after nocturnal awakenings. From parents' reports, sleep disorders had diurnal repercussions on their offspring; however, we found no statistical correlation between disturbances and family stress. Also, no significant correlation was found between sleep disturbances and epilepsy. Finally, a statistical correlation was found between the regular intake of melatonin and the resolution of insomnia.

Conclusions:

Multifactorial variables may be associated to insomnia that could have an impact on the children' behavior. Clinicians need to be aware of the value of screening for sleep disturbance in children with ASD to integrate sleep interventions in the treatment plan.

Keywords:

autism spectrum disorder insomnia melatonin parent stress sleep disturbance

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