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Using pharmacotherapy to address sleep disturbances in autism spectrum disorders

Valeria Mammarella1, Silvia Orecchio1, Noemi Cameli1

  • 1Child Neuropsychiatry Unit, Department of Human Neuroscience, Sapienza University, Rome, Italy.

Expert Review of Neurotherapeutics
|October 9, 2023
PubMed

Insights

Sleep disturbances are common in autism spectrum disorder (ASD) and impact families. Melatonin is the only drug with sufficient evidence for treatment, though others may be considered.

Area of Science:

  • Neurodevelopmental Disorders
  • Sleep Medicine
  • Pharmacology

Background:

  • Sleep disorders are a significant comorbidity in autism spectrum disorder (ASD), affecting children's behavior, mood, and core ASD features.
  • Insomnia in children with ASD negatively impacts family quality of life, highlighting the need for effective management strategies.

Purpose of the Study:

  • To review the scientific evidence for pharmacological treatments of sleep disorders in children (0-18 years) with ASD.
  • To guide clinicians in selecting appropriate treatments by clarifying the evidence base.

Main Methods:

  • Systematic literature review of PubMed and Cochrane Library databases.
  • Search terms included "autism spectrum disorder," "pharmacological treatment," and "sleep disorder."

Main Results:

  • Melatonin is the only compound with sufficient evidence for treating sleep disorders in ASD.
  • Other medications like antihistamines, trazodone, clonidine, ramelteon, gabapentin, and suvorexant may be considered but have less robust evidence.

Conclusions:

  • Treatment of sleep disturbances is a primary goal in managing ASD.
  • Evidence-based selection of medications, with melatonin as the primary option, is crucial for improving outcomes in ASD patients with sleep disorders.
Abstract

Keywords:
Autismchildrendrugsmelatoninneurodevelopmental disorderssleep disorders

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