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Understanding the Complexity of Sleep Disturbances in ASD: From Mechanisms to Management

Adelina Glangher1,2, Ina-Ofelia Focsa1,3, Vanda Roxana Nimigean4

  • 1Psychiatry Research Laboratory, Prof. Dr. Alex. Obregia Clinical Hospital of Psychiatry, 041914 Bucharest, Romania.

Diagnostics (Basel, Switzerland)
|June 12, 2026
PubMed

Insights

Sleep disturbances are common in children with autism spectrum disorder (ASD), impacting 50-80%. Management involves behavioral strategies and sometimes melatonin, addressing underlying biological mechanisms for better outcomes.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Sleep Medicine

Background:

  • Sleep disturbances affect 50-80% of children with autism spectrum disorder (ASD).
  • These include insomnia, parasomnias, and breathing disorders, characterized by difficulty falling asleep, frequent awakenings, and reduced sleep time.
  • Potential causes involve circadian rhythm dysregulation, neurotransmitter system abnormalities (GABA, serotonin), and altered melatonin signaling.

Purpose of the Study:

  • To review the prevalence, biological mechanisms, clinical manifestations, and management of sleep disturbances in ASD.
  • To provide an integrated perspective for clinicians and researchers.
  • To emphasize the importance of understanding multifactorial mechanisms for improved recognition and individualized therapies.

Main Methods:

  • This is a review synthesizing current evidence.
  • The review covers prevalence, biological mechanisms, clinical manifestations, and management strategies.
  • It integrates findings for a comprehensive overview.

Main Results:

  • Sleep disturbances are highly prevalent in ASD, with diverse clinical presentations.
  • Biological underpinnings include circadian rhythm and neurotransmitter system dysregulation.
  • Effective management requires a multimodal approach combining behavioral interventions and, when necessary, pharmacological options like melatonin.

Conclusions:

  • Understanding the complex mechanisms of sleep disturbances in ASD is crucial for effective intervention.
  • A comprehensive approach integrating behavioral strategies, caregiver education, and targeted pharmacological treatments is recommended.
  • Further research into underlying mechanisms can lead to more individualized therapeutic strategies for children with ASD.

Keywords:
altered sleep architectureautism spectrum disordercircadian rhythminsomniamelatoninparasomniassleep disturbancessleep-related breathing disorderssleep-related movement disorders

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