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Sleep Problems in Children with Autism Spectrum Disorder (ASD) *does this surprise you?

Posted by on Sep. 2, 2013 at 9:40 PM
  • 10 Replies

Sleep Problems in Children with Autism Spectrum Disorder (ASD)

 

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September 2, 2013
 

It is well documented that in addition to the core symptoms of social/communication deficits and a restricted repertoire of behaviors, children with autismspectrum disorder (ASD) often experience other comorbid (co-occurring) conditions. In fact, studies estimate that approximately 70 to 84 percent of children with ASD might meet the criteria for a comorbid psychiatric disorder. Co-occurring conditions include mental health (anxiety, depression), neurological (seizure disorder), physical (cerebral palsy, atypical gait), and medical (allergies, asthma) conditions. In addition, unusual responses to sensory stimuli, chronic sleep problems, and low muscle tone can occur in individuals with ASD.

Most parents have had some experience with a child who has difficulty falling asleep; wakes up frequently during the night, and/or only sleeps a few hours each night. Although temporary sleep difficulties are an expected phase of child development, ongoing and persistent sleep disturbances can have an adverse effect on the child, parents and other family members. Indeed, a child’s sleeping problems can quickly become a daily parenting challenge. Consequently, we should also expect that sleep problems in children and adolescents with ASD will represent an additional burden on both children and their families, as they attempt to deal with the challenges associated with the symptoms of ASD. Moreover, there is evidence to suggest that insomnia in itself can aggravate autistic symptoms and further impair adaptability.

Children with ASD appear to experience sleep disturbances more frequently and intensely than typically developing children. Previous population-based and retrospective clinical studies have found a high rate of sleep onset problems in young children with ASD compared to typically developing children. Emotional and behavioral problems are related to sleep problems in the general child population, and have also been associated with sleep problems in children with ASD. For example, a previous study of children with Asperger’s syndrome or high-functioning autism found that those with chronic insomnia were characterized by more co-existing emotional and behavioral symptoms than their peers. Although research suggests that children with ASD have a high rate of sleep problems, even when adjusted for other mental health problems, the lack of longitudinal data and population based studies has limited our ability to understand the complex relationship between co-occurring emotional and behavioral problems and sleep difficulties in this group of children. In order to examine the need for increased sleep health care in children with ASD, sleep problems should be longitudinally studied in a total population setting. This approach allows researchers to examine potential risk factors and assess the development of sleep problems over time, as well as plan for early prevention and identification.

A recent longitudinally-based study published in the journal Autism examined the prevalence and chronicity of sleep problems in children with problems believed to be typical of Autism Spectrum Disorder (ASD). This large Norwegian study followed 3700 children from ages 7-9 to 11-13. The children were assessed for autistic symptoms, sleep problems, and emotional and behavioral problems. Approximately 1% of the children met the criteria for autism. Overall, the frequency of chronic insomnia was more than ten times higher in autistic children compared to non-autistic children (39.3% v 3.6%). These children also developed more sleep problems over time, with an incidence rate at of 37.5% compared to 8.6% in the controls at age 11-13 years. Likewise, sleep problems were more persistent over time in children with autistic symptomatology, with a remission rate of only 8.3% compared to 52.4% in the control group. Despite few girls being represented in the study, the authors found that sleep problems were significantly less prevalent in girls than boys, and that their sleep problems were also more transient. The presence of comorbid Attention-Deficit/Hyperactivity Disorder (ADHD) was a strong and independent risk factor for sleep problems in the ASD group. While emotional and behavioral problems explained a large proportion of the association between sleep problems and autism, children with autistic symptoms had a three-fold increased risk of sleep problems, even when taking into account other explanatory factors, such as gender, family income, parental education, and intellectual disability.

The results of this longitudinal population-based study show a clear association between autism symptoms and sleep problems and support the generally high prevalence rates of sleep problems (56–68%) reported in children with autism. The authors call for increased awareness of sleep problems in children with autistic symptoms and argue for the assessment and treatment of sleeping problems as a standard and integrated part of the assessment and treatment of ASD. This includes both behavioral and pharmacological interventions. They note that “Diagnosing and treating insomnia in children with ASD is thus important both to relieve symptoms of autism, improve quality of life for the children and their families, and may even improve long-term outcome.”

Sivertsen, B., Posserud, M., Gillberg, C., Lundervold, A. J., & Hysing, M. (2012). Sleep problems in children with autism spectrum problems: A longitudinal population-based study. Autism, 16, 139-150. DOI: 10.1177/1362361311404255

The online version of this article can be found at: http://aut.sagepub.com/content/16/2/139

by on Sep. 2, 2013 at 9:40 PM
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Replies (1-10):
ezeria
by on Sep. 2, 2013 at 9:55 PM
I have such a hard time getting my son to sleep! He jumps on the bed and thows stuff and suddenly turns into a wild animal. It is the biggest point of frustration and a moment of dread for every day.
Monkeymama930
by on Sep. 2, 2013 at 10:02 PM
My son never slept as a baby he would go days just resting. Now he will stay in bed 7:30 pm to 6am he's not sleeping but the lights are off except for a nightlight and he has his books. So he looks at book quietly. It's a step :-) I am so grateful for!

My sons doc told me its normal for autistic kids they just don't sleep.

My brother an adult aspie sleeps about 4hrs a night. He says its enough.
JP-StrongForTwo
by on Sep. 2, 2013 at 10:04 PM

DDs sleep issues step from severe anxiety. of a couple different kinds. she takes melatonin for it. and her sleep has improved SO MUCH over the last year. 

ezeria
by on Sep. 3, 2013 at 2:04 AM

 is melatonin safe for children? Bedtime is really rough


Quoting JP-StrongForTwo:

DDs sleep issues step from severe anxiety. of a couple different kinds. she takes melatonin for it. and her sleep has improved SO MUCH over the last year. 


 

JP-StrongForTwo
by on Sep. 3, 2013 at 2:09 AM

I would assume so. her doctor is the one who told me to get it for her. it helps so much. some times she doesnt need it. so i dont think its addictive. she needs it maybe, 3 days out of the week? sometimes a bit more if her anxiety is up. 


Quoting ezeria:

 is melatonin safe for children? Bedtime is really rough


Quoting JP-StrongForTwo:

DDs sleep issues step from severe anxiety. of a couple different kinds. she takes melatonin for it. and her sleep has improved SO MUCH over the last year. 




darbyakeep45
by Darby on Sep. 3, 2013 at 6:30 AM

My son has sleep problems from time to time.  When he was having seizures during the night, it was horrible, but now he's on a new anti-seizure med and things are better.  Sometimes I give him Melatonin to help him sleep but not every day...maybe one or two days each week.  Good luck mama!

kajira
by Emma on Sep. 3, 2013 at 11:33 AM


MElatonin was not a good fit for me as a kid - it made me freak out instead of make me sleep. Be aware that while it works great for SOME kids, it's not a good fit for all and "safe" is relative. It's like taking a benedyrl... it's generally safe if needed, and taken in the correct context, but some people have severe reactoins to it.

Meltonin is similar. I've heard of people having psycho-reactive issues from melatonin, and I've also heard of it increasing aggressive behavior. For me, it didn't make me violent, but I didn't sleep better on it, had more nightmares and it caused anxiety problems.

Quoting JP-StrongForTwo:

I would assume so. her doctor is the one who told me to get it for her. it helps so much. some times she doesnt need it. so i dont think its addictive. she needs it maybe, 3 days out of the week? sometimes a bit more if her anxiety is up. 


Quoting ezeria:

 is melatonin safe for children? Bedtime is really rough


Quoting JP-StrongForTwo:

DDs sleep issues step from severe anxiety. of a couple different kinds. she takes melatonin for it. and her sleep has improved SO MUCH over the last year. 





ezeria
by on Sep. 3, 2013 at 2:40 PM
Hmmm. Well thank you everyone for your imput. I could try it once on a weekend and just sleep with him to see how he reacts
drowningmama
by on Sep. 3, 2013 at 3:26 PM

My 10 year old sleeps only 2-3 hours each night.

bigmama423
by on Sep. 3, 2013 at 5:31 PM

My son has a hard time falling asleep, goes to bed late and usually wakes up very early.

My doctor suggested melatonin as well...I've never given it to him though. I tried it once and it did help me sleep within 30 minutes of taking it...

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