A brief behavioral intervention for insomnia in adolescents with autism spectrum disorders.

Abstract

Behavioral sleep education has shown promise in young children with autism spectrum disorder (ASD), but has received much less study in adolescents with ASD. We conducted a pilot study of a brief sleep intervention delivered to 18 adolescents, ages 11-18 years, and their parents. Adolescents had sleep onset delay, night wakings, or both. Actigraphy and parent and adolescent questionnaires were collected at baseline and 1 month after treatment. Sleep education, delivered in a 2-session format, was associated with improved sleep onset delay and sleep efficiency in adolescents with ASD as measured by actigraphy a month after the intervention. Parent and adolescent questionnaires also indicated improvements in other sleep parameters and sleep hygiene during that time period. Half of the sample was available for follow-up 3 months after completion of the study and, based on verbal parent and/or adolescent report, gains were maintained for those participants. Parents reported high satisfaction with the program and were able to implement recommendations discussed in the sessions at a high rate of understanding and comfort level. This brief behavioral sleep education program shows promising results in improving sleep hygiene and sleep onset latency for adolescents with ASD.

Characterizing Sleep in Adolescents and Adults with Autism Spectrum Disorders

“…Our findings will need to be confirmed in larger samples. These preliminary findings emphasize that a multifactorial approach, which includes elements focused on behavioral sleep education (Loring et al 2016), an evidence-based approach to improve sleep quality (e.g., avoiding too early of a bedtime, limiting electronic devices, limiting, caffeine intake, increasing exercise, and implementing a calming bedtime routine) is important in treating sleep disturbance in this population.…”

“…Tan et al (2012) implemented sleep hygiene interventions which significantly improved the total ASHS scores in an adolescent population with self-reported sleep problems. Loring et al (2016) also reported that ASHS subscales (cognitive, behavioral, sleep stability, and sleep environment) showed statistically significant improvement with behavioral sleep education and sleep hygiene interventions. In both our TD and ASD groups, there were sleep hygiene difficulties resulting in relatively low ASHS scores.…”

“…The role of behavioral contributors in relation to biological and medical/pharmacological factors will require further study. Of note, Loring et al (2016) implemented behavioral sleep interventions in adolescents with ASD, which significantly declined the sleep onset latency from 78.8 to 45.3 minutes.…”

Behavioral Sleep Intervention for Adolescents with Autism Spectrum Disorder: a Pilot Study

“…A review of the autism and sleep literature revealed that only one study has actively included adolescents with ASD in the therapeutic process. Loring et al (2016) provided two sleepeducation sessions to 18 adolescents (11 to 18 years old) with high-functioning autism (HFA, IQ >70) and their parents. Session one targeted sleep hygiene including bedtime routine and arranging the sleep environment, and session two taught relaxation and distraction techniques to facilitate sleep onset.…”

Examining the Relationship Between Autism Traits and Sleep Duration as Predictors of Suicidality

“…Although the correlations are small, these results are in line with previous research about the relationships between autism and reductions in sleep time (Baker and Richdale 2015 ; Salmela et al 2019 ; Veach et al 2017), and day-time functioning impairments (Richdale et al 2014 ). One education-based study (Loring et al 2016 ) using sleep hygiene and cognitive behavioral techniques (CBT-I) with a sample of adolescents with autism and demonstrated significant improvement via actigraphy measurement. Meta-analyses (e.g.…”