Course and Predictors of Sleep and Co-occurring Problems in Children with Autism Spectrum Disorder

Mazurek, Micah O.; Dovgan, Kristen; Neumeyer, Ann M.; Malow, Beth A.

doi:10.1007/s10803-019-03894-5

Cited by 94 publications

(101 citation statements)

References 88 publications

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“…Clinical sleep disturbances are apparent in the majority of ASD cases 2,3,5 . While some have reported that sleep problems are more common in children with lower IQ 52 or higher autism severity 21,52 , others have not 16,20 . More consistent reports have shown that sleep problems are associated with increased selfinjury, anxiety, and aggression [18][19][20][21] as well as with sensory sensitivities [15][16][17][18] , thereby generating considerable challenges and difficulties for ASD children and their families 53 .…”

Section: Sleep Disturbances In Children With Asdmentioning

confidence: 99%

“…Symptoms include prolonged sleep latency, shorter sleep duration, and increased wake periods during the night, as reported by both subjective parental questionnaires and actigraphy measures [8][9][10][11][12][13][14] . Poor sleep in children with ASD is associated with increased sensory sensitivities [15][16][17][18] and increased aberrant behaviors [18][19][20][21] , which impair the quality of life of affected families 14 . PSG studies have corroborated the existence of sleep disturbances in children with ASD [22][23][24][25][26][27][28] , but have yielded mixed results regarding potential abnormalities in sleep architecture.…”

Section: Introductionmentioning

confidence: 99%

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Reduced sleep pressure in young children with autism

Arazi

Meiri

Danan

et al. 2019

Preprint

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Study Objectives: Sleep disturbances and insomnia are highly prevalent in children with Autism Spectrum Disorder (ASD). Sleep homeostasis, a fundamental mechanism of sleep regulation that generates pressure to sleep as a function of wakefulness, has not been studied in children with ASD so far, and its potential contribution to their sleep disturbances remains unknown. Here, we examined whether slow wave activity (SWA), a measure that is indicative of sleep pressure, differs in children with ASD. Methods:In this case-control study, we compared overnight electroencephalogram (EEG) recordings that were performed during Polysomnography (PSG) evaluations of 29 children with ASD and 23 typically developing children.Results: Children with ASD exhibited significantly weaker SWA power, shallower SWA slopes, and a decreased proportion of slow wave sleep in comparison to controls. This difference was largest during the first two hours following sleep onset and decreased gradually thereafter. Furthermore, SWA power of children with ASD was significantly, negatively correlated with the time of their sleep onset in the lab and at home, as reported by parents. Conclusions:These results suggest that children with ASD may have a dysregulation of sleep homeostasis that is manifested in reduced sleep pressure. The extent of this dysregulation in individual children was apparent in the amplitude of their SWA power, which was indicative of the severity of their individual sleep disturbances. We, therefore, suggest that disrupted homeostatic sleep regulation may contribute to sleep disturbances in children with ASD. Statement of significance:Sleep disturbances are apparent in 40-80% of children with autism. Homeostatic sleep regulation, a mechanism that increases the pressure to sleep as a function of prior wakefulness, has not been studied in children with autism. Here, we compared Polysomnography exams of 29 children with autism and 23 matched controls. We found that children with autism exhibited reduced slow-wave-activity power and shallower slopes, particularly during the first two hours of sleep. This suggests that they develop less pressure to sleep. Furthermore, the reduction in slow-wave-activity was associated with the severity of sleep disturbances as observed in the laboratory and as reported by parents. We, therefore, suggest that disrupted homeostatic sleep regulation may contribute to sleep disturbances of children with autism.

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Section: Sleep Disturbances In Children With Asdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Reduced sleep pressure in young children with autism

Arazi

Meiri

Danan

et al. 2019

Preprint

View full text Add to dashboard Cite

show abstract

“…However, more recent studies using actigraphy and polysomnography (PSG, which uses EEG, EMG, and heart rhythm monitoring) support the findings that ASD individuals have shorter sleep time, longer sleep latency, and decreased sleep efficiency relative to typical development (Elrod & Hood, 2015;Singh & Zimmerman, 2015). Sleep problems are predictive of severity of ASD (Cohen et al, 2014;Mazurek et al, 2019;Tudor et al, 2012;Veatch et al, 2017) and greatly impact the quality of life of both ASD individuals and their caregivers. Studies have shown that sleep problems in individuals with ASD also alter parents sleep and increase stress (Meltzer, 2008).…”

Section: In Somnia In Autis M S Pec Trum Disordermentioning

confidence: 99%

“…animal models, ASD, autism, development, EEG, homeostasis, insomnia, neurodevelopment, rodents, sleep & Malow, 2017;Souders et al, 2017). Sleep problems are predictive of severity of ASD core symptoms, social deficits and repetitive behaviors, and associated behavioral issues such as tantrums and aggression (Cohen, Conduit, Lockley, Rajaratnam, & Cornish, 2014;Mazurek, Dovgan, Neumeyer, & Malow, 2019;Tudor, Hoffman, & Sweeney, 2012;Veatch et al, 2017). Sleep problems impact the quality of life of both ASD individuals and their caregivers, thus it is important to understand why they are so prevalent.…”

Section: Introductionmentioning

confidence: 99%

Sleep, brain development, and autism spectrum disorders: Insights from animal models

Wintler

Schoch

Frank

et al. 2020

J of Neuroscience Research

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Sleep is an evolutionarily conserved and powerful drive, although its complete functions are still unknown. One possible function of sleep is that it promotes brain development. The amount of sleep is greatest during ages when the brain is rapidly developing, and sleep has been shown to influence critical period plasticity. This supports a role for sleep in brain development and suggests that abnormal sleep in early life may lead to abnormal development. Autism spectrum disorder (ASD) is the most prevalent neurodevelopmental disorder in the United States. It is estimated that insomnia affects 44%–86% of the ASD population, predicting the severity of ASD core symptoms and associated behavioral problems. Sleep problems impact the quality of life of both ASD individuals and their caregivers, thus it is important to understand why they are so prevalent. In this review, we explore the role of sleep in early life as a causal factor in ASD. First, we review fundamental steps in mammalian sleep ontogeny and regulation and how sleep influences brain development. Next, we summarize current knowledge gained from studying sleep in animal models of ASD. Ultimately, our goal is to highlight the importance of understanding the role of sleep in brain development and the use of animal models to provide mechanistic insight into the origin of sleep problems in ASD.

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“…40 to 80% of children with autism spectrum disorder have sleep problems like difficulty going off to sleep, frequent awakenings and decrease in total sleep time [10]. These co-morbidities can be often treated to modify the natural course of autism and symptomatic relief to the children Melatonin can be used to reduce sleep onset latency in children with sleep disturbance, along with sleep hygiene [11]. Hyperactivity and disruptive behavior are often controlled with careful titration of atypical antipsychotics like Risperidone and Aripiprazole [12].…”

Section: Co-morbidities Of Autismmentioning

confidence: 99%

Current consensus on clinical features, pathogenesis, diagnosis and management of autism spectrum disorder in children: A brief review

Panda

2019

Int J Pediatr Res

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Autism spectrum disorder (ASD) usually presents in early developmental period, in children less than five years usually with poor social relations, verbal and nonverbal communications and stereotypic and repetitive behavior. The prevalence of ASD is increasing rapidly; especially in urban community of developed as well as developing nations. Combined interaction of genetic and environmental factors has been proposed as the possible neuropathogenetic mechanism underlying ASD. Children with ASD have specific abnormalities in functional connectivity of brain and altered fecal microbiota. Children with Fragile X syndrome, Rett syndrome and Tuberous sclerosis often have autistic features.Interviewing the caregiver and observation of the child is the only definitive way to confirm the diagnosis of ASD. Recently DSM V criteria have combined under a single umbrella all the autistic disorders including Asperger syndrome and pervasive developmental disorder-not otherwise satisfied. Apart from DSM V criteria, Autism Diagnostic Observation Schedule (ADOS) and Childhood Autism Rating Scale (CARS) are also useful in diagnosis and evaluation of children with ASD. Autistic children are more likely to have hyperactivity, inattention, sleep abnormalities and epilepsy, as compared to general population. Applied behavioral analysis, sensory integration therapy and structured teaching are used in the management of autism spectrum disorder, along with atypical antipsychotics like Risperidone and Aripiprazole. Various complementary and alternative treatments like music therapy, oral probiotics and gluten free, casein free diet are currently under evaluation in various clinical studies.

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Course and Predictors of Sleep and Co-occurring Problems in Children with Autism Spectrum Disorder

Cited by 94 publications

References 88 publications

Reduced sleep pressure in young children with autism

Reduced sleep pressure in young children with autism

Sleep, brain development, and autism spectrum disorders: Insights from animal models

Current consensus on clinical features, pathogenesis, diagnosis and management of autism spectrum disorder in children: A brief review

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