Influence of sleep disorders on the behavior of individuals with autism spectrum disorder

Abstract

The aim of this study was to investigate the correlation between sleep disorders and the behavior of subjects with autism spectrum disorder (ASD) and control subjects using specific questionnaires. A small percentage (1.8%) of the control subjects had symptoms indicative of sleep-breathing disorders (SBD) and nocturnal sweating. Fifty-nine percent of the subjects with ASD had symptoms indicative of at least one sleep disorder, with SBD the most commonly reported (38%). In the control group, the symptoms of SBD were correlated with social, thought, attentional, aggression, externalizing and behavioral problems. In the ASD group, disorders of arousal (DA) were correlated with thinking problems, and disorders of excessive somnolence were correlated with thinking and behavioral problems. These results suggest that children and adolescents with ASD have a high frequency of sleep disorders, which in turn correlate with some of the behavioral traits that they already exhibit. Furthermore, sleep disturbances, when present in the typically developing children, also correlated with behavioral problems.

Sleep patterns predictive of daytime challenging behavior in individuals with low‐functioning autism

“…A further study examining longitudinal associations between sleep and challenging behavior found that improvements in sleep quality across a year were not associated with improvements in parent‐reported ratings of aggression [May, Cornish, Conduit, Rajaratnam, & Rinehart, ]. Individuals with autism present with a high degree of heterogeneity in terms of their severity of sleep difficulties [Fadini et al, ], behavioral functioning [Maskey, Warnell, Parr, Le Couteur, & McConachie, ], and medication profiles [Siegel & Beaulieu, ], which may contribute to these inconsistent findings. The ability to assess the sleep–behavior relationship from prior studies is further complicated by small sample sizes, short monitoring periods, and subjectivity of retrospective parent‐reported sleep measurements.…”

“…Prior research indicates that 40-80% of individuals with autism experience problems with sleep [Allik, Larsson, & Smedje, 2008;Anders, Iosif, Schwichtenberg, Tang, & Goodlin-Jones, 2011;Rzepecka, McKenzie, McClure, & Murphy, 2011] and 64-93% exhibit at least one challenging behavior (i.e., behaviors that are physically dangerous or impact learning; e.g., aggression, self-injury, or tantrums) [Hattier, Matson, Belva, & Horovitz, 2011;Matson, Mahan, Hess, Fodstad, & Neal, 2010]. Although the association between sleep and behavior has been investigated in adults and individuals with highfunctioning autism [AlBacker & Bashir, 2017;Fadini et al, 2015;Goldman et al, 2011;Hirata et al, 2016;Hollaway, Aman, & Butter, 2013;Mayes & Calhoun, 2009;Mazurek & Sohl, 2016], these relationships are yet to be studied in individuals with low-functioning autism (i.e., individuals with severe intellectual and social-communication impairment) [Cohen, Conduit, Lockley, Rajaratnam, & Cornish, 2014]. Crucially, all previous research on the relationship between sleep and behavior (both in autism and other populations) has focused on the association between an individual's overall sleep quality and their overall incidence or severity of challenging behaviors.…”

“…In individuals with high-functioning autism, however, studies investigating the relationship between overall sleep quality and challenging behaviors have reported mixed results. In some studies, decreased sleep quality (such as reduced sleep duration and increased night awakenings) was associated with increased rates of challenging daytime behaviors (such as tantrums, aggression, and self-injurious behaviors) using retrospective parent reports of average sleep over a few days or weeks [AlBacker & Bashir, 2017;Fadini et al, 2015;Goldman et al, 2011;Mazurek & Sohl, 2016;Sikora, Johnson, Clemons, & Katz, 2012]. Other studies that used more objective measures of sleep, such as polysomnography (PSG) and actigraphy over a 2-week time window, did not find a relationship between sleep quality and rate/severity of challenging behavior [Goodlin-Jones, Tang, Liu, & Anders, 2009;Lambert et al, 2016].…”

Adenosine triphosphate inhibits melatonin synthesis in the rat pineal gland

“…Some clinical evidence supports the relevance of ASMT control; for example, low expression of mRNA and protein was correlated with depression and cognitive impairment , reinforcing the association of ASMT with decreased levels of melatonin in severely depressed patients . Autism spectrum disorders, which present different rates of sleep disturbance , also show a positive correlation between the increase/reduction of NAS/melatonin and the severity of the disorder , suggesting a reduction in ASMT activity. Interestingly, antipurinergic therapy corrects autism‐like features in the Fragile X mouse model .…”

Correlação entre o perfil do sono e o comportamento em indivíduos com transtorno específico da aprendizagem

“…This finding reinforces the hypothesis that sleep disturbance could negatively influence the characteristics of this condition, especially behavior. Correlation between sleep and behavioral changes has been described in several conditions, such as autism (30) , attention deficit hyperactivity disorder (ADHD), and even in schoolchildren with typical development (31) , with improved behavior observed after treatment of sleep disorders (17,25) . This two-way correlation indicates that the investigation of sleep patterns and behavior in SLD can be beneficial to Speech-language Pathology treatment.…”