Practice Tools for Screening and Monitoring Insomnia in Children and Adolescents with Autism Spectrum Disorder

Banaschewski, Tobias; Bruni, Oliviero; Fuentes, Joaquín Lomba; Hill, Catherine M.; Hvolby, Allan; Posserud, Maj Britt; Schröder, Carmen

doi:10.1007/s10803-021-05236-w

Cited by 9 publications

(2 citation statements)

References 72 publications

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“…38,39 Another possible reason may stem from the known under-diagnosis by clinicians of sleep problems in children with ASD. [40][41][42] Finally, it should be noted that it is not impossible that the use of imported OTC melatonin in our sample might be higher than that reported by the parents.…”

Section: Discussionmentioning

confidence: 60%

Real-life course and effectiveness of melatonin treatment for sleep disturbances in children with autism spectrum disorder

Sadeh,

Meiri,

Zigdon

et al. 2023

Preprint

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Objective: Melatonin is considered the most effective pharmacological treatment for the sleep disturbances that are reported in >50% of children with autism spectrum disorder (ASD). However, real-life data about the long-term course and effectiveness of melatonin treatment in children with ASD is lacking. Methods: In this retrospective cohort study, we assessed the adherence to melatonin treatment and its effect on sleep quality and daytime behavior in children with ASD via a parental phone questionnaire of children in the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) database. Cox regression analysis was used to assess the effect of key demographic and clinical characteristics on treatment adherence. Results: Melatonin was recommended for ~8% of children in the ANCAN database. These children were characterized by more severe autistic symptomatology. The median adherence time for melatonin treatment exceeded 88 months, with the most common reason for discontinuation being a lack of effectiveness (14%). Mild side-effects were reported in 14% of children, and 86%, 54%, and 45% experienced improvements in sleep onset, sleep duration and night awakenings, respectively. Notably, melatonin also improved the daytime behaviors of >28% of the children. Adherence to treatment was independently associated with improvements in night awakenings and educational functioning (aHR=0.142, 95%CI=0.036-0.565; and aHR=0.195, 95%CI=0.047-0.806, respectively). Conclusions: Our findings highlight the real-life safety and effectiveness of melatonin treatment in children with ASD. Increasing the awareness of this treatment among families and health providers will help to reduce the burden associated with sleep disturbances in children with ASD and their families.

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Section: Discussionmentioning

confidence: 60%

Real-life course and effectiveness of melatonin treatment for sleep disturbances in children with autism spectrum disorder

Sadeh,

Meiri,

Zigdon

et al. 2023

Preprint

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show abstract

“…Overall, screening for sleep problems in all children with ASD should be recommended, and a sleep specialist should be consulted when comorbid sleep disorders are suspected ( 19 ). Parental questionnaires have the benefit of saving time and costs, can be used as a follow-up instrument, and can measure a broad range of sleep parameters.…”

Section: Introductionmentioning

confidence: 99%

Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

et al. 2023

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BackgroundSleep disorders are one of the most common problems in children with Autism Spectrum Disorder (ASD). However, they often tend to be underdiagnosed and incorrectly treated in clinical practice. This study aims to identify sleep disorders in preschool children with ASD and to explore their relationship with the core symptoms of autism, the child’s developmental and cognitive level as well as the psychiatric comorbidities.MethodsWe recruited 163 preschool children with a diagnosis of ASD. The Children’s Sleep Habits Questionnaire (CSHQ) assessed sleep conditions. Multiple standardized tests were used to evaluate intellectual abilities, the presence of repetitive behaviors (through the Repetitive Behavior Scale-Revised), as well as the emotional-behavioral problems and the psychiatric comorbidities (through the Child Behavior Checklist -CBCL 11/2-5).ResultsThe results showed that poor disorders had consistently higher scores in all areas assessed by the CSHQ and on the CBCL across all domains. The correlational analysis showed that severe sleep disorders were associated with higher scores in internalizing, externalizing, and total problems at the CBCL syndromic scales, and in all DSM-oriented CBCL subscales. Moreover, we found that the association between sleep disorders and restricted and repetitive behaviors (RRBs) is explained by the anxiety-related symptoms.ConclusionBased on these findings, the study recommends that screening for sleep problems followed by early intervention should constitute a routine part of clinical practice for children with ASD.

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Novel Insights into Somatic Comorbidities in Children and Adolescents Across Psychiatric Diagnoses: An Explorative Study

Muskens,

Ester,

Klip

et al. 2023

Child Psychiatry Hum Dev

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Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6–18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.

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Practice Tools for Screening and Monitoring Insomnia in Children and Adolescents with Autism Spectrum Disorder

Cited by 9 publications

References 72 publications

Real-life course and effectiveness of melatonin treatment for sleep disturbances in children with autism spectrum disorder

Real-life course and effectiveness of melatonin treatment for sleep disturbances in children with autism spectrum disorder

Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

Novel Insights into Somatic Comorbidities in Children and Adolescents Across Psychiatric Diagnoses: An Explorative Study

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