Sleep problems in adults with autism spectrum disorder and intellectual disability

Abstract

Sleep problems (SP) are recognized as a common comorbid condition in autism spectrum disorder (ASD) and can influence core autism symptoms and mental and physical health. SPs can be lifelong and have been reported that adults on the autistic spectrum with and without intellectual disability (ID) present SPs (longer sleep latency, frequent night awakenings, and circadian rhythm sleep-wake disorders). A prospective, objective sleep study was conducted in 41 adults with ASD (33 AE 6 years old) and ID and 51 typically developing adults (33 AE 5 years old) using ambulatory circadian monitoring (ACM) recording wrist temperature, motor activity, body position, sleep, and light intensity. The findings indicated that individuals with ASD presented sleep difficulties including low sleep efficiency, prolonged sleep latency and increased number and length of night awakenings, together with daily sedentary behavior, and increased nocturnal activity. Furthermore, indications of an advanced sleepwake phase disorder were found in these autistic adults. Examining sleep and markers of the circadian system showed significant differences between adults with ASD and ID and an age-matched, healthy adult population. The sleep disturbances described for this sample of adults with ASD and ID are similar to those of already described for adults with ASD without ID; their relationship with intellectual ability should be further studied. Improving knowledge of sleep patterns in ASD adults with ID might help to designed targeted interventions to improve their functioning and reduce family stress. Autism Research 2019, 12: 66-79.Lay Summary: SPs are very frequent in autism from childhood to adulthood. We recorded sleep with a watch-like device in adults with autism and ID and compared sleep patterns with nonautistic volunteers. Results showed poorer sleep conditions in adults with autism (increased sleep latency and number/length of night awakenings) that resulted in decreased sleep efficiency. Increasing knowledge of the SPs in adults on the autism spectrum will allow to improve their and their families' quality of life.

A DLG2 deficiency in mice leads to reduced sociability and increased repetitive behavior accompanied by aberrant synaptic transmission in the dorsal striatum

“…Notably, increases in self-grooming behavior measured in the home cage persisted regardless of lights-on or -off conditions (Fig. 4c, d), implying that the mutant mice have a sleep disturbance, as is commonly observed in ASD patients [36,37]. These results suggest that a DLG2 deficiency is associated with increased repetitive behavior.…”

“…This implies that these mutant mice might have disrupted sleep patterns. Sleep problems commonly occur not only in patients with ASD [36,37], but also in those with movement disorders such as Fig. 4 Dlg2 -/mice display increased self-grooming behavior.…”

Intellectual disability and autism spectrum disorders ‘on the fly’: insights from Drosophila

“…Many individuals with ID and/or ASD suffer from sleep disturbances (Ballester et al, 2019; Geoffray et al, 2016; van de Wouw et al, 2013; Veatch et al, 2017). A study from 2013 reported 72% of ID patients to have sleep disturbances (van de Wouw et al, 2013), while a more recent study characterized various qualitative components of sleep in ASD patients, and found an increased number of awakenings during the night, sleep onset latency and reduced sleep efficiency (Ballester et al, 2019). Disturbed sleep does not only negatively affect the emotional status and social behavior of patients, but also their cognitive functioning (Geoffray et al, 2016; Veatch et al, 2017).…”

Neuromodulation and a Reconceptualization of Autism Spectrum Disorders: Using the Locus Coeruleus Functioning as an Exemplar

“…Studies in people with autism have identified various abnormalities in REM sleep including immature organization, decreased quantity, abnormal twitches, undifferentiated sleep and REM sleep behavior disorder, which is characterized by the absence of the muscle atonia that is normal during REM sleep. Clinically, the sleep disturbances are significant in both low and high functioning subjects (136–138). The pervasiveness of the sleep disturbances noted may be masking their significance to clinicians, who may accept this as part of ASD rather than a symptom demanding some urgency.…”