Children with autism spectrum disorder, and those with other types of developmental delays who have symptoms of the disorder, often have a harder time getting to sleep and staying asleep, according a study in the March 2019 issue of Pediatrics.
“Sleep Problems in 2- to 5-Year-Olds with Autism Spectrum Disorder and Other Developmental Delays” compared sleep habits of 1,987 children ages 2 to 5 years from multiple locations within the United States. Children were divided into four groups: children with a classification of an autism spectrum disorder; children with other developmental delays with characteristics of autism spectrum disorder; children with other developmental delays without characteristics of autism; and children in a general population group.
Researchers found that children with autism spectrum disorder or other developmental delays with autism characteristics were more than twice as likely to experience sleep problems as children in the general population group. They theorized that several factors are likely to contribute to sleep problems for the groups with characteristics of autism spectrum disorder including anxiety, difficulty making transitions, and differences in melatonin production. Since childhood sleep problems have been shown to affect a children’s daytime behavior and quality of life for children and their families, the authors conclude that further research on causes and treatments for sleep problems in this group of children is needed.
For parents with children on the spectrum, the AAP study confirms what they’ve long known. As Central Penn Parent reported in April 2018, as many as 80 percent of kids with ASD have sleep problems according to Autism Speaks, an advocacy and support group for those with autism and their families. For the neurotypical population, that percentage drops dramatically to less than 16 percent, reports the journal Sleep Disorders. Aside from the disruption it causes within families, nighttime sleep disturbances in children with ASD often result in a daytime increase in some of the challenging behaviors associated with autism.
Three years ago, the AAP published an analysis of data from a children’s sleep habits questionnaire and found that while 71 percent of the parents surveyed identified a clinically significant sleep problem in their child with ASD, only 30 percent of those children received any sleep disorder diagnosis from their doctor. The reason, that study’s authors opined, was that because of the “many needs of children with ASD, sleep concerns may be eclipsed by these other needs, especially in the limited time available at a clinician visit.” Parents weren’t speaking up about the problem unless asked specifically.
As we provided in our April 2018 article, help is available. Sam Al-Saadi, M.D., a psychiatrist with UPMC Pinnacle who is board-certified in psychiatry and neurology and trained in sleep medicine, provided these tips:
- Reduce the light that last hour to help foster naturally occurring melatonin.
- Only use melatonin supplements for short-term solutions. After a few days it can lead to both falling asleep and awaking earlier.
- Be open to prescription medications. “Taking a medicine is not negative,” says Dr. Al-Saad. At some point, between 60 to 80 percent of kids with autism will be on some type of medication due to a secondary condition that becomes apparent later, like anxiety or hyperactivity. And these conditions can cause sleep problems.