ASD Sleep Behaviors and Sleep Quality

[mrsbuttinski]

Getting a good night of sleep is crucial to a child’s development in the areas of attention, learning, memory, mood regulation, and behavior. Poor sleep quality in children also affects parents’ sleep quality. If a child isn’t sleeping well, chances are his/her parents aren’t sleeping well either.



Many children with Autism Spectrum Disorder (ASD) have difficulty falling asleep or staying asleep, but research into this has been limited. A study conducted by a team at the University of Pennsylvania (UPenn) School of Nursing and CHOP aimed to answer two critical questions: how many children with ASD have sleep problems, and what types of sleep problems are most common in ASD.



For the study, families were asked to answer sleep questionnaires and keep a sleep diary over a 17-day period. Parents noted the time the child went to bed, night wakings, morning wake time, naps, and health status during this period.



The children also wore a device that measures motion, called an actigraph, for 10 nights. An actigraph is a miniaturized wristwatch-like computer, and it is now a part of many fitness wristbands and cell phones. The actigraph measures how much children move at night and provides a measure of how much time children spend in different sleep phases. There were concerns about the children’s ability to fall asleep with something on their wrist, so the researchers created a special pocket for the actigraph that could be sewn into the upper sleeve of a pajama top.



When the researchers analyzed the sleep diaries, actigraphy, and sleep questionnaires, they found that 66.7% of children with ASD had some form of insomnia. The children with ASD took longer to fall asleep and had longer waking episodes during the night.



The most prevalent sleep disorders in this group were behavioral insomnia and required intensive strategies to be implemented by the parents to help their children fall asleep. Strategies included repeated reassurance about fears, rocking, patting, and frequently returning them back to bed. Of note, about a third of the children with ASD that had insomnia had strong bedtime routines, fell asleep by themselves, and did not have any medical conditions that might disrupt sleep. Insomnia in these children with ASD may be due to intrinsic causes. Research suggests that a fairly high state of hyperarousal or anxiety may be causing insomnia in these individuals. Ongoing treatment studies are testing whether alleviating the anxiety will also alleviate sleep difficulties.



Greater understanding of insomnia in the ASD population is critical because good sleep is strongly tied to the ability to attend, learn, and self-regulate. The UPenn School of Nursing and CHOP are presently conducting a Pilot Randomized Control study for sleep impairments in ASD. This study is funded by the Department of Defense to develop and refine a tailored behavioral intervention for children with ASD and insomnia that includes a calming module that addresses arousal dysregulation and anxiety.





Source: Souders, M.C., Mason, T.B., Valladares, O., Bucan, M., Levy, S.E., Mandell, D.S., Weaver, T.E., Pinto-Martin, J. (2009). “Sleep Behaviors and Sleep Quality in Children with Autism Spectrum Disorders.” Sleep, 32(12), 1566-1578. PMID: 20041592




centerforautismresearch.blogspot.com/2015/03/sleep-behaviors-and-sleep-quality.html

[junebug060609]

Longer waking periods in the night? Check.
Hyperarousal when he does wake up? Check.

He usually falls asleep fine on his own. We've had a pretty set bedtime routine with him since he was 6 months old, and I think that helps. He's fine if we deviate from it (which is good with little sis and me solo with them a lot), but he knows when it's lights out I'm not going to let him back out to play.

Now if I could only keep him asleep...or at least quiet so the rest of us could sleep...that'd be great.

[mamaturtle]

Sounds all good!

I just have the issue of DS waking up in the middle of the night to turn on his light. DS wants to sleep with the light on and I have 3 night lights in there.

[numbbears]

Sounds like DS for night time. He has a strong bedtime routine and can fall asleep by himself but he can take 2-3 hours to do it. But naps are totally different for him. They're hit or miss.

[BostonKisses]

Fascinating. Judith's been a good sleeper until a few months ago, but once she was out of the extended newborn phase, she took a long time to fall asleep. And that got progressively worse the older she got. Lately she's been waking up at least once each night because she's scared of "monsters in her room," and then she comes into our bed and tries to have half hour conversations about anything and everything. Fun times. Of course there's the possibility of obstructive sleep apnea at play here as well, but that's going to be reviewed in May when she goes for her sleep study.

She has a solid bedtime routine, and has always been great at self soothing to put herself to sleep (I'm sure we have the NICU to thank for that).

[mack]

This is really fascinating to me. Mackenzie just had a sleep study done. She has had insomnia since she was 4. She has trouble falling asleep, and if she wakes up, getting back to sleep. Some of this is explained. She has periodic limb movement disorder, which explains some of her issues. But I really don't feel like it explains it all. It seems more like she can't shut her brain off.