Sleep behaviors and sleep quality in children with Autism Spectrum Disorders

Abstract

Children with Autism Spectrum Disorders (ASD) are at increased risk for sleep disturbances. Core deficits of ASD and their underlying neurophysiology may predispose children to intrinsic and extrinsic stressors that threaten steep. Poor sleep in children can alter learning, attention and performance. Approximately two-thirds of parents report a sleep disturbance with their ASD child. Few rigorous epidemiological studies have been conducted in this population. Characterization of sleep in a well described ASD group utilizing subjective and objective standardized measures contributes solid descriptive baseline data and provides an important first step in building a foundation for future studies of etiology and intervention. Aims of this descriptive epidemiological study were to estimate the prevalence of sleep disturbances in ASD children D as compared to controls and to describe their sleep behaviors and sleep quality. Participants were randomly selected from the Regional Autism Center Registry at the Children\u27s Hospital of Philadelphia. ASD cohort of 59 children, ages 4-10, 26 autism, 21 PDD-NOS, and 12 Asperger Disorder were compared to 40 typically developing (TD) controls. Diagnosis was confirmed with the ADOS or ASDS. Controls were screened using the SCQ. Data was obtained with Children\u27s Sleep Habits Questionnaire (CSHQ), sleep diaries and ten nights of actigraphy. Actigraphic data was analyzed with the Sadeh algorithm and Scoring Analysis program. Results showed that 66.1% of parents of ASD children (62.5% autism, 76.2% PDD-NOS, 58.3% Asperger) and 45% of parents of the controls report sleep problems on the CSHQ. 66.7% of actigraphic data of children with ASD (75% autism, 52.4% PDD-NOS, 75% Asperger) and 45.9% of the controls showed disturbed sleep. Prevalence estimate of 45% for mild sleep disturbances in TD cohort is consistent with the high end of previous studies and highlights pediatric sleep debt as a concerning public health problem. Prevalence estimate of 66% for moderate sleep disturbances in the ASD cohort is consistent with the previous studies and highlights the significant sleep problems these families face. Predominant underlying sleep disorder in the ASD cohort is Insomnia Due to Pervasive Developmental Disorders (Code 327.15), identified utilizing the International Classification of Sleep Disorders-2 (ICSD-2)