Current Neurology and Neuroscience Reports

, Volume 8, Issue 2, pp 155–161 | Cite as

Sleep in children with autism spectrum disorders



The amount of research conducted on sleep in children and adolescents has increased dramatically over the past decade due to the recognition that many children have significant sleep problems leading to daytime dysfunction. Approximately one third of typically developing children have sleep difficulties at some point, and a similar percentage of adolescents have impaired or insufficient sleep leading to daytime impairments. Sleep problems are known to occur at even greater rates in children with special needs, such as those with developmental disabilities, psychiatric conditions, and medical illnesses. The recognition that interventions can improve sleep and may result in better daytime functioning has fueled a growing interest in more fully characterizing the sleep problems in children with special needs. This article presents a discussion of the sleep problems experienced by children with one particular group of developmental disorders—the autism spectrum disorders.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References and Recommended Reading

  1. 1.
    Owens J, Opipari L, Nobile C, Spirito A: Sleep and daytime behavior in children with obstructive sleep apnea and behavioral sleep disorders. Pediatrics 1998, 102:1178–1184.PubMedCrossRefGoogle Scholar
  2. 2.
    Smedje H, Broman JE, Hetta J: Associations between disturbed sleep and behavioral difficulties in 635 children aged six to eight years: a study based on parents’ perceptions. Eur Child Adolesc Psychiatry 2001, 10:1–9.PubMedCrossRefGoogle Scholar
  3. 3.
    Halbower AC, Mahone EM: Neuropsychological morbidity linked to childhood sleep-disordered breathing. Sleep Med Rev 2006, 10:97–107.PubMedCrossRefGoogle Scholar
  4. 4.
    Christodulu KV, Durand VM: Reducing bedtime disturbance and night waking using positive bedtime routines and sleep restriction. Focus Autism Other Dev Disabil 2004, 19:130–139.CrossRefGoogle Scholar
  5. 5.
    Saper CB, Chou TC, Scammell TE: The sleep switch: hypothalamic control of sleep and wakefulness. Trends Neurosci 2001, 24:726–731.PubMedCrossRefGoogle Scholar
  6. 6.
    Levitt P, Eagleson KL, Powell EM: Regulation of neocortical interneuron development and the implications for neurodevelopmental disorders. Trends Neurosci 2004, 27:400–406.PubMedCrossRefGoogle Scholar
  7. 7.
    McCauley JL, Olson IM, Delahanty R: A linkage disequilibrium map of the 1-Mb 15q12 GABAA receptor subunit cluster and association to autism. Am J Med Genet 2004, 131:51–59.CrossRefGoogle Scholar
  8. 8.
    Lewy AJ, Wehr TA, Goodwin FK, et al.: Light suppresses melatonin secretion in humans. Science 1980, 210:1267–1269.PubMedCrossRefGoogle Scholar
  9. 9.
    Wiggs L, Stores G: Severe sleep disturbance and daytime challenging behaviour in children with severe learning disabilities. J Intellect Disabil Res 1996, 40:518–528.PubMedCrossRefGoogle Scholar
  10. 10.
    Patzold LM, Richdale AL, Tonge BJ: An investigation into sleep characteristics of children with autism and Asperger’s Disorder. J Paediatr Child Health 1998, 34:528–533.PubMedCrossRefGoogle Scholar
  11. 11.
    Richdale AL, Prior MR: The sleep/wake rhythm in children with autism. Eur Child Adolesc Psychiatry 1995, 4:175–186.PubMedCrossRefGoogle Scholar
  12. 12.
    Honomichl RD, Goodlin-Jones BL, Burnham M, et al.: Sleep patterns of children with pervasive developmental disorders. J Autism Dev Disord 2002, 32:553–561.PubMedCrossRefGoogle Scholar
  13. 13.
    Schreck KA, Mulick JA: Parental report of sleep problems in children with autism. J Autism Dev Disord 2000, 30:127–135.PubMedCrossRefGoogle Scholar
  14. 14.
    Bradley EA, Summers JA, Wood HL, Bryson SE: Comparing rates of psychiatric and behavior disorders in adolescents and young adults with severe intellectual disability with and without autism. J Autism Dev Disord 2004, 34:151–161.PubMedCrossRefGoogle Scholar
  15. 15.
    Couturier JL, Speechley KN, Steele M, et al.: Parental perception of sleep problems in children of normal intelligence with pervasive developmental disorders: prevalence, severity, and pattern. J Am Acad Child Adolesc Psychiatry 2005, 44:815–822.PubMedCrossRefGoogle Scholar
  16. 16.
    Paavonen EJ, Nieminen-von Wendt T, Vanhala R, et al.: Effectiveness of melatonin in the treatment of sleep disturbances in children with Asperger disorder. J Child Adolesc Psychopharmacol 2003, 13:83–95.PubMedCrossRefGoogle Scholar
  17. 17.
    Polimeni MA, Richdale AL, Francis AJP: A survey of sleep problems in autism, Asperger’s disorder and typically developing children. J Intellect Disabil Res 2005, 49:260–268.PubMedCrossRefGoogle Scholar
  18. 18.
    Allik H, Larsson JO, Smedje H: Insomnia in school-age children with Asperger syndrome or high-functioning autism. Br Med Council Psychiatry 2006, 6:18.Google Scholar
  19. 19.
    Malow BA, Marzec ML, McGrew SG, et al.: Characterizing sleep in children with autism spectrum disorders: a multidimensional approach. Sleep 2006, 29:1563–1571.PubMedGoogle Scholar
  20. 20.
    Ritvo ER, Ritvo R, Yuwiler A, et al.: Elevated daytime melatonin concentrations in autism: a pilot study. Eur Child Adolesc Psychiatry 1993, 2:75–78.CrossRefGoogle Scholar
  21. 21.
    Nir I, Meir D, Zilber N, et al.: Brief report: circadian melatonin, thyroid-stimulating hormone, prolactin, and cortisol levels in serum of young adults with autism. J Autism Dev Disord 1995, 25:641–654.PubMedCrossRefGoogle Scholar
  22. 22.
    Kulman G, Lissoni P, Rovelli F, et al.: Evidence of pineal endocrine hypofunction in autistic children. Neurol Endocrinol Lett 2000, 20:31–34.Google Scholar
  23. 23.
    Tordjman S, Anderson GM, Pichard N, et al.: Nocturnal excretion of 6-sulphatoxymelatonin in children and adolescents with autistic disorder. Biol Psychiatry 2005, 57:134–138.PubMedCrossRefGoogle Scholar
  24. 24.
    American Academy of Sleep Medicine: International Classification of Sleep Disorders. Westchester, IL: American Academy of Sleep Medicine; 2005.Google Scholar
  25. 25.
    Malow BA: Sleep disorders, epilepsy, and autism. Ment Retard Dev Disabil Res Rev 2004, 10:122–125.PubMedCrossRefGoogle Scholar
  26. 26.
    Thirumalai SS, Shubin RA, Robinson R: Rapid eye movement sleep behavior disorder in children with autism. J Child Neurol 2002, 17:173–178.PubMedGoogle Scholar
  27. 27.
    Mahowald M, Schenck C: REM sleep parasomnias. In Principles and Practice of Sleep Medicine. Edited by Kryger M, Roth T, Dement W. Philadelphia: Elsevier/Saunders; 2005:897–916.Google Scholar
  28. 28.
    Malow BA, McGrew SG, Harvey M, et al.: Impact of treating sleep apnea in a child with autism spectrum disorder. Pediatr Neurol 2006, 34:325–328.PubMedCrossRefGoogle Scholar
  29. 29.
    Godbout R, Bergeron C, Limoges E, et al.: A laboratory study of sleep in Asperger’s syndrome. Neuroreport 2000, 11:127–130.PubMedCrossRefGoogle Scholar
  30. 30.
    Limoges E, Mottron L, Bolduc C, et al.: Atypical sleep architecture and the autism phenotype. Brain 2005, 128:1049–1061.PubMedCrossRefGoogle Scholar
  31. 31.
    Chervin RD, Hedger K, Dillon JE, Pituch KJ: Pediatric Sleep Questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med 2000, 1:21–31.PubMedCrossRefGoogle Scholar
  32. 32.
    Owens JA, Spirito A, McGuinn M: The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 2000, 23:1043–1051.PubMedGoogle Scholar
  33. 33.
    Bazil CW, Castro LH, Walczak TS: Reduction of rapid eye movement sleep by diurnal and nocturnal seizures in temporal lobe epilepsy. Arch Neurol 2000, 57:363–368.PubMedCrossRefGoogle Scholar
  34. 34.
    Mindell JA, Kuhn B, Lewin DS, et al.: Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep 2006, 29:1263–1276.PubMedGoogle Scholar
  35. 35.
    Weiskop S, Richdale A, Matthews J: Behavioural treatment to reduce sleep problems in children with autism or fragile X syndrome. Dev Med Child Neurol 2005, 47:94–104.PubMedCrossRefGoogle Scholar
  36. 36.
    Jan JE, Esperzedl H, Appleton RE: The treatment of sleep disorders with melatonin. Dev Med Child Neurol 1994, 36:97–107.PubMedCrossRefGoogle Scholar
  37. 37.
    Ross C, Davies P, Whitehouse W: Melatonin treatment for sleep disorders in children with neurodevelopmental disorders: an observational study. Dev Med Child Neurol 2002, 44:339–344.PubMedCrossRefGoogle Scholar
  38. 38.
    Phillips L, Appleton R: Systematic review of melatonin treatment in children with neurodevelopmental disabilities and sleep impairment. Dev Med Child Neurol 2004, 46:771–775.PubMedCrossRefGoogle Scholar
  39. 39.
    Dodge NN, Wilson GA: Melatonin for treatment of sleep disorders in children with developmental disabilities. J Child Neurol 2001, 16:581–584.PubMedCrossRefGoogle Scholar
  40. 40.
    Sheldon S: Pro-convulsant effects of oral melatonin in neurologically disabled children. Lancet 1998, 351:1254.PubMedCrossRefGoogle Scholar
  41. 41.
    Andersen IM, Kaczmarska J, McGrew SG, et al.: Melatonin for insomnia in children with autism spectrum disorders. J Child Neurol 2008, In press.Google Scholar
  42. 42.
    Giannotti F, Cortesi F, Cerquiglini A, Bernabei P: An openlabel study of controlled-release melatonin in treatment of sleep disorders in children with autism. J Autism Dev Disord 2006, 36:741–752.PubMedCrossRefGoogle Scholar
  43. 43.
    Jan JE, Hamilton D, Seward N, et al.: Clinical trials of controlled-release melatonin in children with sleep-wake cycle disorders. J Pineal Res 2000, 29:34–39.PubMedCrossRefGoogle Scholar
  44. 44.
    Chesson AL, Littner M, Davila D, et al.: Practice parameters for the use of light therapy in the treatment of sleep disorders. Sleep 1999, 22:641–660.PubMedGoogle Scholar
  45. 45.
    Swedo SE, Allen AJ, Glod CA, et al.: A controlled trial of light therapy for the treatment of pediatric seasonal affective disorder. J Am Acad Child Adolesc Psychiatry 1997, 36:816–821.PubMedCrossRefGoogle Scholar
  46. 46.
    Schwitzer J, Neudorfer C, Blecha HG, Fleischhacker WW: Mania as a side effect of phototherapy. Biol Psychiatry 1990, 28:532–534.PubMedCrossRefGoogle Scholar
  47. 47.
    Bickers DR: Photosensitivity and other reactions to light. In Harrison’s Principles of Internal Medicine, edn 15. Edited by Braunwald E, Fauci AS, Kasper DL, et al.: New York: McGraw-Hill; 2001:345–347.Google Scholar
  48. 48.
    Tuchman R, Rapin I: Epilepsy in autism. Lancet Neurol 2002, 1:352–358.PubMedCrossRefGoogle Scholar
  49. 49.
    Mayer G, Wilde-Frenz J, Kurella B: Sleep related rhythmic movement disorder revisited. J Sleep Res 2007, 16:110–116.PubMedCrossRefGoogle Scholar
  50. 50.
    Diomedi M, Curatolo P, Scalise A, et al.: Sleep abnormalities in mentally retarded autistic subjects: Down’s syndrome with mental retardation and normal subjects. Brain Dev 1999, 21:548–553.PubMedCrossRefGoogle Scholar
  51. 51.
    Chervin RD, Ruzicka DL, Giordani BJ, et al.: Sleep-disordered breathing, behavior, and cognition in children before and after adenotonsillectomy. Pediatrics 2006, 117:769–778.CrossRefGoogle Scholar
  52. 52.
    Gottlieb DJ, Vezina RM, Chase C: Symptoms of sleep-disordered breathing in 5-year-old children are associated with sleepiness and problem behaviors. Pediatrics 2003, 112:870–877.PubMedCrossRefGoogle Scholar
  53. 53.
    Goldstein NA, Fatima M, Campbell TF, Rosenfeld RM: Child behavior and quality of life before and after tonsillectomy and adenoidectomy. Arch Otolaryngol Head Neck Surg 2002, 128:770–775.PubMedGoogle Scholar
  54. 54.
    Schreck KA, Mulick JA, Smith AF: Sleep problems as possible predictors of intensified symptoms of autism. Res Dev Disabil 2004, 24:57–66.CrossRefGoogle Scholar
  55. 55.
    Gabriels RL, Cuccaro ML, Hill DE, et al.: Repetitive behaviors in autism: relationships with associated clinical features. Res Dev Disabil 2005, 26:169–181.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  1. 1.Department of PsychiatryOregon Health & Science UniversityPortlandUSA

Personalised recommendations