Abstract
The prevalence of sleep disturbances in 52 children with Asperger syndrome (AS) as compared with 61 healthy controls (all subjects aged 5–17 years) was investigated. Problems with sleep onset and maintenance, sleep-related fears, negative attitudes toward sleeping, and daytime somnolence were more frequent among children with AS than among controls. Short sleep duration (<9 h) was almost twofold (59% vs. 32%), and the risk for sleep onset problems more than fivefold (53% vs. 10%) more common in the AS group than in the control group. Child-reported sleeping problems were also more prevalent in the AS group than in controls (58% vs. 7%). The results suggest that sleep disturbances should be routinely evaluated in children with AS.


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Achenbach, T. M. (1991). Child behavior checklist/4–18 and 1991 profile. Burlington, VT: Department of Psychiatry, University of Vermont.
Allik, H., Larsson, J.-O., & Smedje, H. (2006a). Sleep patterns of school-age children with Asperger syndrome or high-functioning autism. Journal of Autism and Developmental Disorders, 36, 585–595.
Allik, H., Larsson, J.-O., & Smedje, H. (2006b). Insomnia in school-age children with Asperger Syndrome or high-functioning autism. BMC Psychiatry, 6, 18.
Aronen, E. T., Fjallberg, M., Paavonen, E. J., & Soininen, M. (2002). Day length associates with activity level in children living at 60 degrees north. Child Psychiatry and Human Development, 32(3), 217–226.
Aronen, E. T., Paavonen, E. J., Fjallberg, M., Soininen, M., & Torronen, J. (2000). Sleep and psychiatric symptoms in school-age children. Journal of the American Academy of Child and Adolescent Psychiatry, 39(4), 502–508.
Bruni, O., Ottaviano, S., Guidetti, V., Romoli, M., Innocenzi, M., Cortesi, F. et al. (1996). The sleep disturbance scale for children (SDSC). Construction and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. Journal of Sleep Research, 5(4), 251–261.
Brzezinski, A. (1997). Melatonin in humans. The New England Journal of Medicine, 336(3), 186–195.
Dahlitz, M., Alvarez, B., Vignau, J., English, J., Arendt, J., & Parkes, J. D. (1991). Delayed sleep phase syndrome. Lancet, 337, 1121–1124.
Diomedi, M., Curatolo, P., Scalise, A., Placidi, F., Caretto, F., & Gigli, G. L. (1999). Sleep abnormalities in mentally retarded autistic subjects: Down’s syndrome with mental retardation and normal subjects. Brain and Development, 21(8), 548–553.
Durand, V. M. (1998). Sleep better!: A guide to improving sleep for children with special needs. Baltimore, MD: Paul H. Brookes.
Elia, M., Ferri, R., Musumeci, S. A., Del Gracco, S., Bottitta, M., Scuderi, C. et al. (2000). Sleep in subjects with autistic disorder: A neurophysiological and psychological study. Brain and Development, 22(2), 88–92.
Gail Williams, P., Sears, L. L., & Allard, A. (2004). Sleep problems in children with autism. Journal of Sleep Research, 13, 265–268.
Godbout, R., Bergeron, C., Limoges, E., Stip, E., & Mottron, L. (2000). A laboratory study of sleep in Asperger’s syndrome. Neuroreport, 11(1), 127–130.
Hering, E., Epstein, R., Elroy, S., Iancu, D. R., & Zelnik, N. (1999). Sleep patterns in autistic children. Journal of Autism and Developmental Disorders, 29(2), 143–147.
Hoshino, Y., Watanabe, H., Yashima, Y., Kaneko, M., & Kumashiro, H. (1984). An investigation on sleep disturbance of autistic children. Folia Psychiatrica et Neurologica Japonica, 38(1), 45–52.
Kovacs, M. (1985). The children’s depression inventory (CDI). Psychopharmacology Bulletin, 21(4), 995–998.
Limoges, E., Mottron, L., Bolduc, C., Berthiaume, C., & Godbout, R. (2005). Atypical sleep architecture and the autism phenotype. Brain, 128(Pt. 5), 1049–1061.
Little, R. J. A., & Rubin, D. B. (1987). Statistical analysis with missing data. New York: Wiley.
Malow, B. A., McGrew, S. G., Harvey, M., Hendersson, L. M., & Stone, W. L. (2006). Impact of treating sleep apnea in a child with autism spectrum disorder. Pediatric Neurology, 34, 325–328.
Mustonen, S. (2001). The new Windows version of Survo, 2.32 ed. Helsinki: Survo Systems.
Nieminen-von Wendt, T., Paavonen, E. J., Ylisaukko-Oja, T., Sarenius, S., Källman, T., & von Wendt, L. (2005). Subjective face recognition difficulties, aberrant sensibility, sleeping disturbances and aberrant eating habits in families with Asperger syndrome. BMC Psychiatry, 5(20), 1–8.
Owens, J. A., Spirito, A., McGuinn, M., & Nobile, C. (2000). Sleep habits and sleep disturbance in elementary school-aged children. Journal of Developmental and Behavioral Pediatrics, 21(1), 27–36.
Paavonen, E. J. (2004). Sleep disturbances and psychiatric symptoms in school-aged children. Thesis, University of Helsinki, Helsinki.
Paavonen, E. J., Almqvist, F., Tamminen, T., Moilanen, I., Piha, J., Rasanen, E. et al. (2002). Poor sleep and psychiatric symptoms at school: An epidemiological study. European Child and Adolescent Psychiatry, 11(1), 10–17.
Paavonen, E. J., Aronen, E. T., Moilanen, I., Piha, J., Rasanen, E., Tamminen, T. et al. (2000). Sleep problems of school-aged children: A complementary view. Acta Paediatrica, 89(2), 223–228.
Paavonen, E. J., Nieminen-von Wendt, T., Vanhala, R., Aronen, E. T., & von Wendt, L. (2003a). Effectiveness of melatonin in the treatment of sleep disturbances in children with Asperger disorder. Journal of Child and Adolescent Psychopharmacology, 13(1), 83–95.
Paavonen, E. J., Solantaus, T., Almqvist, F., & Aronen, E. T. (2003b). Four-year follow-up study of sleep and psychiatric symptoms in preadolescents: Relationship of persistent and temporary sleep problems to psychiatric symptoms. Journal of Developmental and Behavioral Pediatrics, 24(5), 307–314.
Patzold, L. M., Richdale, A. L., & Tonge, B. J. (1998). An investigation into sleep characteristics of children with autism and Asperger’s disorder. Journal of Paediatrics and Child Health, 34(6), 528–533.
Polimeni, M. A., Richdale, A. L., & Francis, A. J. (2005). A survey of sleep problems in autism, Asperger’s disorder and typically developing children. Journal of Intellectual Disability Research, 49(Pt. 4), 260–268.
Randazzo, A. C., Muehlbach, M. J., Schweitzer, P. K., & Walsh, J. K. (1998). Cognitive function following acute sleep restriction in children ages 10–14. Sleep, 21(8), 861–868.
Richdale, A. L. (1999). Sleep problems in autism: Prevalence, cause, and intervention. Developmental Medicine and Child Neurology, 41(1), 60–66.
Schreck, K. A., & Mulick, J. A. (2000). Parental report of sleep problems in children with autism. Journal of Autism and Developmental Disorders, 30(2), 127–135.
Schreck, K. A., Mulick, J. A., & Smith, A. F. (2004). Sleep problems as possible predictors of intensified symptoms of autism. Research in Developmental Disabilities, 25(1), 57–66.
Steenari, M. R., Vuontela, V., Paavonen, E. J., Carlson, S., Fjallberg, M., & Aronen, E. (2003). Working memory and sleep in 6- to 13-year-old schoolchildren. Journal of the American Academy of Child and Adolescent Psychiatry, 42(1), 85–92.
Stores, G. (2001). Sleep–wake function in children with neurodevelopmental and psychiatric disorders. Seminars in Pediatric Neurology, 8(4), 188–197.
Stores G., & Wiggs L. (eds.) (2001). Sleep disturbance in children and adolescents with disorders of development: Its significance and management. Series: Clinics in developmental medicine, n.o. 155. London: Mac Keith Press.
Taira, M., Takase, M., & Sasaki, H. (1998). Sleep disorder in children with autism. Psychiatry and Clinical Neurosciences, 52(2), 182–183.
Tani, P., Lindberg, N., Nieminen-von Wendt, T., von Wendt, L., Alanko, L., Appelberg, B. et al. (2003). Insomnia is a frequent finding in adults with Asperger syndrome. BMC Psychiatry, 3(12), doi: 10.1186/1471-244X-3-12.
Tarkkonen, L., & Vehkalahti, K. (2005). Measurement errors in multivariate measurement scales. Journal of Multivariate Analysis, 96(1), 172–189.
Tordjman, S., Anderson, G. M., Pichard, N., Charbuy, H., & Touitou, Y. (2005). Nocturnal excretion of 6-sulphatoxymelatonin in children and adolescents with autistic disorder. Biological Psychiatry, 57, 134–138.
Wiggs, L., & Stores, G. (1996). Severe sleep disturbance and daytime challenging behaviour in children with severe learning disabilities. Journal of Intellectual Disability Research, 40(Pt. 6), 518–528.
Wiggs, L., & Stores, G. (1999). Behavioural treatment for sleep problems in children with severe learning disabilities and challenging daytime behaviour: Effect on daytime behaviour. Journal of Child Psychology and Psychiatry and Allied Disciplines, 40(4), 627–635.
Wiggs, L., & Stores, G. (2004). Sleep patterns and sleep disorders in children with autistic spectrum disorders: Insights using parent report and actigraphy. Developmental Medicine and Child Neurology, 46, 372–380.
Acknowledgments
This study was financially supported by the Finnish Cultural Foundation, the Foundation for Child Psychiatric Research, the Finnish Sleep Research Society, the Foundation for Pediatric Research, the Finnish Medical Foundation, the Signe and Ane Gyllenberg Foundation, the Yrjö Jahnsson Foundation, the Helsinki University Central Hospital Funds (EVO TYH 4217), and the Helsinki University Research Funds (Project 2103035), Hospital for Children and Adolescents, Departments of Child Psychiatry and Neurology, Helsinki University Central Hospital, HUS, University of Helsinki.
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Paavonen, E.J., Vehkalahti, K., Vanhala, R. et al. Sleep in Children with Asperger Syndrome. J Autism Dev Disord 38, 41–51 (2008). https://doi.org/10.1007/s10803-007-0360-x
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DOI: https://doi.org/10.1007/s10803-007-0360-x


