Changes in Sleep Patterns and Disorders in Children and Adolescents with Attention Deficit Hyperactivity Disorders and Autism Spectrum Disorders during the COVID-19 Lockdown

Abstract

Background. The COVID-19 lockdown determined important changes in the sleep of a large percentage of the world population. We assessed the modifications of reported sleep patterns and disturbances in Italian children and adolescents with autism spectrum disorders (ASD) or attention deficit hyperactivity disorders (ADHD), compared to control children, before and during the COVID-19 lockdown in Italy. Methods. Parents of 100 ASD, 236 ADHD patients, and 340 healthy children filled out an anonymous online survey and a modified version of the Sleep Disturbance Scale for Children (SDSC), advertised via social media, to evaluate sleep patterns and disturbances of their children before and during the lockdown. Results. Before the lockdown, bedtime and risetime were not different between the three groups. During the lockdown, ADHD children tended to have a later bedtime and risetime than ASD and controls, while ASD children tended to maintain similar bedtime and risetime. Overall, during the lockdown, a reduced sleep duration significantly differentiated clinical groups from controls. Anxiety at bedtime, difficulties in falling asleep, and daytime sleepiness increased in all groups during the lockdown. Hypnic jerks, rhythmic movement disorders, night awakenings, restless sleep, sleepwalking, and daytime sleepiness increased in ASD and ADHD patients, in particular. Conclusions. This is the first study comparing sleep habits and disorders in ASD and ADHD during the lockdown showing specific differences consistent with the core characteristics of two neurodevelopmental disorders.

Children with neurodevelopmental disorders: how do they sleep?

“…In addition to these, sleep in ASD children can be disturbed by drugs (e.g., selective serotonin reuptake inhibitors) and common medical comorbidities, such as gastrointestinal problems and neurologic problems (e.g., epilepsy) [23]. Finally, changes in daily routine can exacerbate sleep problems in ASD children [24 ▪ ,25].…”

Covid-19 Pandemija Ir Aktyvumo Bei Dėmesio Sutrikimas

“…Nuotolinis mokymasis, būrelių veiklos sustabdymas, socialinė izoliacija (negalėjimas pasimatyti su savo draugais ir artimaisiais) ir kiti apribojimai neigiamai veikia vaikų ir paauglių psichikos sveikatą ir emocinę būklę. Šis laikotarpis ypač sunkus ne vien aktyvumo ir dėmesio sutrikimą turintiems vaikams, bet ir jų artimiesiems -hiperaktyvūs, nedėmesingi vaikai kelią stresą bei trukdo dirbantiems namuose artimiesiems, o mėginimai juos nuraminti, prašymai ramiai pasėdėti vaikams sukelia kančią [7][8][9].…”

“…pandemijos metu susiduria ADS turintys vaikai, yra ne tik jau esamų simptomų (hiperaktyvumas, nedėmesingumas, impulsyvumas) pablogėjimas, bet ir padidėjusio išmaniųjų technologijų (telefonas, kompiuteris, televizorius) naudojimo, nuotolinio mokymosi keliami iššūkiai, miego sutrikimai, nerimas ir depresija [4,[8][9][10][11][12][13].…”

“…Pandemijos metu suprastėjusi aktyvumo ir dėmesio sutrikimą turinčių vaikų ir paauglių miego kokybė, netinkama mityba, sumažėjęs fizinis aktyvumas ir prie ekranų praleidžiamas laikas siejami su didesne nerimo ir depresijos rizika bei esamųjų simptomų pablogėjimu [8][9][10]. Žinoma, kad aktyvumo ir dėmesio sutrikimą turinčių pacientų elgesys priklauso nuo aplinkos pokyčių, tad akivaizdu, kad pandemijos sąlygoti staigūs gyvenimo būdo pasikeitimai turėjo įtakos jų miego kokybei ir elgesiui.…”

Caregiver Perspective on the Impact of COVID-19 on the Psychosocial and Behavioral Health of Children with ASD in the United States: A Questionnaire-Based Survey

“…As the pandemic has progressed, the reported impact of COVID-19 on individuals with ASD and their families has been significant [8,[16][17][18]. Specifically, children with ASD have experienced increased mental health issues [1,12,19], a decline in positive social behaviors and other conduct [19], and an increase in sleep disturbances [20,21]. A number of factors may exacerbate these effects [15,22], including the presence of behavioral issues prior to the pandemic [23] and parental stress levels [24,25].…”