Systematic Review of Sleep Disturbances and Circadian Sleep Desynchronization in Autism Spectrum Disorder: Toward an Integrative Model of a Self-Reinforcing Loop

Carmassi, Claudia; Palagini, Laura; Caruso, Danila; Masci, Isabella; Nobili, Lino; Vita, Antonio; Dell’Osso, Liliana

doi:10.3389/fpsyt.2019.00366

Cited by 156 publications

(133 citation statements)

References 163 publications

(252 reference statements)

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“…The components of CSHQ can be grouped into eight subscales representing common domains of sleep disorders in children. The CSHQ has been validated in preschool and schoolchildren and it is widely used for screening sleep disorders also in ASD (6).…”

Section: Assessment Of Sleep Habitsmentioning

confidence: 99%

“…The prevalence of sleep disturbances in children with ASD is reported to be 50-80 %, compared to 9-50 % in typically developing children (5). In particular, short sleep duration, low sleep quality/effi ciency, circadian sleep desynchronisation and/or delayed sleep are the most commonly presented sleep disturbances (6).…”

Section: Introductionmentioning

confidence: 99%

“…There is evidence that individuals with ASD who suffer from sleep impairments may present with increased severity of ASD core symptoms (6). In a study, the sleep onset delay was linked to stereotyped behaviours and impairments of social interaction, while parasomnia has been associated with communication problems and increase in stereotyped behaviours (7).…”

Section: Introductionmentioning

confidence: 99%

“…During the night, melatonin concentrations increase several times with a peak in the middle of the night (9). Several studies revealed that a proportion of individuals with ASD have lower levels of melatonin (5), as well as that deviations in biorhythm of melatonin secretion were observed (6). Abnormalities in melatonin production have been associated with the severity of ASD impairments (10).…”

Section: Introductionmentioning

confidence: 99%

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Urinary levels of 6-sulphatoxymelatonin and their associations with sleep disorders and behavioural impairments in children with autism spectrum disorder

Babinská¹,

Siklenková²,

Stebelová³

et al. 2019

BLL

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BACKGROUND: Autism spectrum disorder (ASD) is a neurodevelopmental condition associated with sleep disturbances that may result from abnormalities in melatonin production. The correlations of melatonin levels with the severity of sleep disorder and/or severity of ASD were reported. OBJECTIVES: To evaluate urinary levels of the melatonin metabolite, 6-sulphatoxymelatonin (aMT6s), in children with ASD, and their associations with sleep abnormalities and behavioural impairments. METHODS: Study involved 77 children with ASD and 84 controls aged 2.5-15.5 years. Sleep disorders were assessed by Children's Sleep Habits Questionnaire. Morning and afternoon levels of aMT6s were determined by radioimmunoassay method. Urinary creatinine levels were assessed by an enzymatic method. RESULTS: The urinary aMT6s/creatinine values indicate that the night-time melatonin levels are signifi cantly lower in ASD than in controls, but there are no signifi cant differences in the daytime levels. In the ASD group, on average, a 6.8-fold difference between night-time and daytime values of urinary aMT6s/creatinine was found, whereas for the controls a 12.5-fold difference was observed, indicating a lower night-time increase in melatonin levels. In ASD group, the difference in night-time-daytime aMT6s/creatinine value correlated with some types of sleep problems, but not with the severity of ASD. CONCLUSION: The results indicate that in ASD there are differences in the patterns of melatonin secretion that may be associated with sleep impairment (Tab. 4, Fig. 2, Ref. 28).

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Section: Assessment Of Sleep Habitsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Urinary levels of 6-sulphatoxymelatonin and their associations with sleep disorders and behavioural impairments in children with autism spectrum disorder

Babinská¹,

Siklenková²,

Stebelová³

et al. 2019

BLL

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show abstract

“…Indeed, research supports that circadian disruption is prevalent in ASD independently of insomnia, with dysregulation in expression of circadian genes and melatonin being commonly reported (Carmassi et al, 2019;Karaivazoglou & Assimakopoulos, 2018).…”

Section: Summary and Future D Irec Ti On Smentioning

confidence: 96%

Sleep, brain development, and autism spectrum disorders: Insights from animal models

Wintler

Schoch

Frank

et al. 2020

J of Neuroscience Research

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Sleep is an evolutionarily conserved and powerful drive, although its complete functions are still unknown. One possible function of sleep is that it promotes brain development. The amount of sleep is greatest during ages when the brain is rapidly developing, and sleep has been shown to influence critical period plasticity. This supports a role for sleep in brain development and suggests that abnormal sleep in early life may lead to abnormal development. Autism spectrum disorder (ASD) is the most prevalent neurodevelopmental disorder in the United States. It is estimated that insomnia affects 44%–86% of the ASD population, predicting the severity of ASD core symptoms and associated behavioral problems. Sleep problems impact the quality of life of both ASD individuals and their caregivers, thus it is important to understand why they are so prevalent. In this review, we explore the role of sleep in early life as a causal factor in ASD. First, we review fundamental steps in mammalian sleep ontogeny and regulation and how sleep influences brain development. Next, we summarize current knowledge gained from studying sleep in animal models of ASD. Ultimately, our goal is to highlight the importance of understanding the role of sleep in brain development and the use of animal models to provide mechanistic insight into the origin of sleep problems in ASD.

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Enlarged Perivascular Spaces in Infancy and Autism Diagnosis, Cerebrospinal Fluid Volume, and Later Sleep Problems

Garic,

McKinstry,

Rutsohn

et al. 2023

JAMA Netw Open

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ImportancePerivascular spaces (PVS) and cerebrospinal fluid (CSF) are essential components of the glymphatic system, regulating brain homeostasis and clearing neural waste throughout the lifespan. Enlarged PVS have been implicated in neurological disorders and sleep problems in adults, and excessive CSF volume has been reported in infants who develop autism. Enlarged PVS have not been sufficiently studied longitudinally in infancy or in relation to autism outcomes or CSF volume.ObjectiveTo examine whether enlarged PVS are more prevalent in infants who develop autism compared with controls and whether they are associated with trajectories of extra-axial CSF volume (EA-CSF) and sleep problems in later childhood.Design, Setting, and ParticipantsThis prospective, longitudinal cohort study used data from the Infant Brain Imaging Study. Magnetic resonance images were acquired at ages 6, 12, and 24 months (2007-2017), with sleep questionnaires performed between ages 7 and 12 years (starting in 2018). Data were collected at 4 sites in North Carolina, Missouri, Pennsylvania, and Washington. Data were analyzed from March 2021 through August 2022.ExposurePVS (ie, fluid-filled channels that surround blood vessels in the brain) that are enlarged (ie, visible on magnetic resonance imaging).Main Outcomes and MeasuresOutcomes of interest were enlarged PVS and EA-CSF volume from 6 to 24 months, autism diagnosis at 24 months, sleep problems between ages 7 and 12 years.ResultsA total of 311 infants (197 [63.3%] male) were included: 47 infants at high familial likelihood for autism (ie, having an older sibling with autism) who were diagnosed with autism at age 24 months, 180 high likelihood infants not diagnosed with autism, and 84 low likelihood control infants not diagnosed with autism. Sleep measures at school-age were available for 109 participants. Of infants who developed autism, 21 (44.7%) had enlarged PVS at 24 months compared with 48 infants (26.7%) in the high likelihood but no autism diagnosis group (P = .02) and 22 infants in the control group (26.2%) (P = .03). Across all groups, enlarged PVS at 24 months was associated with greater EA-CSF volume from ages 6 to 24 months (β = 4.64; 95% CI, 0.58-8.72; P = .002) and more frequent night wakings at school-age (F = 7.76; η2 = 0.08; P = .006).Conclusions and RelevanceThese findings suggest that enlarged PVS emerged between ages 12 and 24 months in infants who developed autism. These results add to a growing body of evidence that, along with excessive CSF volume and sleep dysfunction, the glymphatic system could be dysregulated in infants who develop autism.

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Systematic Review of Sleep Disturbances and Circadian Sleep Desynchronization in Autism Spectrum Disorder: Toward an Integrative Model of a Self-Reinforcing Loop

Cited by 156 publications

References 163 publications

Urinary levels of 6-sulphatoxymelatonin and their associations with sleep disorders and behavioural impairments in children with autism spectrum disorder

Urinary levels of 6-sulphatoxymelatonin and their associations with sleep disorders and behavioural impairments in children with autism spectrum disorder

Sleep, brain development, and autism spectrum disorders: Insights from animal models

Enlarged Perivascular Spaces in Infancy and Autism Diagnosis, Cerebrospinal Fluid Volume, and Later Sleep Problems

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