Teaching children with autism spectrum disorder how to sleep better: A pilot educational program for parents.

Abstract

While many factors contribute to sleep difficulties in children with autism spectrum disorder (ASD), behavioral sleep education is often effective. However, providing families with the educational tools and the support they need to help their children sleep can be challenging given limited access to care. We piloted the use of a 5-week home sleep education program in 10 parents of children with ASD, ages 3-9 years. Parents read a sleep education manual (extracted from a book on sleep and ASD) and then implemented the suggested strategies with their children. The Children's Sleep Habits Questionnaire, the Family Inventory of Sleep Habits, and actigraphy were completed prior to and after the intervention. Parents also completed a postintervention interview to assess understanding and comfort with implementation. Of 8 completers, 6 children showed improvement in sleep patterns, which included bedtime resistance, time to fall asleep, night wakings, and cosleeping. Actigraphy data showed improvements in sleep latency (time to fall asleep) for most of the children. Two children were able to discontinue supplemental melatonin. All parents reported good to excellent understanding of the manual and reported high comfort levels with implementation. Our pilot findings suggest that some parents can learn effective strategies for promoting sleep and teach them to their children with ASD without the guidance of a trained educator.

Sleeping without Prescription: Management of Sleep Disorders in Children with Autism with Non-Pharmacological Interventions and Over-the-Counter Treatments

“…As a general tenet of pediatric practice, non-pharmacological intervention is the preferred first treatment option before initiation of pharmacologic therapies [17]. Even if sleep medications are popular treatment options for the ease of delivery (taking a pill), as well as the rapid improvement often experienced [21], they have some notable limitations, such as their short-and long-term side effects and the lack of efficacy in some disorders [22]. Accordingly, the latest guidelines for the treatment of insomnia and disrupted sleep behavior in children and adolescents with ASD, published by the American Academy of Neurology [20], recommend parent counseling to implement good sleep habits and behavioral techniques as a first-line approach.…”

Assessment of Sleep in Children with Autism Spectrum Disorder

“…), such that when absent, sleep cannot be initiated, sleep is delayed to obtain them, or sleep cannot be re-initiated in the event of a night waking [ 22 ]. Bedtime resistance is also commonly reported and may relate to a variety of factors including sleep anxiety, sleep-onset association problems, overall non-compliance, over- activity, and general dysregulation [ 21 , 23 , 24 , 25 , 26 , 27 ].…”

Evaluation of agomelatine for the treatment of sleep problems in adults with autism spectrum disorder and co-morbid intellectual disability

“…Participants were recruited from four Spanish autism associations (Figure 1(a)) after researchers met with their parents and caregivers and from a clinic specialising in adults on the autism spectrum. Inclusion criteria were: (a) age 18–65 years; (b) psychiatric diagnosis of ASD using the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders criteria; and (c) a sleep problem with a chronic development (present for more than six months) and still present for at least one month following the introduction of good sleep-hygiene habits (reducing naps, increasing morning exercise, good morning light exposure), as described previously by Malow et al (2016). The sleep problem was reported by carers via a sleep diary and had to meet the International Classification of Sleep Disorders third edition (Sateia, 2014) for insomnia (which includes difficulty falling asleep, difficulty staying asleep or poor quality sleep, and impaired daytime functioning over the past three or more months), or a suspected circadian rhythm sleep–wake disorder (CRSWD; a misalignment between the endogenous circadian rhythm and exogenous factors such as light that affect sleep timing and duration; Thorpy, 2017).…”