Skip to main content
SpringerLink
Log in

Autism Spectrum Disorder

  • Chapter
  • First Online:
Pediatric Sleep Medicine

  • 1170 Accesses

Abstract

Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder associated with significant impairment and rapidly increasing prevalence and societal costs. Children with ASD are at high risk for co-occurring insomnia and other sleep disorders, which are associated with decreased quality of life, impaired learning and cognition, increased stereotypic and challenging behaviors, and increased parental stress and sleep difficulty. There is a critical need for effective assessment and treatment of sleep disorders in this population. Despite the significance of the problem, little research has been conducted to develop and test effective treatments for sleep disorders in children with ASD. Challenges to assessing and treating sleep disorders in this population include the significant heterogeneity of clinical phenotypes and multiple etiological factors contributing to sleep difficulties. The first half of this chapter provides an overview of the epidemiology, etiology, and assessment of sleep disorders in ASD. The second half discusses treatment, provides in-depth review of specific sleep disorders, and presents special intervention and outcome considerations. The chapter concludes with a call for more research on sleep disparities, and developmentally and culturally tailored assessment and treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

Abbreviations

ADHD:

Attention-Deficit/Hyperactivity Disorder

ASD:

Autism Spectrum Disorder

ASHS:

Adolescent Sleep Hygiene Scale

ATN:

Autism Treatment Network

BEDS:

Behavior Evaluation of Disorders of Sleep

BRQ:

Bedtime Routines Questionnaire

CBT-I:

Cognitive Behavioral Treatment for Insomnia

CSHQ:

Children’s Sleep Habit Questionnaire

EEG:

Electroencephalogram

FISH:

Family Inventory of Sleep Habits

GABA:

Gamma-Aminobutyric Acid

GI:

Gastrointestinal

IQ:

Intelligence Quotient

MSPSQ:

Modified Simonds and Parraga Sleep Questionnaire

OSA:

Obstructive Sleep Apnea

PLMS:

Periodic Limb Movement in Sleep

PSG:

Polysomnography

REM:

Rapid Eye Movement

RLS:

Restless Legs Syndrome

SDSC:

Sleep Disturbance Scale for Children

SOL:

Sleep-Onset Latency

SSRI:

Selective Serotonin Reuptake Inhibitor

TD:

Typically Developing

References

  1. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®). Arlington: American Psychiatric Pub; 2013.

    Book  Google Scholar 

  2. Bauman ML. Medical comorbidities in autism: challenges to diagnosis and treatment. Neurotherapeutics. 2010;7(3):320–7.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Kielinen M, Rantala H, Timonen E, Linna S-L, Moilanen I. Associated medical disorders and disabilities in children with autistic disorder: a population-based study. Autism. 2004;8(1):49–60.

    Article  PubMed  Google Scholar 

  4. Leyfer OT, Folstein SE, Bacalman S, Davis NO, Dinh E, Morgan J, et al. Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord. 2006;36(7):849–61.

    Article  PubMed  Google Scholar 

  5. Simonoff E, Pickles A, Charman T, Chandler S, Loucas T, Baird G. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921–9.

    Article  PubMed  Google Scholar 

  6. Aldinger KA, Lane CJ, Veenstra-VanderWeele J, Levitt P. Patterns of risk for multiple co-occurring medical conditions replicate across distinct cohorts of children with autism spectrum disorder. Autism Res. 2015;8(6):771–81.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Doshi-Velez F, Ge Y, Kohane I. Comorbidity clusters in autism spectrum disorders: an electronic health record time-series analysis. Pediatrics. 2014;133(1):e54.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Soke G, Maenner M, Christensen D, Kurzius-Spencer M, Schieve L. Prevalence of co-occurring medical and behavioral conditions/symptoms among 4-and 8-year-old children with autism spectrum disorder in selected areas of the United States in 2010. J Autism Dev Disord. 2018;48(8):2663–76.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z, et al. Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2014. MMWR Surveill Summ. 2018;67(6):1.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Tager-Flusberg H, Kasari C. Minimally verbal school-aged children with autism spectrum disorder: the neglected end of the spectrum. Autism Res. 2013;6(6):468–78.

    Article  PubMed  Google Scholar 

  11. Fombonne E. The changing epidemiology of autism. J Appl Res Intellect Disabil. 2005;18(4):281–94.

    Article  Google Scholar 

  12. Leigh JP, Du J. Brief report: forecasting the economic burden of autism in 2015 and 2025 in the United States. J Autism Dev Disord. 2015;45(12):4135–9.

    Article  PubMed  Google Scholar 

  13. Couturier JL, Speechley KN, Steele M, Norman R, Stringer B, Nicolson R. 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(8):815–22.

    Article  PubMed  Google Scholar 

  14. Krakowiak P, Goodlin-Jones B, Hertz-Picciotto I, Croen LA, Hansen RL. Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: a population-based study. J Sleep Res. 2008;17(2):197–206.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Richdale AL, Schreck KA. Sleep problems in autism spectrum disorders: prevalence, nature, & possible biopsychosocial aetiologies. Sleep Med Rev. 2009;13(6):403–11.

    Article  PubMed  Google Scholar 

  16. Souders MC, Mason TB, Valladares O, Bucan M, Levy SE, Mandell DS, et al. Sleep behaviors and sleep quality in children with autism spectrum disorders. Sleep. 2009;32(12):1566–78.

    Article  PubMed  PubMed Central  Google Scholar 

  17. Reynolds AM, Soke GN, Sabourin KR, Hepburn S, Katz T, Wiggins LD, et al. Sleep problems in 2-to 5-year-olds with autism spectrum disorder and other developmental delays. Pediatrics. 2019;143(3):e20180492.

    Article  PubMed  Google Scholar 

  18. Elrod MG, Hood BS. Sleep differences among children with autism spectrum disorders and typically developing peers: a meta-analysis. J Dev Behav Pediatr. 2015;36(3):166–77.

    Article  PubMed  Google Scholar 

  19. Díaz-Román A, Zhang J, Delorme R, Beggiato A, Cortese S. Sleep in youth with autism spectrum disorders: systematic review and meta-analysis of subjective and objective studies. Evid Based Ment Health. 2018;21(4):146–54.

    Article  PubMed  Google Scholar 

  20. Malow BA, McGrew SG. Sleep disturbances and autism. Sleep Med Clin. 2008;3(3):479–88.

    Article  Google Scholar 

  21. Krakowiak P, Walker CK, Bremer AA, Baker AS, Ozonoff S, Hansen RL, et al. Maternal metabolic conditions and risk for autism and other neurodevelopmental disorders. Pediatrics. 2012;129(5):e1121.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Gail Williams P, Sears LL, Allard A. Sleep problems in children with autism. J Sleep Res. 2004;13(3):265–8.

    Article  CAS  PubMed  Google Scholar 

  23. Geoffray M, Nicolas A, Speranza M, Georgieff N. Are circadian rhythms new pathways to understand autism spectrum disorder? J Physiol. 2016;110(4):434–8.

    Google Scholar 

  24. Glickman G. Circadian rhythms and sleep in children with autism. Neurosci Biobehav Rev. 2010;34(5):755–68.

    Article  PubMed  Google Scholar 

  25. Karaivazoglou K, Assimakopoulos K. Circadian dysregulation in young children with autism spectrum disorder. J Sleep Med Disord. 2018;5(2):1092.

    Google Scholar 

  26. Elrod MG, Nylund CM, Susi AL, Gorman GH, Hisle-Gorman E, Rogers DJ, et al. Prevalence of diagnosed sleep disorders and related diagnostic and surgical procedures in children with autism spectrum disorders. J Dev Behav Pediatr. 2016;37(5):377–84.

    Article  PubMed  Google Scholar 

  27. Humphreys JS, Gringras P, Blair PS, Scott N, Henderson J, Fleming PJ, et al. Sleep patterns in children with autistic spectrum disorders: a prospective cohort study. Arch Dis Child. 2014;99(2):114–8.

    Article  PubMed  Google Scholar 

  28. Anders T, Iosif A-M, Schwichtenberg A, Tang K, Goodlin-Jones B. Sleep and daytime functioning: a short-term longitudinal study of three preschool-age comparison groups. Am J Intellect Dev Disabil. 2012;117(4):275–90.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Sivertsen B, Posserud M-B, Gillberg C, Lundervold AJ, Hysing M. Sleep problems in children with autism spectrum problems: a longitudinal population-based study. Autism. 2012;16(2):139–50.

    Article  PubMed  Google Scholar 

  30. Mannion A, Leader G. An investigation of comorbid psychological disorders, sleep problems, gastrointestinal symptoms and epilepsy in children and adolescents with autism spectrum disorder: a two year follow-up. Res Autism Spectr Disord. 2016;22:20–33.

    Article  Google Scholar 

  31. Fletcher FE, Foster-Owens MD, Conduit R, Rinehart NJ, Riby DM, Cornish KM. The developmental trajectory of parent-report and objective sleep profiles in autism spectrum disorder: associations with anxiety and bedtime routines. Autism. 2017;21(4):493–503.

    Article  PubMed  Google Scholar 

  32. Mazurek MO, Dovgan K, Neumeyer AM, Malow BA. Course and predictors of sleep and co-occurring problems in children with autism spectrum disorder. J Autism Dev Disord. 2019;49:2101–15.

    Article  PubMed  Google Scholar 

  33. Øyane NM, Bjorvatn B. Sleep disturbances in adolescents and young adults with autism and Asperger syndrome. Autism. 2005;9(1):83–94.

    Article  PubMed  Google Scholar 

  34. Jones KB, Cottle K, Bakian A, Farley M, Bilder D, Coon H, et al. A description of medical conditions in adults with autism spectrum disorder: a follow-up of the 1980s Utah/UCLA Autism Epidemiologic Study. Autism. 2016;20(5):551–61.

    Article  PubMed  Google Scholar 

  35. Cohen S, Conduit R, Lockley SW, Rajaratnam SM, Cornish KM. The relationship between sleep and behavior in autism spectrum disorder (ASD): a review. J Neurodev Disord. 2014;6(1):44.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Hollway JA, Aman MG. Sleep correlates of pervasive developmental disorders: a review of the literature. Res Dev Disabil. 2011;32(5):1399–421.

    Article  PubMed  Google Scholar 

  37. Hoffman CD, Sweeney DP, Gilliam JE, Apodaca DD, Lopez-Wagner MC, Castillo MM. Sleep problems and symptomology in children with autism. Focus Autism Other Dev Disabil. 2005;20(4):194–200.

    Article  Google Scholar 

  38. Mayes SD, Calhoun SL. Variables related to sleep problems in children with autism. Res Autism Spectr Disord. 2009;3(4):931–41.

    Article  Google Scholar 

  39. Schreck KA, Mulick JA, Smith AF. Sleep problems as possible predictors of intensified symptoms of autism. Res Dev Disabil. 2004;25(1):57–66.

    Article  PubMed  Google Scholar 

  40. Tudor ME, Hoffman CD, Sweeney DP. Children with autism: sleep problems and symptom severity. Focus Autism Other Dev Disabil. 2012;27(4):254–62.

    Article  Google Scholar 

  41. Elia M, Ferri R, Musumeci SA, Del Gracco S, Bottitta M, Scuderi C, et al. Sleep in subjects with autistic disorder: a neurophysiological and psychological study. Brain Dev. 2000;22(2):88–92.

    Article  CAS  PubMed  Google Scholar 

  42. Malow BA, McGrew SG, Harvey M, Henderson LM, Stone WL. Impact of treating sleep apnea in a child with autism spectrum disorder. Pediatr Neurol. 2006;34(4):325–8.

    Article  PubMed  Google Scholar 

  43. Taylor MA, Schreck KA, Mulick JA. Sleep disruption as a correlate to cognitive and adaptive behavior problems in autism spectrum disorders. Res Dev Disabil. 2012;33(5):1408–17.

    Article  PubMed  Google Scholar 

  44. Gabriels RL, Cuccaro ML, Hill DE, Ivers BJ, Goldson E. Repetitive behaviors in autism: relationships with associated clinical features. Res Dev Disabil. 2005;26(2):169–81.

    Article  PubMed  Google Scholar 

  45. Goldman SE, Surdyka K, Cuevas R, Adkins K, Wang L, Malow BA. Defining the sleep phenotype in children with autism. Dev Neuropsychol. 2009;34(5):560–73.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Hundley RJ, Shui A, Malow BA. Relationship between subtypes of restricted and repetitive behaviors and sleep disturbance in autism spectrum disorder. J Autism Dev Disord. 2016;46(11):3448–57.

    Article  PubMed  Google Scholar 

  47. Mazurek MO, Petroski GF. Sleep problems in children with autism spectrum disorder: examining the contributions of sensory over-responsivity and anxiety. Sleep Med. 2015;16(2):270–9.

    Article  PubMed  Google Scholar 

  48. Reynolds S, Lane SJ, Thacker L. Sensory processing, physiological stress, and sleep behaviors in children with and without autism spectrum disorders. OTJR. 2012;32(1):246–57.

    Google Scholar 

  49. Hollway JA, Aman MG, Butter E. Correlates and risk markers for sleep disturbance in participants of the autism treatment network. J Autism Dev Disord. 2013;43(12):2830–43.

    Article  PubMed  Google Scholar 

  50. May T, Cornish K, Conduit R, Rajaratnam SM, Rinehart NJ. Sleep in high-functioning children with autism: longitudinal developmental change and associations with behavior problems. Behav Sleep Med. 2015;13(1):2–18.

    Article  PubMed  Google Scholar 

  51. Richdale AL, Baker E, Short M, Gradisar M. The role of insomnia, pre-sleep arousal and psychopathology symptoms in daytime impairment in adolescents with high-functioning autism spectrum disorder. Sleep Med. 2014;15(9):1082–8.

    Article  PubMed  Google Scholar 

  52. Richdale AL, Baglin CL. Self-report and caregiver-report of sleep and psychopathology in children with high-functioning autism spectrum disorder: a pilot study. Dev Neurorehabil. 2015;18(4):272–9.

    Article  PubMed  Google Scholar 

  53. Richdale AL. Sleep problems in autism: prevalence, cause, and intervention. Dev Med Child Neurol. 1999;41(1):60–6.

    Article  CAS  PubMed  Google Scholar 

  54. Malow BA, Marzec ML, McGrew SG, Wang L, Henderson LM, Stone WL. Characterizing sleep in children with autism spectrum disorders: a multidimensional approach. Sleep. 2006;29(12):1563–71.

    Article  PubMed  Google Scholar 

  55. Goldman SE, Richdale AL, Clemons T, Malow BA. Parental sleep concerns in autism spectrum disorders: variations from childhood to adolescence. J Autism Dev Disord. 2012;42(4):531–8.

    Article  PubMed  Google Scholar 

  56. Johnson CR, Smith T, DeMand A, Lecavalier L, Evans V, Gurka M, et al. Exploring sleep quality of young children with autism spectrum disorder and disruptive behaviors. Sleep Med. 2018;44:61–6.

    Article  PubMed  PubMed Central  Google Scholar 

  57. Mazurek MO, Engelhardt CR, Hilgard J, Sohl K. Bedtime electronic media use and sleep in children with autism spectrum disorder. J Dev Behav Pediatr. 2016;37(7):525–31.

    Article  PubMed  Google Scholar 

  58. Astill RG, Van der Heijden KB, Van IJzendoorn MH, Van Someren EJ. Sleep, cognition, and behavioral problems in school-age children: a century of research meta-analyzed. Psychol Bull. 2012;138(6):1109.

    Article  PubMed  Google Scholar 

  59. Lambert A, Tessier S, Rochette A-C, Scherzer P, Mottron L, Godbout R. Poor sleep affects daytime functioning in typically developing and autistic children not complaining of sleep problems: a questionnaire-based and polysomnographic study. Res Autism Spectr Disord. 2016;23:94–106.

    Article  Google Scholar 

  60. Cohen S, Fulcher BD, Rajaratnam SM, Conduit R, Sullivan JP, St Hilaire MA, et al. Sleep patterns predictive of daytime challenging behavior in individuals with low-functioning autism. Autism Res. 2018;11(2):391–403.

    Article  PubMed  Google Scholar 

  61. Shui AM, Katz T, Malow BA, Mazurek MO. Predicting sleep problems in children with autism spectrum disorders. Res Dev Disabil. 2018;83:270–9.

    Article  PubMed  Google Scholar 

  62. Souders MC, Zavodny S, Eriksen W, Sinko R, Connell J, Kerns C, et al. Sleep in children with autism spectrum disorder. Curr Psychiatry Rep. 2017;19(6):34.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Bourgeron T, editor. The possible interplay of synaptic and clock genes in autism spectrum disorders. Cold Spring Harb Symp Quant Biol. 2007;72:645–54. https://doi.org/10.1101/sqb.2007.72.020. PMID: 18419324.

  64. Mulder EJ, Anderson GM, Kemperman RF, Oosterloo-Duinkerken A, Minderaa RB, Kema IP. Urinary excretion of 5-hydroxyindoleacetic acid, serotonin and 6-sulphatoxymelatonin in normoserotonemic and hyperserotonemic autistic individuals. Neuropsychobiology. 2010;61(1):27–32.

    Article  CAS  PubMed  Google Scholar 

  65. Tordjman S, Anderson GM, Pichard N, Charbuy H, Touitou Y. Nocturnal excretion of 6-sulphatoxymelatonin in children and adolescents with autistic disorder. Biol Psychiatry. 2005;57(2):134–8.

    Article  CAS  PubMed  Google Scholar 

  66. Daoust A-M, Lusignan F-A, Braun CM, Mottron L, Godbout R. Dream content analysis in persons with an autism spectrum disorder. J Autism Dev Disord. 2008;38(4):634–43.

    Article  PubMed  Google Scholar 

  67. Limoges E, Mottron L, Bolduc C, Berthiaume C, Godbout R. Atypical sleep architecture and the autism phenotype. Brain. 2005;128(5):1049–61.

    Article  PubMed  Google Scholar 

  68. Tanguay PE, Ornitz EM, Forsythe AB, Ritvo ER. Rapid eye movement (REM) activity in normal and autistic children during REM sleep. J Autism Child Schizophr. 1976;6(3):275–88.

    Article  CAS  PubMed  Google Scholar 

  69. Veatch OJ, Keenan BT, Gehrman PR, Malow BA, Pack AI. Pleiotropic genetic effects influencing sleep and neurological disorders. Lancet Neurol. 2017;16(2):158–70.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Veatch OJ, Goldman SE, Adkins KW, Malow BA. Melatonin in children with autism spectrum disorders: how does the evidence fit together? J Nat Sci. 2015;1(7):e125.

    PubMed  PubMed Central  Google Scholar 

  71. Berridge CW, Schmeichel BE, España RA. Noradrenergic modulation of wakefulness/arousal. Sleep Med Rev. 2012;16(2):187–97.

    Article  PubMed  PubMed Central  Google Scholar 

  72. Valentino RJ, Van Bockstaele E. Convergent regulation of locus coeruleus activity as an adaptive response to stress. Eur J Pharmacol. 2008;583(2–3):194–203.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  73. Veatch OJ, Maxwell-Horn AC, Malow BA. Sleep in autism spectrum disorders. Curr Sleep Med Rep. 2015;1(2):131–40.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Tudor ME, Walsh CE, Mulder EC, Lerner MD. Pain as a predictor of sleep problems in youth with autism spectrum disorders. Autism. 2015;19(3):292–300.

    Article  PubMed  Google Scholar 

  75. Mazurek MO, Sohl K. Sleep and behavioral problems in children with autism spectrum disorder. J Autism Dev Disord. 2016;46(6):1906–15.

    Article  PubMed  Google Scholar 

  76. Aman MG, Lam KS, Van Bourgondien ME. Medication patterns in patients with autism: temporal, regional, and demographic influences. J Child Adoles Psychopharmacol. 2005;15(1):116–26.

    Article  Google Scholar 

  77. Malow BA, Katz T, Reynolds AM, Shui A, Carno M, Connolly HV, et al. Sleep difficulties and medications in children with autism spectrum disorders: a registry study. Pediatrics. 2016;137(Suppl 2):S98–S104.

    Article  PubMed  Google Scholar 

  78. Meltzer LJ, Johnson C, Crosette J, Ramos M, Mindell JA. Prevalence of diagnosed sleep disorders in pediatric primary care practices. Pediatrics. 2010;125(6):e1410.

    Article  PubMed  Google Scholar 

  79. Rigney G, Ali NS, Corkum PV, Brown CA, Constantin E, Godbout R, et al. A systematic review to explore the feasibility of a behavioural sleep intervention for insomnia in children with neurodevelopmental disorders: a transdiagnostic approach. Sleep Med Rev. 2018;41:244–54.

    Article  PubMed  Google Scholar 

  80. Engelhardt CR, Mazurek MO, Sohl K. Media use and sleep among boys with autism spectrum disorder, ADHD, or typical development. Pediatrics. 2013;132(6):1081–9.

    Article  PubMed  Google Scholar 

  81. Primeau M, Gershon A, Talbot L, Cotto I, Lotspeich L, Hardan A, et al. Individuals with autism spectrum disorders have equal success rate but require longer periods of systematic desensitization than control patients to complete ambulatory polysomnography. J Clin Sleep Med. 2016;12(03):357–62.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Reed HE, McGrew SG, Artibee K, Surdkya K, Goldman SE, Frank K, et al. Parent-based sleep education workshops in autism. J Child Neurol. 2009;24(8):936–45.

    Article  PubMed  PubMed Central  Google Scholar 

  83. Sitnick SL, Goodlin-Jones BL, Anders TF. The use of actigraphy to study sleep disorders in preschoolers: some concerns about detection of nighttime awakenings. Sleep. 2008;31(3):395.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Malow BA, Adkins KW, Reynolds A, Weiss SK, Loh A, Fawkes D, et al. Parent-based sleep education for children with autism spectrum disorders. J Autism Dev Disord. 2014;44(1):216–28.

    Article  PubMed  Google Scholar 

  85. Adkins KW, Goldman SE, Fawkes D, Surdyka K, Wang L, Song Y, et al. A pilot study of shoulder placement for actigraphy in children. Behav Sleep Med. 2012;10(2):138–47.

    Article  PubMed  PubMed Central  Google Scholar 

  86. Cortesi F, Giannotti F, Ivanenko A, Johnson K. Sleep in children with autistic spectrum disorder. Sleep Med. 2010;11(7):659–64.

    Article  PubMed  Google Scholar 

  87. Johnson CR, Turner KS, Foldes E, Brooks MM, Kronk R, Wiggs L. Behavioral parent training to address sleep disturbances in young children with autism spectrum disorder: a pilot trial. Sleep Med. 2013;14(10):995–1004.

    Article  PubMed  PubMed Central  Google Scholar 

  88. Malow BA, Byars K, Johnson K, Weiss S, Bernal P, Goldman SE, et al. A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders. Pediatrics. 2012;130(Suppl 2):S106–S24.

    Article  PubMed  Google Scholar 

  89. 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(8):1043–52.

    Article  CAS  PubMed  Google Scholar 

  90. Johnson CR, DeMand A, Lecavalier L, Smith T, Aman M, Foldes E, et al. Psychometric properties of the children's sleep habits questionnaire in children with autism spectrum disorder. Sleep Med. 2016;20:5–11.

    Article  PubMed  Google Scholar 

  91. Katz T, Shui AM, Johnson CR, Richdale AL, Reynolds AM, Scahill L, et al. Modification of the children’s sleep habits questionnaire for children with autism spectrum disorder. J Autism Dev Disord. 2018;48(8):2629–41.

    Article  PubMed  Google Scholar 

  92. Wiggs L, Stores G. Sleep patterns and sleep disorders in children with autistic spectrum disorders: insights using parent report and actigraphy. Dev Med Child Neurol. 2004;46(6):372–80.

    Article  PubMed  Google Scholar 

  93. Johnson CR, Turner KS, Foldes EL, Malow BA, Wiggs L. Comparison of sleep questionnaires in the assessment of sleep disturbances in children with autism spectrum disorders. Sleep Med. 2012;13(7):795–801.

    Article  PubMed  PubMed Central  Google Scholar 

  94. Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The Sleep Disturbance Scale for Children (SDSC) construct ion and validation of an instrument to evaluate sleep disturbances in childhood and adolescence. J Sleep Res. 1996;5(4):251–61.

    Article  CAS  PubMed  Google Scholar 

  95. Schreck KA, Mulick JA, Rojahn J. Development of the behavioral evaluation of disorders of sleep scale. J Child Fam Stud. 2003;12(3):349–59.

    Article  Google Scholar 

  96. Malow BA, Crowe C, Henderson L, McGrew SG, Wang L, Song Y, et al. A sleep habits questionnaire for children with autism spectrum disorders. J Child Neurol. 2009;24(1):19–24.

    Article  PubMed  Google Scholar 

  97. Henderson JA, Jordan SS. Development and preliminary evaluation of the bedtime routines questionnaire. J Psychopathol Behav Assess. 2010;32(2):271–80.

    Article  Google Scholar 

  98. LeBourgeois MK, Giannotti F, Cortesi F, Wolfson AR, Harsh J. The relationship between reported sleep quality and sleep hygiene in Italian and American adolescents. Pediatrics. 2005;115(10):257.

    Article  PubMed  Google Scholar 

  99. Hering E, Epstein R, Elroy S, Iancu DR, Zelnik N. Sleep patterns in autistic children. J Autism Dev Disord. 1999;29(2):143–7.

    Article  CAS  PubMed  Google Scholar 

  100. Paavonen EJ, Nieminen-von Wendt T, Vanhala R, Aronen ET, von Wendt L. Effectiveness of melatonin in the treatment of sleep disturbances in children with Asperger disorder. J Child Adolesc Psychopharmacol. 2003;13(1):83–95.

    Article  PubMed  Google Scholar 

  101. Allik H, Larsson J-O, Smedje H. Health-related quality of life in parents of school-age children with Asperger syndrome or high-functioning autism. Health Qual Life Outcomes. 2006;4(1):1.

    Article  PubMed  PubMed Central  Google Scholar 

  102. Lambert A, Tessier S, Chevrier É, Scherzer P, Mottron L, Godbout R. Sleep in children with high functioning autism: polysomnography, questionnaires and diaries in a non-complaining sample. Sleep Med. 2013;14:e137–e8.

    Article  Google Scholar 

  103. Moore M, Evans V, Hanvey G, Johnson C. Assessment of sleep in children with autism spectrum disorder. Children. 2017;4(8):72.

    Article  PubMed Central  Google Scholar 

  104. Dayyat EA, Spruyt K, Molfese DL, Gozal D. Sleep estimates in children: parental versus actigraphic assessments. Nat Sci Sleep. 2011;3:115.

    PubMed  PubMed Central  Google Scholar 

  105. Beavers GA, Iwata BA, Lerman DC. Thirty years of research on the functional analysis of problem behavior. J Appl Behav Anal. 2013;46(1):1–21.

    Article  PubMed  Google Scholar 

  106. Kodak T, Piazza CC. Assessment and behavioral treatment of feeding and sleeping disorders in children with autism spectrum disorders. Child Adolesc Psychiatr Clin N Am. 2008;17(4):887–905.

    Article  PubMed  Google Scholar 

  107. McLay L, France K, Blampied N, Danna K, Hunter J. Using functional behavioral assessment to develop a multicomponent treatment for sleep problems in a 3-year-old boy with autism. Clin Case Stud. 2017;16(3):254–70.

    Article  Google Scholar 

  108. Jin CS, Hanley GP, Beaulieu L. An individualized and comprehensive approach to treating sleep problems in young children. J Appl Behav Anal. 2013;46(1):161–80.

    Article  PubMed  Google Scholar 

  109. Herrmann S. Counting sheep: sleep disorders in children with autism spectrum disorders. J Pediatr Health Care. 2016;30(2):143–54.

    Article  PubMed  Google Scholar 

  110. Nadeau JM, Arnold EB, Keene AC, Collier AB, Lewin AB, Murphy TK, et al. Frequency and clinical correlates of sleep-related problems among anxious youth with autism spectrum disorders. Child Psychiatry Hum Dev. 2015;46(4):558–66.

    Article  PubMed  Google Scholar 

  111. Williams S, Leader G, Mannion A, Chen J. An investigation of anxiety in children and adolescents with autism spectrum disorder. Res Autism Spectr Disord. 2015;10:30–40.

    Article  Google Scholar 

  112. Harder R, Malow BA, Goodpaster RL, Iqbal F, Halbower A, Goldman SE, et al. Heart rate variability during sleep in children with autism spectrum disorder. Clin Auton Res. 2016;26(6):423–32.

    Article  PubMed  PubMed Central  Google Scholar 

  113. Cohen S, Fulcher BD, Rajaratnam SM, Conduit R, Sullivan JP, St Hilaire MA, et al. Behaviorally-determined sleep phenotypes are robustly associated with adaptive functioning in individuals with low functioning autism. Sci Rep. 2017;7(1):14228.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  114. Duerden EG, Taylor MJ, Lee M, McGrath PA, Davis KD, Roberts SW. Decreased sensitivity to thermal stimuli in adolescents with autism spectrum disorder: relation to symptomatology and cognitive ability. J Pain. 2015;16(5):463–71.

    Article  PubMed  Google Scholar 

  115. Tzischinsky O, Meiri G, Manelis L, Bar-Sinai A, Flusser H, Michaelovski A, et al. Sleep disturbances are associated with specific sensory sensitivities in children with autism. Mol Autism. 2018;9(1):22.

    Article  PubMed  PubMed Central  Google Scholar 

  116. Malow BA, Byars K, Johnson K, Weiss S, Bernal P, Goldman SE, et al. A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders. Pediatrics. 2012;130(2):S106.

    Article  PubMed  Google Scholar 

  117. Spielman AJ, Caruso LS, Glovinsky PB. A behavioral perspective on insomnia treatment. Psychiatr Clin. 1987;10(4):541–53.

    CAS  Google Scholar 

  118. Goldman S, Alder M, Burgess H, Corbett B, Hundley R, Wofford D, et al. Characterizing sleep in adolescents and adults with autism spectrum disorders. J Autism Dev Disord. 2017;47(6):1682–95.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  119. Corkum P, Davidson FD, Tan-MacNeill K, Weiss SK. Sleep in children with neurodevelopmental disorders: a focus on insomnia in children with ADHD and ASD. Sleep Med Clin. 2014;9(2):149–68.

    Article  Google Scholar 

  120. Mannion A, Leader G. Sleep problems in autism spectrum disorder: a literature review. Rev J Autism Dev Disord. 2014;1(2):101–9.

    Article  Google Scholar 

  121. Hodge D, Parnell AM, Hoffman CD, Sweeney DP. Methods for assessing sleep in children with autism spectrum disorders: a review. Res Autism Spectr Disord. 2012;6(4):1337–44.

    Article  Google Scholar 

  122. Kirkpatrick B, Louw JS, Leader G. Efficacy of parent training incorporated in behavioral sleep interventions for children with autism spectrum disorder and/or intellectual disabilities: a systematic review. Sleep Med. 2019;53:141.

    Article  PubMed  Google Scholar 

  123. Cuomo BM, Vaz S, Lee EAL, Thompson C, Rogerson JM, Falkmer T. Effectiveness of sleep-based interventions for children with autism spectrum disorder: a meta-synthesis. Pharmacotherapy. 2017;37(5):555–78.

    Article  PubMed  Google Scholar 

  124. Loring WA, Johnston RL, Shui AM, Malow BA. Impact of a brief behavioral intervention for insomnia on daytime behaviors in adolescents with autism spectrum disorders. J Contemp Psychother. 2018;48(3):165–77.

    Article  Google Scholar 

  125. Papadopoulos N, Sciberras E, Hiscock H, Mulraney M, McGillivray J, Rinehart N. The efficacy of a brief behavioral sleep intervention in school-aged children with ADHD and comorbid autism spectrum disorder. J Atten Disord. 2019;23(4):341–50.

    Article  PubMed  Google Scholar 

  126. Bruni O, Angriman M, Calisti F, Comandini A, Esposito G, Cortese S, et al. Practitioner review: treatment of chronic insomnia in children and adolescents with neurodevelopmental disabilities. J Child Psychol Psychiatry. 2018;59(5):489–508.

    Article  PubMed  Google Scholar 

  127. Guénolé F, Godbout R, Nicolas A, Franco P, Claustrat B, Baleyte J-M. Melatonin for disordered sleep in individuals with autism spectrum disorders: systematic review and discussion. Sleep Med Rev. 2011;15(6):379–87.

    Article  PubMed  Google Scholar 

  128. Rossignol DA, Frye RE. Melatonin in autism spectrum disorders: a systematic review and meta-analysis. Dev Med Child Neurol. 2011;53(9):783–92.

    Article  PubMed  Google Scholar 

  129. Piravej K, Tangtrongchitr P, Chandarasiri P, Paothong L, Sukprasong S. Effects of Thai traditional massage on autistic children's behavior. J Altern Complement Med. 2009;15(12):1355–61.

    Article  PubMed  Google Scholar 

  130. Escalona A, Field T, Singer-Strunck R, Cullen C, Hartshorn K. Brief report: improvements in the behavior of children with autism following massage therapy. J Autism Dev Disord. 2001;31(5):513–6.

    Article  CAS  PubMed  Google Scholar 

  131. McCrae CS, Chan WS, Curtis AF, Deroche CB, Munoz M, Muckerman JE, et al. Cognitive behavioral treatment of insomnia in school-aged children with autism spectrum disorder: short report on preliminary findings. Autism Research. 2020;13:167–76. PMID: 31566918.

    Google Scholar 

  132. Andersen IM, Kaczmarska J, McGrew SG, Malow BA. Melatonin for insomnia in children with autism spectrum disorders. J Child Neurol. 2008;23(5):482–5.

    Article  PubMed  Google Scholar 

  133. Piazza CC, Hagopian LP, Hughes CR, Fisher WW. Using chronotherapy to treat severe sleep problems: a case study. Am J Ment Retard. 1997;102(4):358–66.

    Article  Google Scholar 

  134. Marcus CL, Brooks LJ, Ward SD, Draper KA, Gozal D, Halbower AC, et al. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics. 2012;130(3):e714–e55.

    Article  PubMed  Google Scholar 

  135. Hirata I, Mohri I, Kato-Nishimura K, Tachibana M, Kuwada A, Kagitani-Shimono K, et al. Sleep problems are more frequent and associated with problematic behaviors in preschoolers with autism spectrum disorder. Res Dev Disabil. 2016;49:86–99.

    Article  PubMed  Google Scholar 

  136. Kelmanson IA. Sleep disturbances and their associations with emotional/behavioural problems in 5-year-old boys with autism spectrum disorders. Early Child Dev Care. 2020;190:236–51.

    Article  Google Scholar 

  137. Kotagal S, Broomall E. Sleep in children with autism spectrum disorder. Pediatr Neurol. 2012;47(4):242–51.

    Article  PubMed  Google Scholar 

  138. Murata E, Mohri I, Kato-Nishimura K, Iimura J, Ogawa M, Tachibana M, et al. Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder. Res Dev Disabil. 2017;65:127–39.

    Article  PubMed  Google Scholar 

  139. Beebe DW, Gozal D. Obstructive sleep apnea and the prefrontal cortex: towards a comprehensive model linking nocturnal upper airway obstruction to daytime cognitive and behavioral deficits. J Sleep Res 2002;11(1):1–16.

    Google Scholar 

  140. Youssef J, Singh K, Huntington N, Becker R, Kothare SV. Relationship of serum ferritin levels to sleep fragmentation and periodic limb movements of sleep on polysomnography in autism spectrum disorders. Pediatr Neurol. 2013;49(4):274–8.

    Article  PubMed  Google Scholar 

  141. Tsai F-J, Chiang H-L, Lee C-M, Gau SS-F, Lee W-T, Fan P-C, et al. Sleep problems in children with autism, attention-deficit hyperactivity disorder, and epilepsy. Res Autism Spectr Disord. 2012;6(1):413–21.

    Article  Google Scholar 

  142. Lane R, Kessler R, Buckley AW, Rodriguez A, Farmer C, Thurm A, et al. Evaluation of periodic limb movements in sleep and iron status in children with autism. Pediatr Neurol. 2015;53(4):343–9.

    Article  PubMed  PubMed Central  Google Scholar 

  143. Dosman CF, Brian JA, Drmic IE, Senthilselvan A, Harford MM, Smith RW, et al. Children with autism: effect of iron supplementation on sleep and ferritin. Pediatr Neurol. 2007;36(3):152–8.

    Article  PubMed  Google Scholar 

  144. Laberge L, Tremblay RE, Vitaro F, Montplaisir J. Development of parasomnias from childhood to early adolescence. Pediatrics. 2000;106(1 PART 1):67–74.

    Article  CAS  PubMed  Google Scholar 

  145. Thirumalai SS, Shubin RA, Robinson R. Rapid eye movement sleep behavior disorder in children with autism. J Child Neurol. 2002;17(3):173–8.

    Article  PubMed  Google Scholar 

  146. Liu X, Hubbard JA, Fabes RA, Adam JB. Sleep disturbances and correlates of children with autism spectrum disorders. Child Psychiatry Hum Dev. 2006;37(2):179–91.

    Article  PubMed  Google Scholar 

  147. Lang R, White PJ, Machalicek W, Rispoli M, Kang S, Aquilar J, et al. Treatment of bruxism in individuals with developmental disabilities: a systematic review. Res Dev Disabil. 2009;30(5):809–18.

    Article  PubMed  Google Scholar 

  148. Adams HL, Matson JL, Cervantes PE, Goldin RL. The relationship between autism symptom severity and sleep problems: should bidirectionality be considered? Res Autism Spectr Disord. 2014;8(3):193–9.

    Article  Google Scholar 

  149. Mannion A, Leader G, Healy O. An investigation of comorbid psychological disorders, sleep problems, gastrointestinal symptoms and epilepsy in children and adolescents with autism spectrum disorder. Res Autism Spectr Disord. 2013;7(1):35–42.

    Article  Google Scholar 

  150. Park S, Cho S-C, Cho IH, Kim B-N, Kim J-W, Shin M-S, et al. Sleep problems and their correlates and comorbid psychopathology of children with autism spectrum disorders. Res Autism Spectr Disord. 2012;6(3):1068–72.

    Article  Google Scholar 

  151. Rzepecka H, McKenzie K, McClure I, Murphy S. Sleep, anxiety and challenging behaviour in children with intellectual disability and/or autism spectrum disorder. Res Dev Disabil. 2011;32(6):2758–66.

    Article  PubMed  Google Scholar 

  152. Fawkes DB, Malow BA, Weiss SK, Reynolds AM, Loh A, Adkins KW, et al. Conducting actigraphy research in children with neurodevelopmental disorders—a practical approach. Behav Sleep Med. 2015;13(3):181–96.

    Article  PubMed  Google Scholar 

  153. Sivan Y, Kornecki A, Schonfeld T. Screening obstructive sleep apnoea syndrome by home videotape recording in children. Eur Respir J. 1996;9(10):2127–31.

    Article  CAS  PubMed  Google Scholar 

  154. Moon EC, Corkum P, Smith IM. Case study: a case-series evaluation of a behavioral sleep intervention for three children with autism and primary insomnia. J Pediatr Psychol. 2010;36(1):47–54.

    Article  PubMed  Google Scholar 

  155. Roberts CA, Smith KC, Sherman AK. Comparison of online and face-to-face parent education for children with autism and sleep problems. J Autism Dev Disord. 2019;49:1410–22.

    Article  PubMed  Google Scholar 

  156. DeLeon IG, Fisher WW, Marhefka JM. Decreasing self-injurious behavior associated with awakening in a child with autism and developmental delays. Behav Inter Theory Pract Resid Commun Based Clin Prog. 2004;19(2):111–9.

    Google Scholar 

  157. Sanberg SA, Kuhn BR, Kennedy AE. Outcomes of a behavioral intervention for sleep disturbances in children with autism Spectrum disorder. J Autism Dev Disord. 2018;48(12):4250–77.

    Article  PubMed  Google Scholar 

  158. Delemere E, Dounavi K. Parent-implemented bedtime fading and positive routines for children with autism spectrum disorders. J Autism Dev Disord. 2018;48(4):1002–19.

    Article  PubMed  Google Scholar 

  159. Moore D, Cheng Y, McGrath P, Powell NJ. Collaborative virtual environment technology for people with autism. Focus Autism Other Dev Disabil. 2005;20(4):231–43.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Missouri-Columbia, Columbia, MO, USA

    Christina S. McCrae & Ashley F. Curtis

  2. Curry School of Education and Human Development, University of Virginia, Charlottesville, VA, USA

    Micah O. Mazurek & Rose Nevill

  3. Educational, School and Counseling Psychology, University of Missouri-Columbia, Columbia, MO, USA

    Mattina Davenport

  4. Curry School of Education, University of Virginia, Charlottesville, VA, USA

    Erica Fornaris Rouch

Authors
  1. Christina S. McCrae
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Micah O. Mazurek
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rose Nevill
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mattina Davenport
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Erica Fornaris Rouch
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ashley F. Curtis
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Christina S. McCrae .

Editor information

Editors and Affiliations

  1. MU Women’s and Children’s Hospital, University of Missouri, Columbia, MO, USA

    David Gozal

  2. Child Health Research Institute, University of Missouri System, Columbia, MO, USA

    Leila Kheirandish-Gozal

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

McCrae, C.S., Mazurek, M.O., Nevill, R., Davenport, M., Rouch, E.F., Curtis, A.F. (2021). Autism Spectrum Disorder. In: Gozal, D., Kheirandish-Gozal, L. (eds) Pediatric Sleep Medicine. Springer, Cham. https://doi.org/10.1007/978-3-030-65574-7_50

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-65574-7_50

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-65573-0

  • Online ISBN: 978-3-030-65574-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation