Practice Tools for Screening and Monitoring Insomnia in Children and Adolescents with Autism Spectrum Disorder

Tobias Banaschewski,Tobias Banaschewski,Tobias Banaschewski,Carmen Schroder,Maj-Britt Posserud,Allan Hvolby,Allan Hvolby,Oliviero Bruni,Joaquin Fuentes,Catherine Mary Hill,Catherine Mary Hill

doi:10.1007/s10803-021-05236-w

Abstract

Between 50–80% of children with autism spectrum disorder (ASD) have insomnia, which adversely affects their mental and physical health. However, there is no consensus to-date on suitable tools for insomnia screening and monitoring in daily clinical practice. An expert panel of child neuropsychiatry and sleep specialists, with expertise in children with neurodevelopmental disabilities, recommends: (1) performing insomnia screening of all children with ASD; (2) considering discussion or referral to a sleep specialist when comorbid sleep disorders are suspected. The panel further developed structured, brief screening and monitoring tools to facilitate insomnia screening and management in daily practice, monitor treatment effectiveness and standardize and compare outcomes across clinical settings to improve care and well-being of children with ASD and their families.

Highlights

Sleep is essential for optimal child development and health
It affects 1/54 live births according to the Centers for Disease Control and Prevention (CDC), and around 1/160 of all children worldwide, according to the World Health Organization (WHO) and numbers are growing
In children with autism spectrum disorder (ASD) the prevalence of insomnia is within the range of 41–86% (Goodlin-Jones et al, 2008; Miano et al, 2007; Richdale, 1999) and tends to persist (Lai et al, 2019; Richdale, 1999)

Summary

Introduction

Sleep is essential for optimal child development and health. According to consensus statements on the recommended sleep duration by age, children and adolescents need more sleep than adults (Hirshkowitz et al, 2015; Morgenthaler et al, 2006; Paruthi et al, 2016). A clinical practice pathway, developed by the Autism Treatment Network (ATN) in association with the National Initiative for Children’s Healthcare Quality (NICHQ), emphasized the need for screening of sleep problems in ASD when seen by a non-sleep specialist (e.g. general pediatrician, primary care provider, child and adolescent neuro-psychiatrist, or autism medical specialist) (Malow et al, 2012).

Results

Conclusion