Abstract
Although there is evidence that significant sleep problems are common in children with autism spectrum disorder (ASD) and that poor sleep exacerbates problematic daytime behavior, such relationships have received very little attention in both research and clinical practice. Treatment guidelines to help manage challenging behaviors in ASD fail to mention sleep at all, or they present a very limited account. Moreover, limited attention is given to children with low-functioning autism, those individuals who often experience the most severe sleep disruption and behavioral problems. This paper describes the nature of sleep difficulties in ASD and highlights the complexities of sleep disruption in individuals with low-functioning autism. It is proposed that profiling ASD children based on the nature of their sleep disruption might help to understand symptom and behavioral profiles (or vice versa) and therefore lead to better-targeted interventions. This paper concludes with a discussion of the limitations of current knowledge and proposes areas that are important for future research. Treating disordered sleep in ASD has great potential to improve daytime behavior and family functioning in this vulnerable population.
Highlights
There is evidence that significant sleep problems are common in children with autism spectrum disorder (ASD) and that poor sleep exacerbates problematic daytime behavior, such relationships have received very little attention in both research and clinical practice
Other researchers have shown that individuals with low-functioning autism have a higher predisposition to chronic sleep-wake cycle disturbances when compared to higher-functioning individuals, given the degree and severity of their cognitive impairment [17]
Conclusions there is reason to believe that serious sleep problems are common in children with ASD and that poor sleep exacerbates problematic daytime behavior, these conclusions are still premature and require further investigation
Summary
Fewer hours of sleep per night predicted ASD severity score, social skill deficit, and stereotypic behavior. Areas for further research previous studies have identified clear relationships between poor sleep and challenging behaviors in ASD, as reviewed above, it is still unclear what specific sleep problems and symptom relationships are unique to individuals with low-functioning autism. Given that the National Sleep Foundation [79] identifies children with ASD as one of the highest priority populations for sleep research, there is a need for more accurate, objective, noninvasive measures of sleep, as well as data from children with low-functioning autism in order to better characterize the quality and quantity of sleep in this population Another key limitation of the research to date is that very few studies examine behavioral problems and sleep disturbances in ASD longitudinally, with most studies being cross-sectional. It is proposed that profiling ASD children based on the nature of their sleep disruption might help understand symptom and behavioral profiles (or vice versa) and lead to bettertargeted interventions
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