Prevalence, etiology, and treatment of sleep disorders in autism spectrum disorder
Chang, Bryant Duy
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BACKGROUND: Autism Spectrum Disorder is a range of neurodevelopmental disorders that typical manifest as social deficits, delayed or impaired communication skills, and repetitive behaviors in day-to-day life. Patients with Autism Spectrum Disorder (ASD) often present with other concurrent clinical disorders. Sleep disorders (SD) and sleep issues are highly prevalent in ASD children and rank as one of the most common concurrent clinical disorders. Prevalence rates vary widely, ranging from 40 to 80 percent, as compared with that of typically developing children in which prevalence rates are approximately 30 percent. Sleep problems can have an impact on daytime health and may result in neurocognitive dysfunction and behavioral disruptions. A cyclical pattern arises: individuals with autism are observed to have sleep difficulties, which may exacerbate autistic traits, which can in turn further worsen their quality of sleep. Therefore, sleep disorders may have wide ranging effects on daytime functioning, developmental progress, and quality of life for children with ASD. OBJECTIVES: The purpose of this thesis is to provide a review of the research status of ASD, SD, the interplay between these two disorders, and therapeutic interventions that have been researched or are currently being investigated. A goal of this thesis is also to recommend areas of future investigation based on the current state of autism research. METHODS: A literature review of studies, abstracts, and clinical trial data relating to ASD, SD, and other comorbidities observed in ASD was performed. CONCLUSION: Current models and theories on the relationship between ASD and SD suggest that the underlying etiology of autism itself may contribute to sleep troubles, and might even have wide-reaching impacts on other unrelated aspects of ASD. Gastrointestinal, otolaryngologic, and psychiatric comorbidities are observed in autism and may affect sleep in these patients, but the mechanism by which this occurs is unclear. There are many treatments for sleep troubles in ASD such as melatonin and behavioral interventions, with varying success. Much work is required to understand the underlying mechanism between both autism and sleep disorders. There is also a need for more efficacious therapeutic interventions, but there are multiple clinical trials underway which may have promising results. Future studies should also incorporate robust data-collection instruments such as polysomnography to validate findings.