KensLogo Full 2
Search
Close this search box.

Autism and Sleep Problems

Autism and Sleep Problems

Sleep disturbances are common in children with Autism Spectrum Disorder (ASD), with prevalence ranging from 40-80%. Insomnia, characterized by difficulties falling asleep and early morning awakening, is a common sleep disorder in ASD. These sleep issues can persist into adulthood and worsen daytime behavior and social skills deficits. The causes of sleep disturbances in autism are complex and involve various factors such as genetics, physiology, neurology, psychology, and environment.

One factor that may contribute to sleep disturbances in ASD is the abnormal functioning of the hypothalamic-pituitary-adrenal (HPA) axis, which regulates circadian rhythms. This abnormality can lead to decreased melatonin production, affecting sleep in individuals with ASD. The pre-optic area of the hypothalamus, a part of the HPA axis, plays a key role in promoting sleep. It is extensively GABA-ergic, meaning it uses GABA as a neurotransmitter. Impaired GABA-ergic neuronal migration and maturation have been observed in children with ASD, which can lead to reduced arousal as a result of HPA-axis-brainstem dysfunction.

Children with ASD have been found to have impaired melatonin homeostasis and reduced melatonin levels at night. The degree of melatonin dysregulation correlates with the severity of ASD symptoms. Mutations in the ASMT gene, found on the sex chromosomes, have been linked to melatonin dysregulation in ASD. Comorbid psychiatric conditions like anxiety, mood, or attention-deficit/hyperactivity disorders can also negatively impact sleep in children with ASD.

Proper evaluation is necessary to identify the causes of sleep issues in ASD children and rule out physiological and environmental factors. Establishing a consistent bedtime routine may help improve sleep patterns in some ASD children. Environmental cues, such as sound and texture, can affect the sleep of ASD children who may be hypersensitive. Trying suitable pyjama/bedding texture and weight, and eliminating outdoor noises can contribute to better sleep. Continuous soothing sounds like white noise may induce calmness and sleep in some ASD children.

If behavioral changes do not improve sleep, medications like clonidine may be prescribed to reduce sleep latency and awakenings. Melatonin supplementation with 3-6mg has a positive effect on sleep in children with ASD. It works by modulating the HPA-axis and serotonin pathways within the central nervous system. This effect is particularly seen in children with the ASMT mutation. Overall, addressing sleep problems in children with ASD is crucial for their overall well-being and daily functioning.

Sources

Further Reading

Last Updated: Feb 18, 2019

Link to Original Article

Psychologist

Dr. Kenneth Roberson

Dr. Kenneth Roberson is an Adult Autism Psychologist in San Francisco with over 30 years of experience. Click below to ask a question or schedule an appointment.

The Essential Guide

book cover KR

ADULT ASPERGER’S SYNDROME: THE ESSENTIAL GUIDE

Are you looking for a reference guide about Asperger’s in adults?

Do you have questions you’d like to ask an expert in adult Asperger’s?

Download a Chapter for Free!