Doctors Get Guidance On Treating Autism Sleep Problems
Newly released guidelines are aiming to help families and health care providers determine how to best address sleep problems plaguing many young people with autism.
The recommendations from the American Academy of Neurology published online this month in the journal Neurology offer a step-by-step approach.
“For children and teens with autism, sleep problems are more common and more likely to persist, resulting in poor health and poor quality of life,” said Ashura Williams Buckley of the National Institute of Mental Health and the lead author of the guidelines. “Some sleep problems may be directly related to autism, but others are not. Regardless, autism symptoms may make sleep problems worse.”
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The guidelines are based on a review of studies conducted through 2017 on autism and sleep problems in kids and teens. The recommendations address four types of issues — unwillingness to go to bed, difficulty falling asleep or staying asleep, getting too little sleep and behavior issues during the day stemming from insufficient sleep.
When children or teens with autism have sleep problems, doctors should first assess if the issues are caused by medications or other medical conditions, the American Academy of Neurology experts determined.
However, if the difficulties are believed to be more behavioral in nature, the neurology group recommends treatments including establishing a consistent sleep routine, selecting a bedtime that coincides with when the child typically gets sleepy and not using computers and other electronics close to bedtime.
If various strategies are not successful, the guidelines say that doctors should consider adding pharmaceutical-grade melatonin, an artificial form of a hormone that helps the brain know when to sleep. Melatonin use is safe in kids and teens with autism for up to three months, according to the recommendations, but more research is needed to assess longer-term use.
The neurology group notes in the guidelines that there is no evidence to support the routine use of weighted blankets or special mattress technologies to improve sleep for those with autism.
“Sleep problems can make behavioral issues in children and teens with autism even worse,” Williams Buckley said. “That’s why it is important for parents and caregivers to work with health care providers to find a way to improve a child’s sleep because we know that good quality sleep can improve overall health and quality of life in all children.”
In addition to the American Academy of Neurology, the guidelines are endorsed by the American Academy of Sleep Medicine, Autism Speaks, the Child Neurology Society and the Society for Developmental and Behavioral Pediatrics.