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. 2021 Feb;30(1):25-35.
Epub 2021 Feb 1.

The Assessment and Treatment of Sleep Abnormalities in Children and Adolescents with Autism Spectrum Disorder: A Review

Affiliations

The Assessment and Treatment of Sleep Abnormalities in Children and Adolescents with Autism Spectrum Disorder: A Review

Mandeep Rana et al. J Can Acad Child Adolesc Psychiatry. 2021 Feb.

Abstract

Objective: To summarize causes, evaluation methods, and treatment of sleep disturbance in children and adolescents with autism spectrum disorder (ASD).

Methods: A narrative literature and synthesis approach was used.

Results/discussion: Sleep disturbances in this population are common and include insomnia, parasomnias, circadian rhythm disorders, and sleep-related movement disorders. Multiple factors may contribute to the higher rates of sleep disturbances in persons with ASD. Unfortunately, there are not evidence-based guidelines specific for the management of these sleep disorders in this population. There is also a lack of controlled clinical studies. Nevertheless, assessment of sleep problems using both subjective and objective methods are recommended to develop an individualized approach. Behavioural interventions are preferred first line treatment for insomnia. As adjunctive measures, pharmacotherapy may be warranted and choice should be guided based on accompanying symptoms. The most commonly used pharmacotherapy for sleep disturbance, primarily insomnia, include melatonin and alpha agonists. Not all currently used medications are approved for use for children and adolescents.

Objectif: Résumer les causes, les méthodes d’évaluation et de traitement des troubles du sommeil chez les enfants et les adolescents souffrant du trouble du spectre de l’autisme (TSA).

Méthodes: une littérature narrative et une approche de synthèse ont été utilisées.

Résultats/discussion: les troubles du sommeil dans cette population sont communs et comprennent l’insomnie, la parasomnie, les perturbations du rythme circadien, et le trouble du mouvement lié au sommeil. De multiples facteurs peuvent contribuer aux taux élevés de troubles du sommeil chez les personnes souffrant du TSA. Malheureusement il n’existe pas de directives fondées sur des données probantes pour la prise en charge de ces troubles du sommeil dans cette population. Il manque également des études cliniques contrôlées. Néanmoins, l’évaluation des troubles de sommeil à l’aide de méthodes tant subjectives qu’objectives est recommandée pour développer une approche individualisée. Les interventions comportementales sont le traitement de première intention préféré pour l’insomnie. La pharmacothérapie des mesures d’appoint peut être justifiée et le choix devrait être basé sur les symptômes accompagnateurs. La pharmacothérapie la plus utilisée pour les troubles du sommeil, surtout l’insomnie, comprend la mélatonine et les alpha-agonistes. Les médicaments couramment en usage ne sont pas tous approuvés à utiliser pour les enfants et les adolescents.

Keywords: autism spectrum disorder; evaluation; melatonin; mélatonine; sleep disturbance; trouble du spectre de l’autisme; évaluation des troubles du sommeil.

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Conflict of interest statement

Conflicts of Interest The authors have no financial relationships to disclose.

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