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Review
. 2023 Jul-Dec;23(12):1261-1276.
doi: 10.1080/14737175.2023.2267761. Epub 2023 Dec 15.

Using pharmacotherapy to address sleep disturbances in autism spectrum disorders

Valeria Mammarella  1 , Silvia Orecchio  1 , Noemi Cameli  1 , Sara Occhipinti  1 , Lavinia Marcucci  1 , Giuliano De Meo  1 , Alice Innocenti  1 , Raffaele Ferri  2 , Oliviero Bruni  3
Affiliations
Review

Using pharmacotherapy to address sleep disturbances in autism spectrum disorders

Valeria Mammarella et al. Expert Rev Neurother. 2023 Jul-Dec.

Abstract

Introduction: Sleep disorders are the second most common medical comorbidity in autism spectrum disorder (ASD), with effects on daytime behavior and functioning, mood and anxiety, and autism core features. In children with ASD, insomnia also has a negative impact on the whole family's quality of life. Therefore, treatment of sleep disturbances should be considered as a primary goal in the management of ASD patients, and it is important to clarify the scientific evidence to inappropriate treatments.

Areas covered: The authors review the current literature concerning the pharmacological treatment options for the management of sleep-related disorders in patients with ASD (aged 0-18 years) using the PubMed and Cochrane Library databases with the search terms: autism, autistic, autism spectrum disorder, ASD, drug, drug therapy, drug intervention, drug treatment, pharmacotherapy, pharmacological treatment, pharmacological therapy, pharmacological intervention, sleep, sleep disturbance, and sleep disorder.

Expert opinion: Currently, clinicians tend to select medications for the treatment of sleep disorders in ASD based on the first-hand experience of psychiatrists and pediatricians as well as expert opinion. Nevertheless, at the present time, the only compound for which there is sufficient evidence is melatonin, although antihistamines, trazodone, clonidine, ramelteon, gabapentin, or suvorexant can also be considered for selection.

Keywords: Autism; children; drugs; melatonin; neurodevelopmental disorders; sleep disorders.

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