Medically reviewed by
Dacelin St Martin, MD
Triple board-certified in Sleep Medicine,
Internal Medicine, and Pediatrics.
The Study: Room for Discussion | Parameters of the Study in Question |
Collecting the Data | How to Improve an Autistic Child’s Sleep
Overview
Children with autistic spectrum disorders (ASD) typically have trouble sleeping. Experts have suggested that as many as 40-80 percent of children living with autism experience sleep abnormalities.[1]
Furthermore, many studies have shown that autism predisposes people to sleep troubles.[3,4] However, until recently, very few studies have elucidated the genetic component of the association between autistic spectrum disorders and sleep problems. A groundbreaking new study proves this association.[2]
This article will elaborate on the fantastic study and highlight how people living with autism can improve their sleep.
The Study: Room for Discussion
A group of Canadian scientists, collaborating with other renowned researchers globally, have demonstrated a genetic relationship between autism and sleep abnormalities.[2]
The researchers analyzed the genetic information of 5,860 autistic children and 2,092 of their healthy siblings from the Simons Simplex Collection (SSC) and MSSNG genetic repositories. Also, the research incorporated genetic data from 7,509 adolescents and adults from the wider population.
Subsequently, the genetic data of the participants who had autism were compared with the genetic information of their healthy siblings and other people to detect if there were significant differences.
The study’s findings revealed that children with autism had a higher frequency of copy number variants (CNVs) in 1,053 genes linked with insomnia and 312 genes that modulate the circadian cycle compared to their siblings unaffected by the disorder and the unrelated participants.[2]
Surprisingly, the study results indicated that only 39 percent of autistic participants experienced insomnia symptoms. Thomas Jongens, a professor of genetics at the University of Pennsylvania, commented that he was astonished that the study didn’t detect an increased frequency of sleep problems among the participants who have autism despite having an insomnia-associated genetic abnormality.
Parameters of the Study in Question
Some researchers believe a study design flaw was responsible for this unexpected finding. They suggested that the databases used for the analysis lacked the specific information necessary to identify changes in sleeping patterns.
The data was gleaned from questionnaires that focused on just one aspect of sleep — the total amount of time spent in bed — and ignored other elements, such as the duration of rapid-eye-movement (REM) sleep and the amount of time an individual gets up in the middle of the night.[2]
Lucia Peixoto, an assistant professor of translational medicine at Washington State University Spokane, said that any investigation of sleep-related problems needs to be conducted from various perspectives.
Peixoto explains, “The length of sleep by itself does not indicate insomnia. Even in our research with animal models, we have only seen a slight reduction in the amount of time spent sleeping.”
In addition, there needs to be more information in the databases about the methods the participants’ families may have tried to promote the sleep of their wards, such as taking melatonin supplements or staying away from screens in the evening. Jongens suggested that the parents of the participants with autism may have used some tried therapies to improve their wards’ sleep.
Furthermore, some experts have suggested that the genetic abnormalities detected in the study may not necessarily translate to sleep troubles.
Rackeb Tesfaye, who is one of the authors of the study, commented that there is a potential that circadian and insomnia genes contribute to autism in ways that are not directly related to sleep, as the circadian rhythm modulates many biological functions, including one’s cognitive functions and hormone production.
Tesfaye explains, “Circadian aberration at the gene level may be phenotypically associated with anything other than sleep,” she said.
Her hypothesis is indeed supported by the study’s findings, which show that the genes associated with an increased risk of insomnia are only moderately active in the hypothalamus, the brain region responsible for regulating sleep.
In contrast, these genes are significantly more involved in other locations in the brain. Also, this is corroborated by a recent study that indicates that insomnia-linked genetic mutations are more associated with psychiatric disorders than sleep problems.[7]
“The fact that the genes are pleiotropic—that is, they contribute to a variety of distinct traits—creates an intriguing but complicated scenario,” said Tesfaye.
Tesfaye also added that more research is needed to elucidate how these genes contribute to psychiatric and sleep conditions.
Collecting the Data
Olivia Veatch, assistant professor of psychiatry at the University of Kansas, opined that assessing insomnia in children based on parents’ reports is problematic.
Veatch explains, “When a parent reports that their child goes to bed at a given time and gets up at the same time, this does not necessarily suggest that they are aware of how long it took the child to fall asleep or how fragmented their child’s sleep was,” she said.
She suggested that actigraphy may help to clarify the degree of sleep troubles among people living with autism; however, she felt its use might be difficult for autistic patients.
“Using actigraphy, researchers have connected objectively poor sleep to genetic variations in individuals without autism.[8] However, it will be difficult to replicate this study in the autistic community,” Veatch said.
Finally, Tesfaye suggested that more research is needed to elucidate how the insomnia risk genes identified in their study contribute to psychiatric and sleep conditions.
How to Improve an Autistic Child’s Sleep
● Maintain a Relaxing Sleep Environment: An autistic child may have an easier time sleeping and staying asleep if they have access to familiar sleep aids, such as a soft blanket or a favorite stuffed animal. You can read your child a bedtime story to make them feel relaxed and ready for sleep. Try to keep this up every night. A relaxing bedtime routine always helps.[5]
● Reduce Environmental Noise: Children with autism may find the sounds of everyday household activities, such as the television, music, etc., over-stimulating or uncomfortable.[5] This noise can affect their sleep latency and make it difficult for them to sleep. Reducing these sounds when it is your child’s bedtime can improve sleep.
● Use Dim Lights: It’s not unusual for children and adolescents to fear the dark. However, an excessively bright light can keep your toddler or youngster from sleeping at night. In contrast, a dim light can benefit them.[5]
● Try Melatonin Supplements: Studies show that melatonin improves sleep for children with autism.[6] Typically, melatonin makes it easier for one to fall and stay asleep. You must see a sleep specialist before starting melatonin supplements.
References:
-
- Cortesi, F., Giannotti, F., Ivanenko, A., & Johnson, K. (2010). Sleep in children with autistic spectrum disorder. Sleep Medicine, 11(7), 659–664. https://doi.org/10.1016/j.sleep.2010.01.010
- Tesfaye, R., Huguet, G., Schmilovich, Z., Renne, T., Loum, M. A., Douard, E., Saci, Z., Jean-Louis, M., Martineau, J. L., Whelan, R., Desrivieres, S., Heinz, A., Schumann, G., Hayward, C., Elsabbagh, M., & Jacquemont, S. (2022). Investigating the contributions of circadian pathway and insomnia risk genes to autism and sleep disturbances. Translational Psychiatry, 12(1), 424. https://doi.org/10.1038/s41398-022-02188-2
- Hodge, D., Carollo, T. M., Lewin, M., Hoffman, C. D., & Sweeney, D. P. (2014). Sleep patterns in children with and without autism spectrum disorders: developmental comparisons. Research in Developmental Disabilities, 35(7), 1631–1638. https://doi.org/10.1016/j.ridd.2014.03.037
- Johnson, C. R., Turner, K. S., Foldes, E. L., Malow, B. A., & Wiggs, L. (2012). Comparison of sleep questionnaires in the assessment of sleep disturbances in children with autism spectrum disorders. Sleep Medicine, 13(7), 795–801. https://doi.org/10.1016/j.sleep.2012.03.005
- Richdale, A. L., & Schreck, K. A. (2019). Examining sleep hygiene factors and sleep in young children with and without autism spectrum disorder. Research in Autism Spectrum Disorders, 57, 154–162. https://doi.org/10.1016/j.rasd.2018.10.008
- Malow, B., Adkins, K. W., McGrew, S. G., Wang, L., Goldman, S. E., Fawkes, D., & Burnette, C. (2012). Melatonin for sleep in children with autism: a controlled trial examining dose, tolerability, and outcomes. Journal of Autism and Developmental Disorders, 42(8), 1729–1737; author reply 1738. https://doi.org/10.1007/s10803-011-1418-3
- Singla, R., Mishra, A., & Cao, R. (2022). The trilateral interactions between mammalian target of rapamycin (mTOR) signaling, the circadian clock, and psychiatric disorders: an emerging model. Translational Psychiatry, 12(1), 355. https://doi.org/10.1038/s41398-022-02120-8
- Jones, S.E., van Hees, V.T., Mazzotti, D.R. et al. (2019). Genetic studies of accelerometer-based sleep measures yield new insights into human sleep behaviour. Nat Commun 10, 1585 (2019). https://doi.org/10.1038/s41467-019-09576-1
