The Relationship between Sleep Problems, Neurobiological Alterations, Core Symptoms of Autism Spectrum Disorder, and Psychiatric Comorbidities

J. Clin. Med. 2018, 7(5)

Abstract

Children with Autism Spectrum Disorder (ASD) are at an increased risk for sleep disturbances, and studies indicate that between 50 and 80% of children with ASD experience sleep problems. These problems increase parental stress and adversely affect family quality of life. Studies have also suggested that sleep disturbances may increase behavioral problems in this clinical population. Although understanding the causes of sleep disorders in ASD is a clinical priority, the causal relationship between these two conditions remains unclear. Given the complex nature of ASD, the etiology of sleep problems in this clinical population is probably multi-factorial. In this overview, we discuss in detail three possible etiological explanations of sleep problems in ASD that can all contribute to the high rate of these symptoms in ASD. Specifically, we examine how neurobiological alterations, genetic mutations, and disrupted sleep architecture can cause sleep problems in individuals with ASD. We also discuss how sleep problems may be a direct result of core symptoms of ASD. Finally, a detailed examination of the relationship between sleep problems and associated clinical features and psychiatric comorbidities in individuals with ASD is described. Read more…

Conclusions

Studies have highlighted that children with ASD often experience sleep problems. However, the relationship between these conditions still remains unclear. Sleep disturbances may also contribute to stress in families of children with ASD, and may also worsen problem behaviors in this clinical population [96]. Therefore, understanding the possible etiological causes of sleep problems is a clinical priority. Clinicians should be aware that, given the complex nature of ASD, the etiology of sleep problems in ASD is probably multi-factorial. In this overview, we discussed in detail three possible etiological explanations of sleep problems in ASD that can all contribute to the high rate of these symptoms in ASD. Future research using objective measure of sleep could help to shed light on the relationship between these two conditions. Longitudinal studies that could identify patterns of sleep and could discern between the bidirectional impaction of sleep problems and associated clinical features and psychiatric comorbidities in individuals with ASD are needed. Finally, these researchers could help to develop and identify the most appropriate intervention and treatment strategies.