Insomnia in school-age children with Asperger syndrome or high-functioning autism

BMC Psychiatry. 2006 Apr 28;6:18. doi: 10.1186/1471-244X-6-18.

Abstract

Background: Asperger syndrome (AS) and high-functioning autism (HFA) are pervasive developmental disorders (PDD) in individuals of normal intelligence. Childhood AS/HFA is considered to be often associated with disturbed sleep, in particular with difficulties initiating and/or maintaining sleep (insomnia). However, studies about the topic are still scarce. The present study investigated childhood AS/HFA regarding a wide range of parent reported sleep-wake behaviour, with a particular focus on insomnia.

Methods: Thirty-two 8-12 yr old children with AS/HFA were compared with 32 age and gender matched typically developing children regarding sleep and associated behavioural characteristics. Several aspects of sleep-wake behaviour including insomnia were surveyed using a structured paediatric sleep questionnaire in which parents reported their children's sleep patterns for the previous six months. Recent sleep patterns were monitored by use of a one-week sleep diary and actigraphy. Behavioural characteristics were surveyed by use of information gleaned from parent and teacher-ratings in the High-Functioning Autism Spectrum Screening Questionnaire, and in the Strengths and Difficulties Questionnaire.

Results: Parent-reported difficulties initiating sleep and daytime sleepiness were more common in children with AS/HFA than in controls, and 10/32 children with AS/HFA (31.2%) but none of the controls fulfilled our definition of paediatric insomnia. The parent-reported insomnia corresponded to the findings obtained by actigraphy. Children with insomnia had also more parent-reported autistic and emotional symptoms, and more teacher-reported emotional and hyperactivity symptoms than those children without insomnia.

Conclusion: Parental reports indicate that in childhood AS/HFA insomnia is a common and distressing symptom which is frequently associated with coexistent behaviour problems. Identification and treatment of sleep problems need to be a routine part of the treatment plan for children with AS/HFA.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Affective Symptoms / diagnosis
  • Affective Symptoms / epidemiology
  • Affective Symptoms / psychology
  • Asperger Syndrome / diagnosis
  • Asperger Syndrome / epidemiology*
  • Asperger Syndrome / psychology
  • Autistic Disorder / diagnosis
  • Autistic Disorder / epidemiology*
  • Autistic Disorder / psychology
  • Child
  • Child Behavior / physiology
  • Child Behavior Disorders / diagnosis
  • Child Behavior Disorders / epidemiology
  • Child Behavior Disorders / psychology
  • Comorbidity
  • Female
  • Humans
  • International Classification of Diseases / statistics & numerical data
  • Male
  • Medical Records
  • Parents / psychology
  • Prevalence
  • Psychiatric Status Rating Scales / statistics & numerical data
  • Sleep Initiation and Maintenance Disorders / diagnosis*
  • Sleep Initiation and Maintenance Disorders / epidemiology
  • Sleep Initiation and Maintenance Disorders / psychology
  • Surveys and Questionnaires
  • Teaching / statistics & numerical data