Treatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects

J Autism Dev Disord. 2015 Nov;45(11):3613-23. doi: 10.1007/s10803-015-2507-5.


Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N = 224) was conducted with registry and postal survey data completed by the primary caregiver. We calculated quality of life outcomes for the child and the primary caregiver associated with treatments to improve sleep in the child based on prior clinical trials. Predicted treatment effects for melatonin and behavioral interventions were similar in magnitude for the child and for the caregiver. Accounting for caregiver spillover effects associated with treatments for the child with ASD increases treatment benefits and improves cost-effectiveness profiles.

Keywords: Autism spectrum disorder; Caregiver health; Child health; Child sleep habits; Cost-effectiveness analysis; Quality adjusted life year.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Autistic Disorder / complications
  • Autistic Disorder / drug therapy*
  • Autistic Disorder / therapy*
  • Behavior Therapy*
  • Caregivers / psychology*
  • Child
  • Cost of Illness
  • Cost-Benefit Analysis
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Melatonin / therapeutic use*
  • Prospective Studies
  • Quality of Life
  • Quality-Adjusted Life Years
  • Registries*
  • Sleep Wake Disorders / complications
  • Sleep Wake Disorders / drug therapy
  • Sleep Wake Disorders / therapy*
  • Surveys and Questionnaires
  • Young Adult


  • Melatonin