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


CONCLUSIONS
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.
Allik
Hiie
H
Karolinska Institutet, Dept. of Woman and Child Health, Child and Adolescent Psychiatric Unit, Astrid Lindgren Children's Hospital, SE-171 76 Stockholm, Sweden. Hiie.Allik@ki.se
Larsson
Jan-Olov
JO
Smedje
Hans
H
D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D020817:Asperger Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D001321:Autistic Disorder / Q000175:diagnosis / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002652:Child Behavior / Q000502:physiology; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D015897:Comorbidity; D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000706:statistics & numerical data; D008297:Male; D008499:Medical Records; D010290:Parents / Q000523:psychology; D015995:Prevalence; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D011795:Surveys and Questionnaires; D013663:Teaching / Q000706:statistics & numerical data