title: Sleep in children with autistic spectrum disorder: a questionnaire and polysomnographic study.
abstract: OBJECTIVE
  To evaluate sleep in children with autistic spectrum disorder (ASD) by means of sleep questionnaires and polysomnography; moreover, to analyze their cyclic alternating pattern (CAP).
  
  
  METHODS
  Thirty-one patients with ASD (28 males, 3 females, aged 3.7-19 years) and age-matched normal controls were included. ASD children were evaluated by a standard sleep questionnaire that consisted of 45 items in a Likert-type scale covering several areas of sleep disorders and by overnight polysomnography in the sleep laboratory after one adaptation night.
  
  
  RESULTS
  The questionnaire results showed that parents of ASD children reported a high prevalence of disorders of initiating and maintaining sleep, enuresis, repetitive behavior when falling asleep, and daytime sleepiness. Polysomnographically, ASD children showed reduced time in bed, total sleep time, sleep period time and rapid eye movement (REM) latency. ASD subjects had a CAP rate during slow-wave sleep (SWS) lower than normal controls, together with a lower percentage of A1 subtypes.
  
  
  CONCLUSIONS
  ASD children questionnaires showed a higher percentage of disorders of initiating and maintaining sleep than normal controls; this was not completely confirmed by sleep staging. CAP measures showed subtle alterations of NREM sleep which could be detected with an appropriate methodology of analysis. The reduction of A1 subtypes during SWS might play a role in the impairment of cognitive functioning in these subjects.
authors.affiliation: Department of Neurology, Sleep Research Centre, Oasi Institute for Research on Mental Retardation and Brain Aging (IRCCS), Via C. Ruggero 73, 94018 Troina, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Miano
authors.forename: Oliviero
authors.initials: O
authors.lastname: Bruni
authors.forename: Maurizio
authors.initials: M
authors.lastname: Elia
authors.forename: Alessia
authors.initials: A
authors.lastname: Trovato
authors.forename: Arianna
authors.initials: A
authors.lastname: Smerieri
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Verrillo
authors.forename: Michele
authors.initials: M
authors.lastname: Roccella
authors.forename: Mario G
authors.initials: MG
authors.lastname: Terzano
authors.forename: Raffaele
authors.initials: R
authors.lastname: Ferri
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D001321:Autistic Disorder / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D010287:Parent-Child Relations; D017286:Polysomnography; D020178:Sleep Disorders, Circadian Rhythm / Q000175:diagnosis* / Q000453:epidemiology*; D012894:Sleep Stages / Q000502:physiology; D012895:Sleep, REM / Q000502:physiology; D011795:Surveys and Questionnaires