Treatment strategies for complex behavioral insomnia in children with neurodevelopmental disorders.
OBJECTIVE
This review describes recent research in pediatric behavioral insomnias in neurodevelopmental disorders and their treatment.


RESULTS
Insomnia in children with autism spectrum disorder (ASD) and other neurodevelopmental disorders (NDDs) is typically complex, chronic, and difficult to adequately control. Abnormalities in genetic and/or epigenetic regulation of sleep/wakefulness and its timing predispose patients with NDD to insomnia, although poor sleep hygiene, maladaptive associations, and limit-setting are likely to contribute. Parents are agents for change in problematic sleep behaviors in patients with NDD. We review the benefits of behavioral therapies and melatonin to treat sleep problems in children with NDD. Problematic sleep is so prevalent in some neurodevelopmental syndromes (Rett, Angelman, Williams, and Smith-Magenis) that it is part of their diagnostic criteria.


CONCLUSIONS
Children and adolescents with neurological disorders frequently have complex sleep disorders that require treatment. Understanding the basic pathology and treatment strategies provides an opportunity to improve well being and quality of life in those affected by NDD and their families.
aDepartment of Neurology, University of New Mexico School of Medicine bPediatric Sleep Medicine Services, University Hospital Sleep Disorders Center cClinical Neurodiagnostic Laboratory, University of New Mexico Medical Center dDepartment of Internal Medicine eAdult Sleep Medicine Services fProgram in Sleep Medicine, University of New Mexico Hospital Sleep Disorders Center, Albuquerque, New Mexico, USA.
Madeleine
M
Grigg-Damberger
Frank
F
Ralls
D017204:Angelman Syndrome / Q000175:diagnosis; D002492:Central Nervous System Depressants / Q000627:therapeutic use*; D002648:Child; D002659:Child Development Disorders, Pervasive / Q000150:complications / Q000523:psychology / Q000628:therapy*; D002675:Child, Preschool; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000008:administration & dosage / Q000627:therapeutic use*; D010290:Parents; D011788:Quality of Life / Q000523:psychology; D015518:Rett Syndrome / Q000175:diagnosis; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D058496:Smith-Magenis Syndrome / Q000175:diagnosis; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D018980:Williams Syndrome / Q000175:diagnosis
D002492:Central Nervous System Depressants; D008550:Melatonin