title: Treatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects.
abstract: 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.
authors.affiliation: Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA. tilfordmickj@uams.edu.|Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, AR, USA. tilfordmickj@uams.edu.
authors.forename: J Mick
authors.initials: JM
authors.lastname: Tilford
authors.affiliation: Division of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Nalin
authors.initials: N
authors.lastname: Payakachat
authors.affiliation: Department of Pediatrics, Harvard Medical School, Boston, MA, USA.|Center for Adolescent Health Policy, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Karen A
authors.initials: KA
authors.lastname: Kuhlthau
authors.affiliation: Center for Mental Healthcare and Outcomes Research, Central Arkansas Veterans Healthcare System and Psychiatric Research Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Pyne
authors.affiliation: Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Kovacs
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Jayne
authors.initials: J
authors.lastname: Bellando
authors.affiliation: Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: D Keith
authors.initials: DK
authors.lastname: Williams
authors.affiliation: Department of Health Policy and Management, Erasmus University, Rotterdam, The Netherlands.
authors.forename: Werner B F
authors.initials: WB
authors.lastname: Brouwer
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Frye
mesh_terms: D000328:Adult; D001321:Autistic Disorder / Q000150:complications / Q000188:drug therapy* / Q000628:therapy*; D001521:Behavior Therapy; D017028:Caregivers / Q000523:psychology*; D002648:Child; D017281:Cost of Illness; D003362:Cost-Benefit Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000627:therapeutic use*; D011446:Prospective Studies; D011788:Quality of Life; D019057:Quality-Adjusted Life Years; D012042:Registries; D012893:Sleep Wake Disorders / Q000150:complications / Q000188:drug therapy / Q000628:therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D008550:Melatonin
keywords: Autism spectrum disorder; Caregiver health; Child health; Child sleep habits; Cost-effectiveness analysis; Quality adjusted life year