title: Sleep Difficulties and Medications in Children With Autism Spectrum Disorders: A Registry Study.
abstract: Sleep difficulties are common in children with autism spectrum disorders, with wide-ranging effects on the child's daytime behavior. We reviewed data within our Autism Speaks Autism Treatment Network Registry to determine the prevalence of sleep difficulties and patterns of medication use.
  
  
  
  Data from 1518 children ages 4 to 10 years were analyzed to determine the number of children documented to have sleep difficulties by parent-completed questionnaires and clinician-completed forms and how these findings related to the use of sleep medications.
  
  
  
  The Children's Sleep Habits Questionnaire total score was ≥41 (associated with clinically significant sleep problems in past research) in 71% of children. The prevalence of sleep diagnoses was less frequent (30% of children aged 4-10 years; P < .0001). Medications for sleep were prescribed in 46% of 4- to 10-year-olds given a sleep diagnosis. The most common medication used for sleep was melatonin followed by α-agonists, with a variety of other medications taken for sleep (anticonvulsants, antidepressants, atypical antipsychotics, and benzodiazepines). Children taking medications for sleep had worse daytime behavior and pediatric quality of life than children not taking sleep medications.
  
  
  
  Parent concerns about sleep may not be reflected in the information gathered during a clinic visit, supporting the need to develop screening practice pathways for sleep in autism spectrum disorders. Furthermore, many medications taken for sleep have adverse effects, supporting the need for evidence-based interventions in this population.
authors.affiliation: Sleep Disorders Division, Department of Neurology, Vanderbilt University School of Medicine, Nashville, Tennessee; beth.malow@vanderbilt.edu.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Malow
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado;
authors.forename: Terry
authors.initials: T
authors.lastname: Katz
authors.affiliation: Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado;
authors.forename: Ann M
authors.initials: AM
authors.lastname: Reynolds
authors.affiliation: Biostatistics Center, Massachusetts General Hospital, Boston, Massachusetts;
authors.forename: Amy
authors.initials: A
authors.lastname: Shui
authors.affiliation: Department of Pediatrics, University of Rochester, Rochester, New York;
authors.forename: Margaret
authors.initials: M
authors.lastname: Carno
authors.affiliation: Department of Pediatrics, University of Rochester, Rochester, New York;
authors.forename: Heidi V
authors.initials: HV
authors.lastname: Connolly
authors.affiliation: Department of Pediatrics, Nationwide Children's Hospital, Columbus, Ohio; and.
authors.forename: Daniel
authors.initials: D
authors.lastname: Coury
authors.affiliation: Department of Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
authors.forename: Amanda E
authors.initials: AE
authors.lastname: Bennett
mesh_terms: D000067877:Autism Spectrum Disorder / Q000150:complications* / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D004363:Drug Utilization; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D012042:Registries; D007319:Sleep Initiation and Maintenance Disorders / Q000150:complications* / Q000188:drug therapy / Q000453:epidemiology; D011795:Surveys and Questionnaires