title: Prevalence of Diagnosed Sleep Disorders and Related Diagnostic and Surgical Procedures in Children with Autism Spectrum Disorders.
abstract: Sleep disorders are common and important comorbid conditions in children with autism spectrum disorder (ASD) and can contribute to cognitive and behavioral problems. Sleep-disordered breathing (SDB) is a diagnosable and treatable cause of behavioral problems in children. We aimed to quantify the relative risk for children with ASD versus controls of being diagnosed with sleep disorders including SDB and undergoing related diagnostic and surgical procedures.
  
  
  
  This retrospective case-cohort study included 48,762 children with ASD aged 2 to 18 years enrolled in the military health system (MHS) from 2000 to 2013. Children with ASD were matched 1:5 by birthdate, sex, and enrollment time to children without an ASD diagnosis. The MHS database was queried for International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for sleep disorders or ICD-9-CM and Current Procedural Terminology codes for diagnostic and surgical procedures. Relative risks (RR) and 95% confidence intervals (CI) were determined with binary Poisson regression conditional on the match and adjusting for confounders.
  
  
  
  Children with ASD were at higher risk of receiving any sleep disorder diagnosis (RR: 1.97 [95% CI, 1.91-2.02]) including SDB (RR: 1.96 [95% CI, 1.88-2.05]). Children with ASD also were at increased risk of undergoing polysomnography (RR: 3.74 [95% CI, 3.56-3.93]) and sleep disorder-related surgery (RR: 1.50 [95% CI, 1.46-1.54]).
  
  
  
  Children with ASD are more likely to be given a sleep disorder diagnosis including SDB and are more likely to undergo related diagnostic and surgical procedures compared with controls without ASD.
authors.affiliation: *Developmental-Behavioral Pediatrics Department, Madigan Army Medical Center, Joint Base Lewis McChord, WA; †Pediatric Department, Uniformed Services University, Bethesda, MD; ‡Pediatric Otolaryngology Department, Madigan Army Medical Center, Joint Base Lewis McChord, WA; §Pediatric Department, Pediatric Subspecialty Services, Walter Reed National Military Medical Center, Bethesda, MD.
authors.forename: Marilisa G
authors.initials: MG
authors.lastname: Elrod
authors.forename: Cade M
authors.initials: CM
authors.lastname: Nylund
authors.forename: Apryl L
authors.initials: AL
authors.lastname: Susi
authors.forename: Gregory H
authors.initials: GH
authors.lastname: Gorman
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hisle-Gorman
authors.forename: Derek J
authors.initials: DJ
authors.lastname: Rogers
authors.forename: Christine
authors.initials: C
authors.lastname: Erdie-Lalena
mesh_terms: D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography / Q000706:statistics & numerical data*; D015995:Prevalence; D012189:Retrospective Studies; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery; D013514:Surgical Procedures, Operative / Q000706:statistics & numerical data*