Sleep disorders in autistic children linked to behavioral regulation problems | Spectrum

Costs of lost sleep: Children with autism are prone to persistent sleep problems, which can affect their executive function.

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Sleep problems in young children with autism are associated with behavior regulation difficulties later in childhood, according to a new longitudinal study.

The discovery underscores the importance of helping families solve sleep problems in their young children with autism, says lead researcher Mayada Elsabbagh, associate professor of neurology and neurosurgery at McGill University in Montreal, Canada.

Beyond the well-established importance of high-quality sleep for general health, providing support and therapy to improve sleep quality in children with autism may also help them develop better behavioral regulation as they grow older. ‘they grow up, she adds.

“What’s exciting about this study… maybe it suggests some areas of focus,” says Annette Estes, professor of speech and hearing sciences at the University of Washington in Seattle, who did not participate in the study. Estes has previously suggested that sleep disturbances in early childhood could hamper healthy brain development and thus contribute to autism.

The study is one of the first to directly examine a long-suspected link between sleep quality in children with autism and executive function, a set of mental skills that includes the ability to monitor one’s own behavior to achieve goals. “This provides further confirmation of the idea that these neural systems are linked,” explains Elsabbagh.

In children without autism, sleep disorders usually go away in the first few years of life. And in these children, poor sleep is linked to poor executive function.

This connection and other findings have led to the hypothesis that sleep problems in autistic children, who are more likely to experience persistent sleep disturbances, may also contribute to their executive function.

To sleep fights:

For the new research, Elsabbagh’s team analyzed data from 217 children with autism participating in Pathways in ASD, a longitudinal study that began in 2005. They assessed participants’ sleep problems using the Questionnaire on children’s sleep habits, a survey parents completed when their children were between 2 and 4 years old and again about three years later. The researchers also assessed the executive functioning of children aged about 7 to 12 on four occasions using questionnaires completed by parents and teachers.

More severe sleep difficulties in early childhood were associated with less behavioral regulation, the team found. Other types of executive function, such as children’s ability to manage their own thoughts, have not shown any association with difficulty sleeping.

The age at which children have difficulty sleeping can make a difference. For example, children who took a long time to fall asleep at the age of 2 to 4 years had only mild difficulty regulating behavior about four years later. However, children who took a long time to fall asleep around the age of 6 or 7 had more severe behavior regulation difficulties about a year later.

The reason for the age-related findings is unclear, the researchers said.

Frequent nocturnal awakenings from 2 to 4 years old were not associated with later behavioral regulation problems, possibly because such awakenings are common in all children, the team found.

The book was published in May in To sleep.

Clouded matter:

The study does not confirm a causal relationship between sleep and behavioral regulation difficulties, says Estes. But it is suggested that sleep problems precede the manifestation of behavioral regulation problems in children, she adds.

More granular measures of sleep problems could clarify the link to behavior regulation, says Estes. Some children may have trouble falling asleep, while others may wake up at night or early in the morning. The frequency of these problems also varies. Another complication is that children vary in their ideal bedtime and amount of sleep, Estes says.

Children who sleep through the night may also have unusual sleep patterns that can only be detected by objective measurements such as monitoring their brain waves, says Amanda Richdale, director of the Olga Tennison Autism Research Center at La Trobe University in Melbourne, Australia, which was not involved in the study.

Future studies could step in to help children with sleep problems early in life and determine whether this alleviates executive function deficits, Elsabbagh says. Multiple factors beyond sleep quality likely contribute to executive function, she adds.

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