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Sleep Disturbance in Kids and Teens on the Autism Spectrum

“Any advice for helping our HFA child (age 6) with sleep difficulties? She has a hard time getting to sleep, will wake up numerous times through the night. We have a real chore with trying to wake her up in the morning, and we are getting reports from her teacher that she frequently doses off during class.”

Sleep disturbance is common in kids and teens with Asperger’s (AS) and High Functioning Autism (HFA) at all levels of cognitive functioning. Sleep disturbance correlates with family distress and may have significant effects on daytime functioning and quality of life for these young people. In some cases, there may be an identifiable cause (e.g., obstructive sleep apnea, gastroesophageal reflux).

Assessment and treatment for sleep problems are guided by history and physical examination. When there is not an identifiable medical cause, behavioral interventions often are effective (e.g., sleep-hygiene measures, restriction of daytime sleep, positive bedtime routines, extinction procedures).

Relatively little information is available regarding drug treatment for sleep issues in kids with AS and HFA or other developmental disorders. Recommendations typically are based on case reports and open-label trials, extrapolation from the adult literature, and expert consensus.

There is some evidence of problems with melatonin-regulation in kids on the autism spectrum. Melatonin may be effective in improving sleep onset in young people with sleep/wake disorders. 
A recent study suggested that controlled-release melatonin improved sleep in a group of 25 kids with AS and HFA, and that treatment gains were maintained at 1- and 2-year follow-up. Many children on the autism spectrum respond well (with no apparent adverse effects) to treatment with the melatonin receptor agonist “ramelteon.”

Trazodone, α2-agonists, newer non-benzodiazepine hypnotic agents (e.g., zolpidem and zaleplon), chloral hydrate, benzodiazepines, and antihistamines are sometimes used to treat pediatric insomnia. In some cases, other conditions (e.g., epilepsy, depression, anxiety, aggressive outbursts, etc.) warrant drug treatment, and an agent that also assists with sleep can be chosen.


•    Anonymous said... Cranio sacral therapy should do the trick
•    Anonymous said... Our son used to do the same and she suggested taking melatonin 20 min before bed ' it's an over the counter supplement. Helped a lot.ask your Dr about it because there are different doses available.
•    Anonymous said... See your specialist about getting a script for melatonin, works wonders, is a natural thing , also look at her mattress that will also help
•    Anonymous said... Tart Cherry juice before bedtime naturally produces and releases melatonin. This has helped my son as well as using essential oil Lavendar on his feet before going to bed every night.
•    Anonymous said... We do a 1 mg melatonin split in half.
•    Anonymous said... We used valerian hops homeopathic drops and after a while they did the trick!! More restful than agitated sleep too. X

*   Anonymous said... my son slept in my bed for years..being close caused him to be more calm and therefore fall back to sleep quicker than if he was alone.. its to do with how much their brain works..if there is stuff it is trying to process no chance its going to let the person sleep until the processing has been done.. look after yourself through it ..use afternoon naps etc...
*  Anonymous said...We use 6 mg of melatonin but our son is on many other medications for his Aspergers
*   Anonymous said...My son takes 6 mg of melatonin along with several medications. He is 7 yrs old and when my husband and I do get a full night of sleep we are blessed. Also our little man needs to sleep through the night. He has Aspergers, hyfunctional autism and the list of diagnoses goes on.
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