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Sleep Better !: Improving Sleep For Persons With Autism Spectrum Disorder

This document discusses sleep problems in individuals with autism spectrum disorder (ASD) and potential interventions. It notes that 50-80% of children with ASD experience sleep problems like insomnia, prolonged sleep latency, and disrupted sleep. Common problems persist and worsen with age. The document reviews developmental sleep patterns, daily schedules, light therapy, melatonin, behavioral interventions, and tools for assessing sleep problems and selecting treatments. It emphasizes matching interventions to a family's needs, disruptions tolerance, and attitudes.

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Eduardo Baltar Soares
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77 views

Sleep Better !: Improving Sleep For Persons With Autism Spectrum Disorder

This document discusses sleep problems in individuals with autism spectrum disorder (ASD) and potential interventions. It notes that 50-80% of children with ASD experience sleep problems like insomnia, prolonged sleep latency, and disrupted sleep. Common problems persist and worsen with age. The document reviews developmental sleep patterns, daily schedules, light therapy, melatonin, behavioral interventions, and tools for assessing sleep problems and selecting treatments. It emphasizes matching interventions to a family's needs, disruptions tolerance, and attitudes.

Uploaded by

Eduardo Baltar Soares
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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April 27, 2015

Sleep Better !
Improving Sleep for Persons
with Autism Spectrum Disorder
V. Mark Durand, Ph.D.
University of South Florida St. Petersburg

Sleep Stages

Sleep Problems in ASD Sleep Problems in ASD


 Research on the prevalence of sleep problems in  The main problems reported among both young
children with ASD suggests a range from 50%- children and adolescents with ASD tend to be
80% insomnia with prolonged sleep latency (time to
 Children with ASD develop more sleep fall asleep), disruption at bedtime, decreased
problems as they grow older and they tend to sleep efficiency (decreased time asleep/time in
continue to experience sleep problems over time. bed), decreased total sleep time and decreased
sleep duration.

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April 27, 2015

Sleep Disorders

Developmental Issues
 By 3 months - you can fade nighttime
feedings
 By 6 months - infants can sleep through the
night

Daily Schedules Bright Light Therapy


 You can “trick” the brain into a different time  Different devices
schedule by organizing daily activities  Brightness
– Meals controversial
– Dressing
– Washing

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April 27, 2015

Melatonin Assessing Sleep Problems


 Can effect circadian  Polysomnographic (PSG) evaluation -
rhythms and initiate includes assessment of airflow, leg
sleep movements, brain wave activity, eye
 Temporary effects movements, muscle movements, and heart
 No long-term outcome activity
studies
 Multiple Sleep Latency Test (MSLT) - naps
at 2 hour intervals

Assessing Sleep Problems


 Actigraphy
 “There’s an app for that !” (e.g., Sleep
Cycle)

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April 27, 2015

The Good Sleep Habits Checklist The Good Sleep Habits Checklist
 Establish a set  Limit alcohol  Reduce noise in the
bedtime routine  Try milk bedroom
 Develop a regular  Eat a balanced diet  Reduce light in the
bedtime and a regular  Do not exercise at bedroom
time to awaken bedtime  Avoid extreme
 Eliminate caffeine 6  Exercise earlier temperature changes
hours before bed in the bedroom
 Restrict activities in
bed

Medication for Sleep Herbal Remedies


 Common medications  Valarian root and Hops
– Benadryl - contains antihistamines which cause  No outcome studies
drowsiness
– Clonidine - blood pressure medication - side
effect is as a sleep aid
 Not generally recommended for long-term
use (more than 2-4 weeks)

Graduated Extinction
 Gradually increase the time between visits
to the child’s room.
 Parents are still allowed to check on their
child, but are not allowed to pick up their
child.
 They are asked to keep interactions to a
minimum.

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April 27, 2015

Scheduled Awakening
 The parent arouses and consoles the child
15-60 minutes before a typical sleep
interruption.
 Upon elimination of the sleep problem, the
scheduled awakenings are gradually
reduced.

Sleep Restriction
 The new sleep time for the child should be
approximately 90% of his/her previous
average sleep time.
 Adjust bedtime or time child is awakened to
create new schedule.
 For each successful week, adjust schedule
by 15 minutes.

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April 27, 2015

Choosing Interventions

Selecting Sleep Interventions


SSIQ - Disruption Tolerance
Questionnaire (SSIQ)
 Designing the treatment plan to fit the needs  Is the person disruptive at bedtime or when
of the family waking up at night in a way that is too
serious or upsetting to ignore?
 Administered with child sleep assessments
– Yes No

 Would it be difficult or impossible for you to


listen to this person being upset for long
periods of time (more than a few minutes)?
– Yes No

SSIQ - Disruption Tolerance SSIQ - Schedule Tolerance


 Do you find it too difficult to put your child  Are you, or another member of your family,
back in bed once he or she gets up? willing to stay up later at night to put a sleep
– Yes No plan into action?
– Yes No
 Scoring: If the parents answer “yes” to one
or more of these questions, they may not be  Are you, or another member of your family,
good candidates for using graduated willing to get up earlier in the morning to put
extinction as an intervention for sleep a sleep plan into action?
problems. – Yes No

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April 27, 2015

SSIQ - Schedule Tolerance SSIQ - Attitudinal Barriers


 Scoring: If the parents answer “no” to one  Do you feel emotionally unable to deal
or more of these questions, they may not be directly with your child’s sleep problem?
good candidates for scheduled awakenings – Yes No
or sleep restriction as interventions for their
child’s sleep problems.  Do you feel guilty making your child go to
bed (or go back to bed) when he or she
does not want to?
– Yes No

SSIQ - Attitudinal Barriers Sleep Protocols


 Do you think it would be emotionally damaging to  Durand, V.M. (2008). When children
your child if you tried to change the way he or she don't sleep well: Interventions for
slept? pediatric sleep disorders, Therapist
– Yes No guide. New York: Oxford University
Press.
 Scoring: If the parents answer “yes” to one or
more of these questions, they may need cognitive-  Durand, V.M. (2008). When children
behavioral intervention to explore their attitudes don't sleep well: Interventions for
about their ability or their child’s ability to improve pediatric sleep disorders, Workbook.
sleep. New York: Oxford University Press.

Sleep Better!
 Coverage of sleep
problems and their
treatments
 Written for families

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