Children with autistic spectrum disorders (ASDs) have a high prevalence of sleep disorders for a variety of reasons. Sleep disorders in this population are easily missed due to comorbidities and diagnostic overshadowing. Their impact on the physical, cognitive, and emotional well-being of the children and their caregivers is considerable. Parent-directed behavioral interventions are effective when properly implemented and should always precede the use of medication. Before commencing any medication it is important to first agree on realistic treatment targets in partnership with parents and child if possible. Sleep disorders in children with autism are the most studied and show a response to both parent-directed behavioral interventions and exogenous melatonin. Evidence from robust trials shows that melatonin can improve sleep latency, duration, longest sleep period, hyperactive symptoms, and parental quality of life. Other medications are frequently used but the evidence base for their efficacy and safety is often lacking. Agreeing on clear and achievable treatment goals is particularly important in this population.
Elsevier, Principles and Practice of Pediatric Sleep Medicine, Third Edition, 2024, Pages 167-174
