Sleep problems in autism: prevalence, cause, and intervention

Autism, Asperger's disorder (AD), and pervasive developmental disorder not otherwise specified (PDDNOS) are commonly referred to as 'autistic spectrum disorders' (ASD)(1) and are classified as pervasive developmental disorders (PDD) in the fourth edition of the Diagnostic and Statistical,Manual on Mental Disorders (DSM-IV)(2). Deviant and delayed development in social and communication skills and the presence of restricted routines and interests, and stereotypic behaviours are variously present in ASD(2,3). The majority of children with autism have an intellectual disability (ID) while those with AD do not(2) . Sleep problems are among a number of secondary behavioural difficulties which may occur in children with autism(2), but little is known about their occurrence in XD or PDDNOS. Seigel(4) comments that 'autism is not uncommonly related to disturbances of sleep' (p 292). Sleep problems are reported to differentiate young children with autism from those with Other disabilities, particularly retrospectively(5,6). Nevertheless, Rapin and Katzman(7) comment that the 'Study of the prevalent and troublesome sleep disorders of autism has barely started' (p 8). Additionally, studies of sleep difficulties in children with an ID indicate that such problems can be a source of stress for families(8), particularly when children have autism(9). This paper reviews sleep problems in children with autism and addresses the issues of aetiology and intervention. Reference to AD and PDDNOS is also made. To set the nature of these sleep difficulties in context, brief reviews of sleep problems in typically developing children and children with an ID are provided.