Sleep-wake Cycle Alterations in Children and Adolescents with Autism Spectrum Disorders (Narrative Review)
Abstract
Autism spectrum disorders (ASDs) are heterogeneous group of neuropsychiatric developmental disorders characterized by abnormal social interactions, communication, and stereotypical behavior. Major part of children and adolescents with ASDs have comorbid sleep-wake cycle alterations such as insomnia, circadian dysregulation, breathing disorders during sleep, parasomnia, etc. The interaction between ASDs and sleep disorders is multifactorial and bidirectional. There is data on biological, psychological, socio-environmental factors that contribute to sleep problems development, including sensory hyperreactivity, alterations of melatonin circadian rhythm, genetic mutations, inter- and externalizing behavior, changes in the environment. Disease itself, comorbid conditions (attention deficient hyperactivity disorder, mood disorders, epilepsy), as well as drugs used to treat them often have negative effects on sleep macro- and microstructure. This review examines and discusses the problem of sleep-wake cycle alterations in children with ASDs, its prevalence, structure, etiopathogenesis, clinical manifestations, sleep architecture features, diagnostic principles, and management options. Timely detection and treatment of sleep-wake cycle alterations in patients with ASDs can lead to improvements not only in their sleep quality, but also in overall functioning and development, as well as in overall family well-being.
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