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Asperger's Kids & Sleep Problems

"We are parents of a newly diagnosed son (age 9) with high functioning aspergers. He wakes up in the middle of the night. He is in good health. We have tried Valerian, but that has not helped much. Is this a common trait for children with autism? Could this be hormonal? Can you suggest anything to remedy this?" 


The first known attempt to evaluate the sleep patterns of kids with Aspergers and High-Functioning Autism (taking into account sleep architecture and the Cyclic Alternating Pattern or CAP) finds that these boys and girls have:
  • sleep restlessness
  • problems related to initiating sleep
  • morning problems
  • daytime sleepiness
  • a high prevalence of some sleep disorders

The study, authored by Oliviero Bruni, MD, of the Center for Pediatric Sleep Disorders at University La Sapienza in Rome, Italy, focused on 8 kids with Aspergers, 10 with Autism, and 12 healthy control kids. The moms and dads of these kids filled out the following materials:
  • Autism Diagnostic Observation Schedule, a semi-structured, standardized assessment of communication, social interaction and play or imaginative use of materials for children who have been referred because of possible Autism spectrum disorders
  • Child Behavior Checklist, a questionnaire used to examine daytime behavior in kids
  • Pediatric Daytime Sleepiness Scale, which evaluates the relationship between daytime sleepiness and school-related outcomes
  • Sleep questionnaire

In addition, the kids took the Wechsler Intelligence Scale for Children, which measures verbal IQ, performance IQ and a full-scale IQ, and also underwent an overnight poly-somnogram, or sleep study.

Several sleep parameters (i.e., time in bed, sleep period time, number of awakenings per hour, and sleep efficiency) were evaluated. CAP, a periodic EEG activity of non-REM sleep characterized by repeated spontaneous sequences of short-lived events (phase A) with the return to background activity identifying the interval that separates the repetitive elements (phase B), was also scored.

According to the results, 50 percent of the kids with Aspergers were reluctant to go to bed, while 75 percent felt a need for light or a television in the bedroom, 87 percent had difficulty getting to sleep at night, and 75 percent fell asleep sweating. In addition, 50 percent felt un-refreshed when waking up in the morning, 87 percent had difficulty waking up in the morning, and 87 percent felt sleepy during the day.

With respect to the CAP (in comparison to healthy controls), subjects with Aspergers showed a lower total CAP rate in the first two sleep stages, but not in slow wave sleep. In addition, they showed an increased percentage of synchronized EEG patterns and a decreased percentage of desynchronized EEG patterns. Further, the duration of the A and B phases, and consequently the entire CAP cycle, was longer. Compared to the kids with Autism, Aspergers subjects showed an increased CAP rate in slow wave sleep and a decrease in the second sleep stage. The duration of the A phases was longer, as well as the CAP cycle duration.

This study showed peculiar CAP modifications in kids with Aspergers and represented an attempt to correlate the quantification of sleep EEG oscillations with the degree of mental ability or disability.

Aspergers is one of several Autism Spectrum Disorders (ASDs) characterized by difficulties in social interaction and by restricted and stereotyped interests and activities. Aspergers is distinguished from the other ASDs in having no general delay in language or cognitive development. Although it is not mentioned in standard diagnostic criteria, there are frequent reports of motor clumsiness and atypical use of language.

It is recommended that kids in preschool sleep between 11-13 hours a night, school-aged kids between 10-11 hours of sleep a night, and adolescents about nine hours a night. Here are just a few tips to help your youngster sleep better:
  1. At bedtime, do not allow your youngster to have foods or drinks that contain caffeine. This includes chocolate and sodas. Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.
  2. Do not let your youngster fall asleep while sitting in the car during transport, sitting in front of the TV, being held, rocked, etc.
  3. Establish a relaxing setting at bedtime.
  4. Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your youngster ready to go to sleep each night.
  5. Interact with your youngster at bedtime. Don't let the TV, computer or video games take your place.
  6. Keep your kids from TV programs, movies, and video games that are not right for their age.
  7. Supplements such as melatonin and ZMA have been found to be effective in a significant number of cases.

Kids are encouraged to inform their moms and dads of any sleep problems they may have. Caretakers who suspect that their youngster might be suffering from a sleep disorder are encouraged to consult with their youngster's doctor or a sleep specialist.


More resources for parents of children and teens with High-Functioning Autism and Asperger's:

COMMENTS: 

*   Anonymous said... wondering if anyone on here can help,,i have a 12 year old son who cant sleep,his doctor at camhs put him on melatonin which worked for a few weeks,now it dosnt seem to be,,he cant drop off too sleep which means hes getting 5 hours a night even on school nights and his school have rang me to say that hes nodding off in class,ive tryed routine etc but dosnt work,once he is asleep he will stay asleep but he cant drop off in the 1st place 

*   Anonymous said... I have problems sleeping and no-doctor will provide me with any medication and im suffering too.
*   Anonymous said... my lad had to have assesments 1st to see if he really needed it,it was a last option for me,,some foods have melatonin but low levels of it.
*   Parenting Aspergers Children - Support Group said… http://www.myaspergerschild.com/2010/01/aspergers-children-and-sleep-problems.html
*   Parenting Aspergers Children - Support Group said… Try ZMA (Zinc Monomethionine Aspartate). This is a new recommendation that is getting some amazing results!!
*   Anonymous said... Any advice for children with AS that have sleep issues? He takes 5 mg melatonin and .1 clodnine before bed but is still up every two hrs he is 3.5 yrs old 
*   Anonymous said... My son was the same way when he was younger. I kept trying higher doses of melatonin but it only gave him headaches. So then I did the reverse and gave him a very small dose of 300 mcg and it worked! Now he is 8 and we have added a long, warm bath to his routine and he reads about 45-60 minutes on his own. It really seems to calm him down.
•    Anonymous said... Clonidine for my aspie to
•    Anonymous said... In the U.S. at least, melatonin is not prescription - it's sold with vitamins and supplements - maybe have a look?
•    Anonymous said... It is common for our family. He wakes up just enough for his brain to start moving- and he's up. We have discovered him in our car, in the backyard and also setting off fireworks in the kitchen. (he found our hiding spot!) Our family doctor prescribe an antihistimine and it helps both his sleep issues and some of his eating issues. My son is Asperger's/ADHD, so it is also combatting the medicine he takes during the day- for his appetite. And believe it or not- and I am not a medicine pusher- his sleep at night and getting up through the night seemed to normalize once I had him on adhd medicines. I was warned to stay away from melatonin for prepubescent boys, the doctor said they hadn't fully tested it. But, there was some indication that it may retard there physical/sexual development.
•    Anonymous said... Melatonin didn't work for my 9 yr old aspie. Clonidine works for him.
•    Anonymous said... Melatonin for my little ones
•    Anonymous said... Melatonin has been great for my 8 year old son, don't know how I managed without it
•    Anonymous said... Melatonin has opposite effect on my aspie teen, keeping him awake more than he is (don't think he's slept a night in his life) and giving him extreme nightmares. So we r still at a loss. Physical exercise helps but hard to get him to move much.
•    Anonymous said... Melatonin works for my 8yr old Aspie.
•    Anonymous said... My 13 year old son still wakes up most nights unless he stays up really late. Can make for a rough day when he is tired and grumpy. I just make him go to his room and recalibrate. I have heard from my other friends that this is pretty normal.
•    Anonymous said... My 13 yr old (high functioning female AS) has never slept very well or very long. The only thing that seems to work with her is extreme amounts of physical exercise. Her main hobbies are JuJitsu and climbing and she does 2 - 4 hours a day of one or the other. Even with that she rarely gets more than 5 hours sleep in 24. Having said that she doesn't seem to suffer from this 'lack' of sleep and at 13 is quite capable of keeping herself occupied at night with books or Gameboys. Nobody else in her class can understand why she has an official bedtime on school nights of 11:30 - 12! She has found her own balance over the years and it seems to work for her. 19 yr old ('more' AS than her) on the other hand can now quite happily sleep for 12-14 hours a day if left to his own devices which comes with it's own set of problems ...
•    Anonymous said... My 8 yr old began using melatonin 2 years ago... We started with 0.5 mg and are now using 2.5 mg. he needs it almost every night but on weekends I hold off to see if he can go to sleep on his own. Which he can sometimes . Melatonin has significantly reduced the 1-2 hour falling asleep snuggle sessions we use to have to do. He still would wake every night and rise early. After we began a gluten and dairy free diet this summer (due to allergies found by the naturopath) we had our first night where he slept all night. Honestly it has happened less then 5 times in his life! We are now 3.5 months into this dietary change and last week he slept through the night 5 school nights in row! I continue to see he sleep improving . Not perfect but huge improvements. The diet has also helped his growth as he had only gained about 3 pounds in over 2 years And had not changed show size in 2.5 years. In past we did a trial with guanfecine as some have mentioned and he did sleep but usually at school which was not the point . All the best as you search for what will work for your child.
•    Anonymous said... my daughter can't go to sleep until past midnight every night and then can't get up in the morning.... but drugs are not routinely prescribed in UK. We struggle.
•    Anonymous said... My eight year old was finally put on Clonidine and MOST nights, he sleeps well.
•    Anonymous said... My son (now 12) was diagnosed at about the same age...I could NOT keep that kid asleep all night long for ANYTHING. I finally tried Melatolin (I don't know how to spell that)...he has not had a problem sleeping since then. I have read that Aspie kids don't produce the same levels of Melatolin as others. I hope that helps.
•    Anonymous said... my son had the same problem. Melatonin worked pretty well for him. Now he is 15 and no longer needs it.
•    Anonymous said... My son has hfa he also had ADHD which is now completely gone with nuerotherapy, diet and learning program's. he wakes in the night to play the iPad etc to calm himself, we started yesterday treating his beta which is the back part of his brain. We just had two weeks school holidays and they were the best EVER, not one meltdown and biggest shock of all I could reason with him - unbelievable. He is calm and focused. We are in Australia and this has worked for us
•    Anonymous said... Our son is 7 and wakes during the night but will lay and listen to his music we keep on low all night for him. We find this helps him a lot.
•    Anonymous said... The simple supplement of Melatonin sometimes works. My daughter is 13, and Melatonin would help, but taken too often she would begin waking up too early in the mornings. However, sometimes a couple of nights is all it takes to establish a sleep rhythm.
•    Anonymous said... They have put my son on GuanFACINE and he sleeps throughout the night. He is only 6. We tried 4 different ADHD medications and all increased his hyperactivity.
•    Anonymous said... We have to use Clonidine for my daughter. she wakes several times but goes right back to sleep
•    Anonymous said... We tried everything with my 9 year old Aspie. Nothing worked. We finally bought him a weighted blanket, custom made. He hasn't had an issue since. He has slept every night in his own bed the whole night since it came in the mail
•    Anonymous said... We use 5mg time-release Melatonin for our 10 year old. We found it worked 80% of the time. I added 100mg of L-Theanine and now it's a winner. We also have a custom weighted blanket, purchased from DreamCatcher Weighted Blankets. The combo ensures he gets a good, solid 10-11 hours a night and he falls asleep fast. One last thing we added, that I almost forgot, is a white noise machine for his room. It helps him to shut out his thoughts and quiet down.
•    Anonymous said... we use over the counter sleeping pills
•    Anonymous said... Where did you get the blanket Allison? My son has been waking up a lot and now is starting to sleep walk, I wonder if the blanket would work.
•    Anonymous said... Yes Melatonin has worked for my Aspie.
•    Anonymous said...  5am every morning here.
•    Anonymous said...  Our doctor had a try a few things that never worked, then a different doctor said he can just take Melatonin, which has been working very well for my 9-year-old.
•    Anonymous said... A nutritionist told me that melatonin was potentially dangerous for kids. (Can't remember why, I'll check.) Relaxing routines including breathing, relaxation exercises, warm baths with lavender, reading, etc. do help. My now 13 yo son use to come to our room at least once a night until he was about 11. I'm afraid they are just wired differently. Benadryl is helpful also, but they are not going to have the same sleep habits as nuerotypicals.
•    Anonymous said... Essential oils. Melatonin causes seizures an dB brain bleed in children.
There is also something called Lorinthine. It's amazing
•    Anonymous said... I call them " all nighters" mine has them several times a month...melatonin helps
•    Anonymous said... I love essential oils & we diffuse lavender & vetiver at bed time. It works wonders for instant relaxation & peaceful sleep! BTW - I have to add that therapeutic grade essential oils, ONLY -- like Young Living Essential Oils.
•    Anonymous said... Many nights with only 4 hours sleep, yep
•    Anonymous said... Many people on the spectrum are low in magnesium. I give that to my 10 yr old son before bed. Not only does he sleep better, his disposition is better. He is less angry, more understanding! You can do a search on it. smile emoticon. Good luck!
•    Anonymous said... Melatonin gets my vote
•    Anonymous said... Melatonin should be the best option given it is the crucial hormone for sleep.
•    Anonymous said... My 8yr old is the same he takes Catapres and Melatonin at nite, works great for a couple of weeks but he tends to repeat cycles so two weeks later we are back to sleepless nites, he can stay awake quite happily for 36+ hrs at a time smile emoticon
•    Anonymous said... Our son is 8 with the same diagnosis. Our doctors put him on trazadone to help him sleep. I notice a big difference when he doesn't get enough sleep
•    Anonymous said... The extended release formulation of melatonin works quite well
•    Anonymous said... Try Essentials oils . We use a combination of Lavender, Peace & Calming and Cedarwood. It seems to work great.
•    Anonymous said... Try melatonin
•    Anonymous said... We have never had trouble with our ADHD And HFA son - we have a strict bedtime its black and white - if we do not follow it there can be troubles. When he had his ipad he would wake in the middle of the night to play it but since its broken that hasnt been an issue.
•    Anonymous said... We use melatonin too! Seems to help, but he is still an early riser.
•    Anonymous said... We use P5P plus, it is B6 with Magnesium, we have used it for 4 years it calms our son and he sleeps well. We administer it at bedtime.


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