International Meeting for Autism Research (London, May 15-17, 2008): Sleep Education Classes for Parents of Children with Autism Spectrum Disorders

Sleep Education Classes for Parents of Children with Autism Spectrum Disorders

Thursday, May 15, 2008
Champagne Terrace/Bordeaux (Novotel London West)
B. A. Malow , Neurology/Sleep, Vanderbilt University, Nashville, TN
S. G. McGrew , Pediatrics, Vanderbilt University, Nashville, TN
K. Artibee , Neurology, Vanderbilt University, Nashville, TN
H. Reed , Neurology, Vanderbilt University, Nashville, TN
S. E. Goldman , Neurology/Sleep, Vanderbilt University, Nashville, TN
K. Frank , Kennedy Center, Vanderbilt University, Nashville, TN
Background: Children with autism spectrum disorders (ASD) have a high prevalence of insomnia, which has both biological and behavioral causes.
Objectives: Our hypothesis is that parents of children with autism and insomnia, through participation in a sleep education program, can teach their children to become better sleepers. Furthermore, enhanced sleep in children with ASD may result in improved daytime behavior.
Methods: We provided a structured setting in which small groups of parents learned about establishing effective sleep habits for their children with ASD. All children had a clinical diagnosis of ASD, confirmed by the Autism Diagnostic Observation Schedule, and did not have a history of epilepsy. A series of three two-hour workshops were conducted on-site at our Children’s Hospital. Workshops were led by two physicians with presentations as well as breakout sessions, homework, and question-and-answer periods focused on bedtime routine and night wakings. Sleep and behavior questionnaires, in addition to one week of actigraphy, were collected prior to the workshop and one month after the workshop. Data were analyzed using paired t-tests to detect change.
Results:   To date, we have analyzed data obtained from 12 children, ages 3-10 years, whose parents have completed the workshop. Improvements after treatment were seen in the total scale as well as several insomnia-related subscales of the Child Sleep Habits Questionnaire (CSHQ), including bedtime resistance, sleep onset delay, sleep duration, and sleep anxiety (p ≤ 0.03), but not subscales related to sleep-disordered breathing and parasomnias (p > 0.1). Significant improvements were also noted in the affective (p = 0.007) and attention-deficit hyperactivity (p = 0.027) domains of the Child Behavior Checklist (CBCL). Review of individual actigraphy records showed improvements after treatment in sleep latency and night wakings.
Conclusions: Sleep education classes improve sleep parameters and aspects of daytime behavior in children with ASD.
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