Prevalence of sleep abnormalities in Indian children with Autism Spectrum Disorder; a cross sectional study

Publication date: Available online 31 May 2017
Source:Pediatric Neurology
Author(s): R. Aathira, Sheffali Gulati, Manjari Tripathi, Garima Shukla, Biswaroop Chakrabarty, Savita Sapra, Nitika Dang, Anupama Gupta, Madhulika Kabra, R.M. Pandey
BackgroundThe prevalence of Autism spectrum disorder (ASD) is on rise. Apart from the core behavioral issues of impaired communication and social interaction and restricted and/or repeated behavioral phenotype, comorbidities like sleep problems are increasingly getting recognized as important determinants of management and overall quality of life.MethodsThis study was conducted in a tertiary care teaching hospital in north India over a two year period. Children diagnosed with ASD and normally developing children (controls) aged 3 to 10 years were enrolled in the study. Both groups underwent sleep evaluation based on CSHQ (Children's Sleep Habit Questionnaire). Children with ASD also underwent PSG (Polysomnography), CARS (Childhood Autism Rating Scale), CBCL(Childhood Behavioral Checklist) and DP-3(Developmental Profile-3) assessments.ResultsThe prevalence of poor sleepers among ASD and controls were 77.5% (C.I. 66-86.5). and 29.2% (C.I. 18.6-41.5) respectively (p<0.001). The salient findings on PSG were reduced sleep efficiency, decreased REM (rapid eye movement) and SWS (slow wave sleep) duration and desaturation index>1. The CBCL score was significantly high in poor sleepers compared to good sleepers on CSHQ (p=0.004). There was no correlation of CARS or DP-3 score with sleep problems in ASD children.ConclusionsNearly three-fourth of ASD children have sleep abnormalities with possible effect on behavioral phenotype. The PSG findings provide further insight with opportunity for pharmacological interventions. Screening for sleep problems is imperative for appropriate management and overall improvement in quality of life in children with ASD.



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