Characterizing Sleep in Adolescents and Adults with Autism Spectrum Disorders.
S E Goldman, M L Alder, H J Burgess and 7 others
PMID 28286917WHAT IT FOUND
Adolescents and adults with autism took longer to fall asleep and had more trouble going to bed.
In a small pilot, their melatonin timing and cortisol patterns did not differ from matched peers.
Key findings
01On actigraphy, participants with autism had longer sleep latency and lower sleep efficiency than typically developing participants, while wake time after sleep onset and total sleep time did not differ.
02On the Adolescent Sleep-Wake Scale, total score and Going to Bed and Falling Asleep subscales were lower for participants with autism, indicating more difficulty going to bed and falling asleep; maintaining sleep, reinitiating sleep, and returning to wakefulness did not differ.
03Morning cortisol, evening cortisol, and morning-evening difference did not differ by diagnosis, and average dim-light melatonin onset was similar between groups, within 11 minutes and around 21:00.
STILL TO COME
How it was doneWhat they found
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study was a small pilot, with 28 participants with autism and 13 typically developing participants completing. It included higher functioning adolescents and adults who could cooperate with wearing an actigraphy watch for four weeks and collecting saliva samples, so it may not represent people with more severe support needs. Only 7 participants with autism and 7 typically developing participants had usable dim-light melatonin onset profiles. Participants had a broad age range and some took psychotropic medications, which can affect sleep and cortisol. Some participants had erratic sleep schedules, and enrollment occurred during both school and break times, so sleep timing could be variable. The study did not define circadian preference with a morningness/eveningness questionnaire. Participants were diagnosed using both DSM-IV and DSM-5 criteria, so comparison by autism subtype or severity was limited. Psychiatric comorbidities, including affective disorders, may have confounded sleep findings. Untreated sleep-affecting conditions were excluded, so the findings may not generalize to the broader autism population where such conditions are common.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that sleep onset delay in autism is caused by abnormal melatonin or cortisol. The study found longer sleep latency but no group differences in cortisol or dim-light melatonin onset, and the melatonin and cortisol samples came from a small subset.