Sleep Disorders and their Sleep Disorders and their Treatment for Children with Treatment for Children with Autism Spectrum DisordersAutism Spectrum Disorders

V. Mark Durand, Ph.D.V. Mark Durand, Ph.D.

USF St. PetersburgUSF St. Petersburg

Developmental IssuesDevelopmental Issues

By 3 months - you can fade nighttime By 3 months - you can fade nighttime feedingsfeedings

By 6 months - infants can sleep through the By 6 months - infants can sleep through the nightnight

Bright Light TherapyBright Light Therapy

Different devicesDifferent devices Brightness Brightness

controversialcontroversial

MelatoninMelatonin

Can effect circadian Can effect circadian rhythms and initiate rhythms and initiate sleepsleep

Temporary effectsTemporary effects No long-term outcome No long-term outcome

studiesstudies

Assessing Sleep ProblemsAssessing Sleep Problems

Polysomnographic (PSG) evaluation - Polysomnographic (PSG) evaluation - includes assessment of airflow, leg includes assessment of airflow, leg movements, brain wave activity, eye movements, brain wave activity, eye movements, muscle movements, and heart movements, muscle movements, and heart activityactivity

------------------------------------- A.M. ------------------------------------- ------------------------------------- P.M. -------------------------------------Midnight 2:00 4:00 6:00 8:00 10:00 Noon 2:00 4:00 6:00 8:00 10:00 Midnight

Day Date

SUN

MON

TUE

WED

THU

FRI

SAT

SUN

MON

TUE

WED

THU

FRI

SAT

SUN

------------------------------------- A.M. ------------------------------------- ------------------------------------- P.M. -------------------------------------Midnight 2:00 4:00 6:00 8:00 10:00 Noon 2:00 4:00 6:00 8:00 10:00 Midnight

Day Date

SUN

MON

TUE

WED

THU

FRI

SAT

SUN

MON

TUE

WED

THU

FRI

SAT

SUN

26-Aug

22-Aug

23-Aug

24-Aug

25-Aug

3-Sep

4-Sep

5-Sep

27-Aug

28-Aug

29-Aug

30-Aug

31-Aug

1-Sep

2-Sep

The Good Sleep Habits ChecklistThe Good Sleep Habits Checklist

Establish a set Establish a set bedtime routinebedtime routine

Develop a regular Develop a regular bedtime and a regular bedtime and a regular time to awakentime to awaken

Eliminate caffeine 6 Eliminate caffeine 6 hours before bedhours before bed

Limit alcoholLimit alcohol Try milkTry milk Eat a balanced dietEat a balanced diet Do not exercise at Do not exercise at

bedtimebedtime Exercise earlierExercise earlier Restrict activities in Restrict activities in

bedbed

The Good Sleep Habits ChecklistThe Good Sleep Habits Checklist

Reduce noise in the Reduce noise in the bedroombedroom

Reduce light in the Reduce light in the bedroombedroom

Avoid extreme Avoid extreme temperature changes temperature changes in the bedroomin the bedroom

Graduated ExtinctionGraduated Extinction

Gradually increase the time between visits Gradually increase the time between visits to the child’s room. to the child’s room.

Parents are still allowed to check on their Parents are still allowed to check on their child, but are not allowed to pick up their child, but are not allowed to pick up their child.child.

They are asked to keep They are asked to keep interactions to a minimum.interactions to a minimum.

Scheduled AwakeningScheduled Awakening

The parent arouses and consoles the child The parent arouses and consoles the child 15-60 minutes before a typical sleep 15-60 minutes before a typical sleep interruption.interruption.

Upon elimination of the sleep problem, the Upon elimination of the sleep problem, the scheduled awakenings are gradually scheduled awakenings are gradually reduced.reduced.

Sleep RestrictionSleep Restriction

The new sleep time for the child should be The new sleep time for the child should be approximately 90% of his/her previous approximately 90% of his/her previous average sleep time.average sleep time.

Adjust bedtime or time child is awakened to Adjust bedtime or time child is awakened to create new schedule.create new schedule.

For each successful week, adjust schedule For each successful week, adjust schedule by 15 minutes.by 15 minutes.

Sleep Better!Sleep Better!

Comprehensive Comprehensive coverage of sleep coverage of sleep problems and their problems and their treatmentstreatments

Written for familiesWritten for families