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Query: UMLS:C0004352 (autism)
 32,579 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We describe our experience in using melatonin to treat insomnia, a common sleep concern, in children with autism spectrum disorders. One hundred seven children (2-18 years of age) with a confirmed diagnosis of autism spectrum disorders who received melatonin were identified by reviewing the electronic medical records of a single pediatrician. All parents were counseled on sleep hygiene techniques. Clinical response to melatonin, based on parental report, was categorized as (1) sleep no longer a concern, (2) improved sleep but continued parental concerns, (3) sleep continues to be a major concern, and (4) worsened sleep. The melatonin dose varied from 0.75 to 6 mg. After initiation of melatonin, parents of 27 children (25%) no longer reported sleep concerns at follow-up visits. Parents of 64 children (60%) reported improved sleep, although continued to have concerns regarding sleep. Parents of 14 children (13%) continued to report sleep problems as a major concern, with only 1 child having worse sleep after starting melatonin (1%), and 1 child having undetermined response (1%). Only 3 children had mild side-effects after starting melatonin, which included morning sleepiness and increased enuresis. There was no reported increase in seizures after starting melatonin in children with pre-existing epilepsy and no new-onset seizures. The majority of children were taking psychotropic medications. Melatonin appears to be a safe and well-tolerated treatment for insomnia in children with autism spectrum disorders. Controlled trials to determine efficacy appear warranted.
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PMID:Melatonin for insomnia in children with autism spectrum disorders. 1818 47

Children with autism spectrum disorders (ASD) often exhibit sleep and behavioral disorders. Treatment of sleep disorders can be difficult in these children. Clonidine, an alpha2-adrenergic receptor agonist, has been shown to be effective in reducing impulsivity, inattention, and hyperactivity, as well as in serving as a sedative for medial procedures. An open labeled retrospective study of clonidine in treatment of insomnia, and/or hyperactivity, inattention, mood disorder, and aggressive behaviors was conducted using parent reports of sleep initiation and maintenance, as well as behaviors prior and during clonidine treatment. Clonidine was effective in reducing sleep initiation latency and night awakening, to a less degree in improving attention deficits hyperactivity, mood instability and aggressiveness in this cohort of 19 children with ASD. The side effects were largely tolerable. Further evaluation with placebo-controlled double-blind clinical trial of clonidine use in ASD will provide more insight into the clinical efficacy and safety of the medicine in ASD.
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PMID:Use of clonidine in children with autism spectrum disorders. 1828 Jun 81

Children with autism spectrum disorders frequently have significant sleep problems, most commonly insomnia. Fortunately, a variety of treatments are available, including behavioral interventions and pharmacotherapy. When establishing a treatment plan, it is imperative to understand the underlying etiology of the sleep problem, which in many cases is multifactorial. Some sleep problems, such as suspected obstructive sleep apnea, should be referred to a sleep specialist. Identifying and treating sleep disorders may not only result in improved sleep but also may favorably affect daytime behavior and family functioning. In general, when treating insomnia, behavioral interventions should be instituted initially, followed by pharmacotherapy if needed.
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PMID:Sleep in children with autism spectrum disorders. 1878 8

Sleep difficulties in children with autism spectrum disorders are common, with poor sleep hygiene a contributing factor. We developed the Family Inventory of Sleep Habits to measure sleep hygiene in this population. Its validity and reliability in 2 groups of children aged 4 to 10 years, those with a clinical diagnosis of autism spectrum disorders, and those who are typically developing are described. In both groups, total and modified (reflecting insomnia subscales) scores on the Children's Sleep Habits Questionnaire showed significant negative correlations with the total score. The Peabody Picture Vocabulary Test-III was significantly correlated with total score in the autism spectrum group but not in the typically developing group. Age and socioeconomic status were not correlated with total score in either group. This preliminary work suggests that the Family Inventory of Sleep Habits is a valid and reliable measure of sleep hygiene in autism spectrum disorders.
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PMID:A sleep habits questionnaire for children with autism spectrum disorders. 1916 14

To determine if parents can successfully teach their children with autism spectrum disorders to become better sleepers, we piloted small group parent education workshops focused on behavioral sleep strategies. Workshops consisted of three 2-hour sessions conducted over consecutive weeks by 2 physicians. Curricula included establishing effective daytime and nighttime habits, initiating a bedtime routine, and optimizing parental interactions at bedtime and during night wakings. Baseline and treatment questionnaires and actigraphy were analyzed in 20 children, ages 3 to 10 years. Improvements after treatment were seen in the total scale and several insomnia-related subscales of the Children's Sleep Habits Questionnaire. Actigraphy documented reduced sleep latency in children presenting with sleep onset delay. Improvements were also noted in measures of sleep habits and daytime behavior. Brief parent-based behavioral sleep workshops in children with autism spectrum disorders appear effective in improving subjective and objective measures of sleep, sleep habits, and daytime behavior.
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PMID:Parent-based sleep education workshops in autism. 1949 Nov 10

Sleep disturbances are frequent in children and adolescents with psychiatric disorders nevertheless there are few drugs available to treat them. Only certain antihistaminic H1 have the marketing authorization for treatment of childhood insomnia. Very few studies have been made in children about the hypnotics that are most widely used in adult patients: zopiclone, zolpidem and the hypnotic benzodiazepines. However, melatonin has recently become the most studied hypnotic drug in children since the marketing of a sustained-released form gave it the status of a drug and improved its pharmacokinetic properties. In child psychiatry, pharmacological treatment of insomnia should be considered in patients with attention deficit hyperactivity disorder in which sleep disturbances can be aggravated by psycho stimulant treatment, in autism spectrum disorders, and in the anxiety/depression.
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PMID:[Pharmacologic treatment of insomnia in children and adolescent psychiatric patients]. 2020 89

Children and adolescents with autistic spectrum disorders (ASD) suffer from sleep problems, particularly insomnia, at a higher rate than typically developing children, ranging from 40% to 80%. Sleep problems in ASD might occur as a result of complex interactions between biological, psychological, social/environmental, and family factors, including child rearing practices that are not conducive to good sleep. Interestingly, children with a history of developmental regression have a more disturbed sleep pattern than children without regression. Even though regulation of sleep in children with ASD is still poorly understood, circadian abnormalities in autism might be the result of genetic abnormalities related to melatonin synthesis and melatonin's role in modulating synaptic transmission. Recently a bifurcation of the sleep/wake cycle with increased sensitivity to external noise and short sleep duration causing irregular sleep onset and wake up times has been suggested. Identifying and treating sleep disorders may result not only in improved sleep, but also impact favorably on daytime behavior and family functioning. Several studies have also demonstrated effectiveness of behavioral interventions for sleep onset and maintenance problems in these populations. When behavioral interventions are not effective or lead only to a partial response, pharmacological treatment options should be considered. Studies of melatonin use in children with ASD provide evidence for its effectiveness and safety in the long run. The clinician assessing a child with an ASD should screen carefully for sleep disorders and make referrals as indicated.
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PMID:Sleep in children with autistic spectrum disorder. 2060 10

Hand dominance is defined as a proneness to use one hand rather than another in performing the majority of activities and this is the most obvious example of cerebral lateralization and an exclusive human characteristic. Left-handed people comprise 6-14% of the total population, while in Serbia, this percentage is 5-10%, moving from undeveloped to developed environments, where a socio-cultural pressure is less present. There is no agreement between investigators who in fact may be considered a left-handed person, about the percentage of left-handers in the population and about the etiology of left-handedness. In the scientific literature left-handedness has been related to health disorders (spine deformities, immunological disorders, migraine, neurosis, depressive psychosis, schizophrenia, insomnia, homosexuality, diabetes mellitus, arterial hypertension, sleep apnea, enuresis nocturna and Down Syndrome), developmental disorders (autism, dislexia and sttutering) and traumatism. The most reliable scientific evidences have been published about the relationship between left-handedness and spinal deformities in school children in puberty and with traumatism in general population. The controversy of other results in up-to-now investigations of health aspects of left-handedness may partly be explained by a scientific disagreement whether writing with the left hand is a sufficient criterium for left-handedness, or is it necessary to investigate other parameters for laterality assessment. Explanation of health aspects of left-handedness is dominantly based on Geschwind-Galaburda model about "anomalous" cerebral domination, as a consequence of hormonal disbalance.
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PMID:[Left-handedness and health]. 2060 90

Neuroscientific and clinical studies of music over the past two decades have substantially increased our understanding of its use as a means of therapy. The authors briefly review current literature related to music's effect on people with different mental illnesses, and examine several neurobiological theories that may explain its effectiveness or lack thereof in treating psychiatric disorders. Neuroscientific studies have shown music to be an agent capable of influencing complex neurobiological processes in the brain and suggest that it can potentially play an important role in treatment. Clinical studies provide some evidence that music therapy can be used as an alternative therapy in treating depression, autism, schizophrenia, and dementia, as well as problems of agitation, anxiety, sleeplessness, and substance misuse, though whether it can actually replace other modes of treatment remains undetermined. Future research should include translational studies involving both neuroscience and clinical medicine that investigate the long-term effects of music intervention and that lead to the development of new strategies for music therapy.
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PMID:Mental health implications of music: insight from neuroscientific and clinical studies. 2125 Aug 95

This study examined the prevalence and chronicity of sleep problems in children who manifest problems believed to be typical of Autism Spectrum Disorders (ASD). Using data from a longitudinal total population study, symptoms of ASD, insomnia and potential explanatory factors were assessed at ages 7-9 and 11-13. Children were included in a group defined as having Autism Spectrum Problems (ASP) if they scored above a strict threshold on the Autism Spectrum Screening Questionnaire (ASSQ). Twenty-eight (0.8%) of 3700 children fulfilled the selected criteria for ASP at both waves, and the prevalence of chronic insomnia was more than ten times higher in these children compared to the controls. Children with ASP developed more sleep problems over time, with an incidence rate at wave 2 of 37.5% compared to 8.6% in the controls. The sleep problems were more persistent over time, with a remission rate of 8.3% compared to 52.4% in the controls. ASP was a strong predictor of sleep problems at wave 2 (OR = 12.44), and while emotional and behavioural problems explained a large proportion of this association, the effect of ASP on insomnia remained significant in the fully adjusted model (OR = 3.25). These findings call for increased awareness of sleep problems in children with ASP.
Autism 2012 Mar
PMID:Sleep problems in children with autism spectrum problems: a longitudinal population-based study. 2147 25


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