University of Canterbury researchers have taken a major step forward in treating sleep problems in children with Autism Spectrum Disorder and have now extended the project to include children with rare genetic neurodevelopmental disorders.
A high proportion of these children have difficulty with bedtime routines, problems settling to sleep, waking at night and waking too early.
"This is harmful to the child’s development in many areas of life and adds to the stress experienced by parents and siblings," says Associate Professor Laurie McLay, a principal investigator in the Good Nights Canterbury Autism and Sleep Project.
She says sleep problems can be related to a number of factors, including sleep/wake schedules, sleep hygiene, and other aspects of the sleep environment.
“There is often some kind of circadian component – some aspect of the sleep/wake cycle that will need to be adjusted.” The circadian rhythm is a 24-hour internal clock that cycles between sleepiness and alertness. “We start by looking at circadian components then we look at sleep hygiene (factors in the bedroom environment and bedtime routine) and other environmental factors that might be maintaining the sleep problem,” Laurie says.
"Our research has now shown that there is a range of strategies therapists can recommend to parents and children that are highly effective in helping children with ASD get a good night’s sleep, but they need to be tailored to each child. It is the individualisation that makes the big difference.”
Funded by the Health Research Council and the IHC Foundation, the project involved 41 families with a child aged 3 to 15 years who had received a clinical diagnosis of ASD and had at least one severe sleep problem. Two-thirds of the children were boys. The families came from throughout New Zealand, with those outside Christchurch taking part by email, phone and Zoom/Skype.
A sleep diary kept by parents, complemented by videos of parent-child interaction and a range of standardised questionnaires, helped researchers understand the child and their sleep problem.
Researchers analysed the child’s sleep/wake schedules, sleep hygiene, and environmental factors, including the interactions between the parents and child, that might have contributed to the sleep problem to create an individualised sleep treatment.
The study found that the severity of the sleep problem was reduced for the majority of the children. The benefits of treatment were maintained at both short-term and long-term follow-up (at 4–6 weeks and again at 12–14 weeks after treatment). As yet unpublished results also show that the improvement in the children’s sleep also let to reductions in their ASD symptoms and their behaviour and to some improvements in parents’ wellbeing.
The team is continuing its research and welcomes enquiries from parents interested in participating. Contact Laurie McLay or Karyn France.
The research has been published in the Journal of Autism and Developmental Disorders
Listen to the Radio New Zealand interview