Disrupted Sleep in Boys with ASD

Children with autism spectrum disorder (ASD) are at a higher risk of insomnia and sleep-related disorders. Studies have found that 50-80% of these children experience sleep-disorders, including delayed sleep onset and night waking, which is significantly higher than typically developing children. This decrease in sleep may have a causal relationship with the repetitive behaviors, inattention, hyperactivity, and stereotypic behaviors common in ASD. Moreover, the increase in inattention and problematic behaviors also interfere with learning and cognition.

The issues associated with sleep-depravation can be worsened in those with ASD due to their special sensory processing differences. Thus, individuals with ASD are often prescribed melatonin to induce sleep in response to darkness. This is because melatonin is a key hormone that regulates the circadian rhythm of the body. Circadian rhythm is mainly regulated by the light and dark cycle of the day, but it can be disrupted in different ways through modern-day technologies. Artificial bright lights from computers or TV screens is one of the big examples that disrupts the circadian rhythm. The usage of screened media not only affects individuals with ASD, but it is a well-established fact it also heavily affects typically developing individuals.

However, media usages affect individuals with ASD more heavily due to their tendency to spend more time on TV and have more difficulty disengaging from screens. Due to this increased screen usage, even during bedtime, melatonin production and circadian rhythm is altered, which in turn leads to sleep problems. Because individuals with ASD have more difficulties in disengaging and controlling their screen hours, in-room access to video games as well as video game exposure per day were associated with less time spent in bed. Video games have been found to be a huge issue for adolescents with ASD, especially males. Some sleep time can be spent on playing video games, decreasing sleep time in general, but the increased arousal from playing video games right be bedtime also can cause boys with ASD to resist sleep. It is apparent that decrease in screened media and video games is encouraged to increase sleep time and quality.

Although it is true that increased screen time increases sleep-related problems, this study was only conducted on boys with ASD, thus cannot be readily applied to girls with ASD. More studies are done with boys than girls because of camouflaging, so more boys are identified as having ASD than girls. The CDC also reports that boys are diagnosed at higher rates than girls, possibly due to a combination of social and biological factors. Since girls and boys display some different characteristics of ASD, more research should be conducted in order to diagnose more girls earlier for not only better intervention, but for more representation for researches.

Reference

Engelhardt, C. R., Mazurek, M. O., & Sohl, K. (2013). Media use and sleep among boys with autism spectrum disorder, ADHD, or typical development. Pediatrics, 132(6), 1081–1089. https://doi.org/10.1542/peds.2013-2066

Goldman, S. E., Adkins, K. W., Calcutt, M. W., Carter, M. D., Goodpaster, R. L., Wang, L., Shi, Y., Burgess, H. J., Hachey, D. L., & Malow, B. A. (2014). Melatonin in children with autism spectrum disorders: endogenous and pharmacokinetic profiles in relation to sleep. Journal of autism and developmental disorders, 44(10), 2525–2535. https://doi.org/10.1007/s10803-014-2123-9