Autism Spectrum Disorder and Sleep

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental condition that significantly impacts daily functioning, including sleep, an essential component of mental, emotional, and physical health. Sleep disturbances are among the most prevalent and persistent challenges faced by children with ASD, often exacerbating behavioral difficulties and straining family dynamics. This thesis explores the clinical relevance of these disturbances by integrating developmental psychology, neuropsychology, and therapeutic perspectives. A thorough examination of core sleep disorders, including insomnia, circadian rhythm disruptions, parasomnias, and comorbid conditions such as restless legs syndrome, highlights their diverse presentations and mechanisms in autistic children. Polysomnographic studies reveal abnormalities primarily in REM sleep architecture, often coupled with heightened sensory sensitivities and irregular motor patterns during rest. These findings are analyzed in relation to the broader cognitive, emotional, and familial impacts of poor sleep in ASD. The thesis also delves into the underlying neurobiological and behavioral mechanisms, including melatonin secretion irregularities, sensory processing differences, and difficulties in self-regulation. The final and most extensive section reviews interventions ranging from behavioral strategies and pharmacological treatments to sensory-based approaches, emphasizing the importance of individualized, multimodal care plans. By synthesizing current literature and clinical insights, this review aims to illuminate the multifaceted nature of sleep difficulties in children with ASD and to advocate for early, integrative interventions that support both the child and their family’s well-being.