Chapter 4: Sleep Disturbances in Autism Spectrum Disorders: Contributions of Neurological Conditions (and Their Medications)

Sleep difficulties are common in autism spectrum disorders (ASD), ranging from 44–83% in various epidemiological studies depending on population, measures used, and definitions used. These difficulties are predominantly categorized as disorders of sleep initiation or sleep maintenance and present with significant problems for family and child (refer to Chapters 6 & 7). Contributors to poor sleep in this population are multifactorial, and include neurobiological factors intrinsic to ASD (e.g., neurotransmitter abnormalities), medical causes, and behavioral causes (e.g., poor sleep hygiene). In this chapter, we will focus on neurobiological factors as well as neurological conditions (e.g., epilepsy, motor impairments) that contribute to poor sleep in ASD. The relationship between neurobiological factors and neurological conditions and sleep in ASD is complex and bidirectional, with these factors and conditions affecting sleep and in turn, poor sleep resulting in neurocognitive effects.