孤独症谱系障碍儿童共患睡眠障碍治疗进展

doi:10.12372/jcp.2025.23e1245

Abstract

Abstract:

Sleep disorders are one of the most common comorbidities in children with autism spectrum disorders (ASD), which not only impair the child's daytime function, but also aggravate the symptoms of ASD, and significantly reduce the quality of life of children with ASD and their families. Therefore, timely and effective intervention and management of children with ASD with comorbid sleep disorders is of great significance to improve the health, social function and quality of life of children. This article reviews the progress in the treatment of sleep disorders in children with ASD, aiming to improve the understanding of autism among clinicians.

Key words: sleep disorder, autism spectrum disorder, child

TAO Mengjiao, ZHANG Jianzhao, YANG Jian. Progress in the treatment of sleep disorders in children with autism spectrum disorder[J].Journal of Clinical Pediatrics, 2025, 43(4): 312-317.

References 44

[1]	Lord C, Elsabbagh M, Baird G, et al. Autism spectrum disorder[J]. Lancet, 2018, 392(10146): 508-520. doi: S0140-6736(18)31129-2 pmid: 30078460
[2]	Muhle RA, Reed HE, Stratigos KA, et al. The emerging clinical neuroscience of autism spectrum disorder: a review[J]. JAMA Psychiatry, 2018, 75(5): 514-523. doi: 10.1001/jamapsychiatry.2017.4685 pmid: 29590280
[3]	Maenner MJ, Warren Z, Williams AR, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years - autism and developmental disabilities monitoring network, 11 sites, United States, 2020[J]. MMWR Surveill Summ, 2023, 72(2): 1-14. doi: 10.15585/mmwr.ss7202a1 pmid: 36952288
[4]	Zhou H, Xu X, Yan W, et al. Prevalence of autism spectrum disorder in China: a nationwide multi-center population-based study among children aged 6 to 12 years[J]. Neurosci Bull, 2020, 36(9): 961-971. doi: 10.1007/s12264-020-00530-6 pmid: 32607739
[5]	Wang G, Liu Z, Xu G, et al. Sleep disturbances and associated factors in Chinese children with autism spectrum disorder: a retrospective and cross-sectional study[J]. Child Psychiatry Hum Dev, 2016, 47(2): 248-258.
[6]	Hvolby A, Christensen J, Gasse C, et al. Cumulative incidence and relative risk of sleep problems among children and adolescents with newly diagnosed neurodevelopmental disorders: a nationwide register-based study[J]. J Sleep Res, 2021, 30(3): e13122.
[7]	Bougeard C, Picarel-Blanchot F, Schmid R, et al. Prevalence of autism spectrum disorder and co-morbidities in children and adolescents: a systematic literature review[J]. Front Psychiatry, 2021, 12: 744709.
[8]	Malhi P, Kaur A, Singhi P, et al. Sleep dysfunction and behavioral daytime problems in children with autism spectrum disorders: a comparative study[J]. Indian J Pediatr, 2019, 86(1): 12-17. doi: 10.1007/s12098-018-2731-z pmid: 29951780
[9]	Inthikoot N, Chonchaiya W. Sleep problems in children with autism spectrum disorder and typical development[J]. Pediatr Int, 2021, 63(6): 649-657.
[10]	Mazurek MO, Sohl K. Sleep and behavioral problems in children with autism spectrum disorder[J]. J Autism Dev Disord, 2016, 46(6): 1906-1915. doi: 10.1007/s10803-016-2723-7 pmid: 26823076
[11]	Malow BA, Katz T, Reynolds AM, et al. Sleep difficulties and medications in children with autism spectrum disorders: a registry study[J]. Pediatrics, 2016, 137(Suppl 2): S98-S104.
[12]	Saletin JM, Koopman-Verhoeff ME, Han G, et al. Sleep problems and autism impairments in a large community sample of children and adolescents[J]. Child Psychiatry Hum Dev, 2024, 55(5): 1167-1175.
[13]	Malow BA, Byars K, Johnson K, et al. A practice pathway for the identification, evaluation, and management of insomnia in children and adolescents with autism spectrum disorders[J]. Pediatrics, 2012, 130 Suppl 2(Suppl 2): S106-S124.
[14]	American Psychiatric Association, DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5™[M]. 5th ed. American Psychiatric Publishing, Inc., 2013. https://doi.org/10.1176/appi.books.9780890425596.
[15]	Executive Board, 143 International Classification of Diseases: International Statistical Classification of Diseases and Related Health Problems: update on the eleventh revision: report by the Director-General[EB/OL]. World Health Organization, 2018. [2024-01-02]. https://iris.who.int/handle/10665/327092.
[16]	Owens JA, Spirito A, McGuinn M. The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children[J]. Sleep, 2000, 23(8): 1043-1051. pmid: 11145319
[17]	Reynolds AM, Soke GN, Sabourin KR, et al. Sleep problems in 2- to 5-year-olds with autism spectrum disorder and other developmental delays[J]. Pediatrics, 2019, 143(3): e20180492.
[18]	Jenabi E, Ataei S, Bashirian S. Evaluation of drug interventions for the treatment of sleep disorders in children with autism spectrum disorders: a systematic review[J]. Korean J Pediatr, 2019, 62(11): 405-409. doi: 10.3345/kjp.2019.00668 pmid: 31760719
[19]	Cortese S, Wang F, Angriman M, et al. Sleep disorders in children and adolescents with autism spectrum disorder: diagnosis, epidemiology, and management[J]. CNS Drugs, 2020, 34(4): 415-423. doi: 10.1007/s40263-020-00710-y pmid: 32112261
[20]	Zoghbi HY, Bear MF. Synaptic dysfunction in neurodevelopmental disorders associated with autism and intellectual disabilities[J]. Cold Spring Harb Perspect Biol, 2012, 4(3): a009886.
[21]	Yang Z, Matsumoto A, Nakayama K, et al. Circadian-relevant genes are highly polymorphic in autism spectrum disorder patients[J]. Brain Dev, 2016, 38(1): 91-99.
[22]	Geoffray MM, Nicolas A, Speranza M, et al. Are circadian rhythms new pathways to understand Autism Spectrum Disorder?[J]. J Physiol Paris, 2016, 110(4 Pt B): 434-438. doi: S0928-4257(17)30039-6 pmid: 28625682
[23]	Williams Buckley A, Hirtz D, Oskoui M, et al. Practice guideline: treatment for insomnia and disrupted sleep behavior in children and adolescents with autism spectrum disorder: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology[J]. Neurology, 2020, 94(9): 392-404. doi: 10.1212/WNL.0000000000009033 pmid: 32051244
[24]	Hyman SL, Levy SE, Myers SM, et al. Identification, evaluation, and management of children with autism spectrum disorder[J]. Pediatrics, 2020, 145(1): e20193447.
[25]	Su Maw S, Haga C. Effectiveness of cognitive, developmental, and behavioural interventions for Autism Spectrum Disorder in preschool-aged children: a systematic review and meta-analysis[J]. Heliyon, 2018, 4(9): e00763.
[26]	Danial JT, Wood JJ. Cognitive behavioral therapy for children with autism: review and considerations for future research[J]. J Dev Behav Pediatr, 2013, 34(9): 702-715. doi: 10.1097/DBP.0b013e31829f676c pmid: 23917373
[27]	Brand S, Jossen S, Holsboer-Trachsler E, et al. Impact of aerobic exercise on sleep and motor skills in children with autism spectrum disorders - a pilot study[J]. Neuropsychiatr Dis Treat, 2015, 11: 1911-1920.
[28]	McCrae CS, Chan WS, Curtis AF, et al. Cognitive behavioral treatment of insomnia in school-aged children with autism spectrum disorder: a pilot feasibility study[J]. Autism Res, 2020, 13(1): 167-176. doi: 10.1002/aur.2204 pmid: 31566918
[29]	Tse CYA, Lee HP, Chan KSK, et al. Examining the impact of physical activity on sleep quality and executive functions in children with autism spectrum disorder: a randomized controlled trial[J]. Autism, 2019, 23(7): 1699-1710. doi: 10.1177/1362361318823910 pmid: 30663324
[30]	陈涵彬, 贺安妮, 惠靖瑞, 等. 褪黑素治疗孤独症谱系障碍儿童睡眠障碍有效性的荟萃分析[J]. 发育医学电子杂志, 2021, 9(1): 26-31.
	Chen HB, He AN, Hui JR, et al. Meta-analysis of the efficacy of melatonin in the treatment of sleep disorders in children with autism spectrum disorder[J]. Fayu Yixue Dianzi Zazhi, 2021, 9(1): 26-31.
[31]	Bruni O, Alonso-Alconada D, Besag F, et al. Current role of melatonin in pediatric neurology: clinical recommendations[J]. Eur J Paediatr Neurol, 2015, 19(2): 122-133.
[32]	Goldman SE, Adkins KW, Calcutt MW, et al. Melatonin in children with autism spectrum disorders: endogenous and pharmacokinetic profiles in relation to sleep[J]. J Autism Dev Disord, 2014, 44(10): 2525-2535. doi: 10.1007/s10803-014-2123-9 pmid: 24752680
[33]	Xiong M, Li F, Liu Z, et al. Efficacy of melatonin for insomnia in children with autism spectrum disorder: a meta-analysis[J]. Neuropediatrics, 2023, 54(3): 167-173.
[34]	Tordjman S, Davlantis KS, Georgieff N, et al. Autism as a disorder of biological and behavioral rhythms: toward new therapeutic perspectives[J]. Front Pediatr, 2015, 3: 1. doi: 10.3389/fped.2015.00001 pmid: 25756039
[35]	Malow BA, Findling RL, Schroder CM, et al. Sleep, growth, and puberty after 2 years of prolonged-release melatonin in children with autism spectrum disorder[J]. J Am Acad Child Adolesc Psychiatry, 2021, 60(2): 252-261.
[36]	Nardone R, Sebastianelli L, Versace V, et al. Effects of repetitive transcranial magnetic stimulation in subjects with sleep disorders[J]. Sleep Med, 2020, 71: 113-121. doi: S1389-9457(20)30071-X pmid: 32173186
[37]	Jiao J, Tan L, Zhang Y, et al. Repetitive transcranial magnetic stimulation for insomnia in patients with autism spectrum disorder: study protocol for a randomized, double-blind, and sham-controlled clinical trial[J]. Front Psychiatry, 2022, 13: 977341.
[38]	Qiu J, Kong X, Li J, et al. Transcranial direct current stimulation (tDCS) over the left dorsal lateral prefrontal cortex in children with autism spectrum disorder (ASD)[J]. Neural Plast, 2021, 2021: 6627507.
[39]	Rivera-Urbina GN, Nitsche MA, Vicario CM, et al. Applications of transcranial direct current stimulation in children and pediatrics[J]. Rev Neurosci, 2017, 28(2): 173-184.
[40]	Simonoff E, Pickles A, Charman T, et al. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample[J]. J Am Acad Child Adolesc Psychiatry, 2008, 47(8): 921-929.
[41]	Mazzone L, Postorino V, Siracusano M, et al. The relationship between sleep problems, neurobiological alterations, core symptoms of autism spectrum disorder, and psychiatric comorbidities[J]. J Clin Med, 2018, 7(5): 102.
[42]	Cohen S, Conduit R, Lockley SW, et al. The relationship between sleep and behavior in autism spectrum disorder (ASD): a review[J]. J Neurodev Disord, 2014, 6(1): 44. doi: 10.1186/1866-1955-6-44 pmid: 25530819
[43]	Krämer M, Seefeldt WL, Heinrichs N, et al. Subjective, autonomic, and endocrine reactivity during social stress in children with social phobia[J]. J Abnorm Child Psychol, 2012, 40(1): 95-104. doi: 10.1007/s10802-011-9548-9 pmid: 21800016
[44]	Gold AK, Sylvia LG. The role of sleep in bipolar disorder[J]. Nat Sci Sleep, 2016, 8: 207-214. doi: 10.2147/NSS.S85754 pmid: 27418862

Progress in the treatment of sleep disorders in children with autism spectrum disorder

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