Aspies For Freedom

http://www.sciencedaily.com/releases/200...085018.htm

ScienceDaily (Nov. 21, 2007) — The first known attempt to evaluate the sleep patterns of children with Asperper [sic] Syndrome (AS), taking into account sleep architecture and the cyclic alternating pattern (CAP), finds that children with AS have a high prevalence of some sleep disorders and mainly problems related to initiating sleep and sleep restlessness together with morning problems and daytime sleepiness, according to a new study.

The study, authored by Oliviero Bruni, MD, of the Center for Pediatric Sleep Disorders at University La Sapienza in Rome, Italy, focused on eight children with AS, 10 children with autism and 12 healthy control children. The parents of the children with AS filled out the following materials:

1. Sleep questionnaire.
2. Pediatric Daytime Sleepiness Scale, which evaluates the relationship between daytime sleepiness and school-related outcomes.
3. Autism Diagnostic Observation Schedule, a semi-structured, standardized assessment of communication, social interaction and play or imaginative use of materials for individuals who have been referred because of possible autism spectrum disorders.
4. Child Behavior Checklist, a questionnaire used to examine daytime behavior in children.

In addition, the children took the Wechsler Intelligence Scale for Children, which measures verbal IQ, performance IQ and a full-scale IQ, and also underwent an overnight polysomnogram, or sleep study.

Several sleep parameters, such as time in bed, sleep period time, number of awakenings per hour, and sleep efficiency, were evaluated. CAP, a periodic EEG activity of non-REM sleep characterized by repeated spontaneous sequences of short-lived events (phase A) with the return to background activity identifying the interval that separates the repetitive elements (phase B), was also scored.

According to the results, 50 percent of the children with AS were reluctant to go to bed, while 75 percent felt a need for light or a television in the bedroom, 87 percent had difficulty getting to sleep at night and 75 percent fell asleep sweating. In addition, 50 percent felt unrefreshed when waking up in the morning, 87 percent had difficulty waking up in the morning and 87 percent felt sleepy during the day.

With respect to the CAP, in comparison to healthy controls, subjects with AS showed a lower total CAP rate in the first two sleep stages, but not in slow wave sleep. In addition, they showed an increased percentage of synchronized EEG patterns and a decreased percentage of desynchronized EEG patterns. Further, the duration of the A and B phases, and consequently the entire CAP cycle, was longer. Compared to the children with autism, AS subjects showed an increased CAP rate in slow wave sleep and a decrease in the second sleep stage. The duration of the A phases was longer, as well as the CAP cycle duration.

"This study showed peculiar CAP modifications in children with AS and represented an attempt to correlate the quantification of sleep EEG oscillations with the degree of mental ability or disability," said Dr. Bruni.

AS is one of several autism spectrum disorders (ASDs) characterized by difficulties in social interaction and by restricted and stereotyped interests and activities. AS is distinguished from the other ASDs in having no general delay in language or cognitive development. Although it is not mentioned in standard diagnostic criteria, there are frequent reports of motor clumsiness and atypical use of language.

It is recommended that children in pre-school sleep between 11-13 hours a night, school-aged children between 10-11 hours of sleep a night, and adolescents about nine hours a night.

The American Academy of Sleep Medicine (AASM) offers some tips to help your child sleep better:

- Follow a consistent bedtime routine. Set aside 10 to 30 minutes to get your child ready to go to sleep each night.
- Establish a relaxing setting at bedtime.
- Interact with your child at bedtime. Don't let the TV, computer or video games take your place.
- Keep your children from TV programs, movies, and video games that are not right for their age.
- Do not let your child fall asleep while being held, rocked, fed a bottle, or while nursing.
- At bedtime, do not allow your child to have foods or drinks that contain caffeine. This includes chocolate and sodas. Try not to give him or her any medicine that has a stimulant at bedtime. This includes cough medicines and decongestants.

Children are encouraged to inform their parents of any sleep problems they may have. Parents who suspect that their child might be suffering from a sleep disorder are encouraged to consult with their child's pediatrician or a sleep specialist.

The journal article, entitled, "Sleep Architecture and NREM Alterations in Children and Adolescents with Asperger Syndrome", was published in Sleep November 1, 2007.

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Are these findings familiar to anyone on here? I have always insisted on sleeping with the lights on in my room, for as long as I can remember... I'm not (and have never been) scared of the dark, but I am unable to sleep if the lights are out. I have always had problems with insomnia in general for much of my life, and I had to take sleeping pills for a period of about five years up until like 2005.

I never get the whole "waking up refreshed" thing though. I always feel very tired when I wake up, never like I could just hop out of bed and get going. Is this not normal? I do get adequate amounts of sleep, usually around 10-11 hours a night on most days, but I never feel "refreshed" upon awakening.

Oh, yay, ANOTHER thing I can use to convince my stubborn parents that I have AS.

I have always had trouble sleeping.

Thanks for posting this article...  It's the first time that I've seem something that speaks to AS and sleep-issues in the same sentence. One of my kids is dealing with sleep problems...  well, we all are. Awaking mostly... difficulty getting to sleep. (Typical teen? Hardly...) The doc put her on trazadone for depression, and then we tried melatonin. Both work for a while. She seems to adapt quickly to both (needing more)... The psychologist suggested adding Tylenol PM to the mix, then alternate use of the three, so as to keep from increasing the doses... It is still not working... I think the ‘depression’ is from having to go to school with a ‘social’ problem, simple.

Something else, you might want to go to a sleep clinic to be tested for Sleep-Apnea. Heredity blessed me with the problem so I use a c-pap device. I’m thinking of surgery for the condition so I can ‘chuck’ the machine. It helps incredibly with reducing snoring, as well as aiding in ‘awaking refreshed’. Some folks I know with the same issue have difficulty adapting to such devices.

Good luck.

Beammeup

Ahh... I was on Trazadone for several years as a sleep aid and an enhancer for the other antidepressant I was on at the time... I've heard the aforementioned medication is a weak antidepressant by itself, but it helps when combined with other medications (especially when used on people who had both depression and insomnia, as I did). As with your daughter, I don't feel I had true, clinical depression - it was just a reaction to getting bullied at school and failing a bunch of my classes. Once I was out of that situation, the "depression" disappeared, and I have not had any issues with it since.

I never looked into sleep apnea as a cause of morning fatigue, though. Isn't that something they would have detected earlier on? It can be a pretty serious problem.

You don't say. This sounds terribly familiar.

Hmm...  interesting. I can only sleep with absolutely no light at all and either no noise or white noise like a fan.  I've always been a night owl, and that is what I've attributed to my grumpy arousal in the morning. (by the child that wakes up before dawn like clockwork...)  My head still hurts from this morning.

Awfully small sample size, isn't it?  Twenty kids, total, and only eight with AS.  Fine as such, but hardly generalizable to the entire population.

The only time I have trouble falling asleep is after an Aspie meeting, because I am going over everything in my mind.  If I am in my usual (blissfully) socially isolated state, going to sleep is not a problem.  But I often wake up after about six hours and never really get back to sleep.  Oh well, that's what caffeine is for, right?

My little Aspie sleeps about ten hours a night, with me, and has few if any problems.  She was a great sleeper from about six weeks old, sleeping through the night.  We'll see if that continues once she's ejected from the family bed at the age of five (or so!)  She used to take naps, but quit when she started preschool.

I don't think this is a universal Aspie thing.  If you've seen one Aspie, you've seen one Aspie.  Some Aspies have sleep problems, others do not.

I couldn't agree more Tigger!  My son has problems getting to sleep, it sounds awful but I've kinda given up now I'm too exhausted, I just leave him to it, when I go to bed I can hear him chattering away to himself or reading his beloved Mr Men books, he drops off eventually.  

I'd also like some advice that applies to real parents as well as real kids, when you have AS and/or various "disorders" yourself, raising a child can be challenging to say the least so being consistant and following routines is often very difficult, well it is for me anyway.

LOL, they could have saved their money and just asked me.  I have the craziest sleeping patterns of almost of anyone I know, and so does my AS child.

Difficult to detect unless you have a partner/caregiver observing while you sleep...  And Apnea, as with many 'differences',  comes in varying degrees from a slight problem to severe. My DX is somewhere in between.

It was my partner asking me in the morning: "Why did you stop breathing", which was the first indicator that there was a problem...

I didn't have a clue.... So off to the sleep clinic I went... Spent the night all wired-up from head to toe, and there was a video camera aimed at me with some poor bloke staying up all night observing every minute of me....  jeeze...  

In the morning the data says:  Yes... you stoppped breathing X-times an hour.

In my case I'm told  that my brain tends to complain a bit  when I stop breathing during sleep, so it wakes me enough to catch a breath.... All occuring somewhat unconciously. I'm told that this prevents the brain from entering REM, a deeper healing sleep.

Oh well... I'm getting lots of REM sleep now....

Side note... could be hereditary. I had an Uncle with an identical problem. He had a machine, then surgery. He lived until he was 90.

LOL

Well duh, Tony Attwood even states that in his book. And *** unmedicated I am an insominc LOL

That is sad Rossco. Reminds me of something else that's sad but has nothing to do with sleeping.

Hello,

Interesting study; I have some mild sleep issues. I cannot sleep with any lights on or visible, it will keep me up forever. On the other hand, I am one of those early-bird individuals who naturally awake and start bouncing off the walls at 6:30 a.m.

Will

I stay up at night and sleep during the day, and when going to work even if I got three hours of sleep beforehand I somehow manage to stay up the entire night again. It could have to do with the caffeine intake or it could be something else.

Oh yeah ... our son (4) is put to bed at 8 pm, he insists he has to go to the loo about 15-30 times before he starts to sleep at 11 pm. And of course he needs a light. He is very ungrateful when we wake him up as early as 8 am!