Rana Mandeep, Kothare Sanjeev, DeBassio William
Department of Pediatrics, Division of Pediatric Neurology and Sleep Medicine, Boston University School of Medicine, Boston Medical Center, Boston, Massachusetts, USA.
Department of Pediatrics, Division of Pediatric Neurology, Cohen Children's Medical Center, Zucker School of Medicine Hofstra/Northwell, New York, USA.
J Can Acad Child Adolesc Psychiatry. 2021 Feb;30(1):25-35. Epub 2021 Feb 1.
To summarize causes, evaluation methods, and treatment of sleep disturbance in children and adolescents with autism spectrum disorder (ASD).
A narrative literature and synthesis approach was used.
RESULTS/DISCUSSION: Sleep disturbances in this population are common and include insomnia, parasomnias, circadian rhythm disorders, and sleep-related movement disorders. Multiple factors may contribute to the higher rates of sleep disturbances in persons with ASD. Unfortunately, there are not evidence-based guidelines specific for the management of these sleep disorders in this population. There is also a lack of controlled clinical studies. Nevertheless, assessment of sleep problems using both subjective and objective methods are recommended to develop an individualized approach. Behavioural interventions are preferred first line treatment for insomnia. As adjunctive measures, pharmacotherapy may be warranted and choice should be guided based on accompanying symptoms. The most commonly used pharmacotherapy for sleep disturbance, primarily insomnia, include melatonin and alpha agonists. Not all currently used medications are approved for use for children and adolescents.
总结自闭症谱系障碍（ASD）儿童和青少年睡眠障碍的病因、评估方法及治疗。
采用叙述性文献综述和综合分析方法。
结果/讨论：该人群睡眠障碍很常见，包括失眠、异态睡眠、昼夜节律障碍及睡眠相关运动障碍。多种因素可能导致ASD患者睡眠障碍发生率较高。遗憾的是，目前尚无针对该人群这些睡眠障碍管理的循证指南。同时也缺乏对照临床研究。尽管如此，建议采用主观和客观方法评估睡眠问题，以制定个体化方案。行为干预是失眠首选的一线治疗方法。作为辅助措施，药物治疗可能是必要的，应根据伴随症状指导用药选择。治疗睡眠障碍（主要是失眠）最常用的药物包括褪黑素和α激动剂。并非所有目前使用的药物都被批准用于儿童和青少年。
