We are told that eight hours of sleep each night is best, but for ASD individuals that may be easier said than done, and new research may explain why. A new study published in July in the Journal of Child Psychology and Psychiatry of autistic people and their relatives says that the genetic factors influencing autism may overlap with the ones that underlie insomnia, but the two conditions didn’t show much overlap in environmental influences.
Lead investigator Mark Taylor, a researcher in psychiatric epidemiology at the Karolinska Institute in Stockholm, Sweden, says the results may help explain the frequent co-occurrence of autism and sleep issues. According to previous research, up to 90 percent of people with autism have disrupted sleep and about 30 percent have a clinical diagnosis of a sleep disorder. Taylor says this new research shows autistic individuals are commonly diagnosed with insomnia, and as a result, are prescribed melatonin to help them sleep. His team was also looking at their siblings and relatives in this study and the relatives of people with autism are also at a higher risk of developing insomnia. Philippe Mourrain, an associate professor of psychiatry and behavioral sciences at Stanford University in California was not involved in this research, but says the strong overlap between these conditions underscores how important diagnosing and treating sleep problems in autistic individuals is. He also says that sleep problems are overlooked and thought of as a byproduct not worthy of investigating but poor sleep can impact brain development and influence how severe autism traits can get.
Taylor and his team used Swedish national health registries to identify over 50,000 people with autism, along with almost 56,000 of their full siblings (including 60 identical twins and 340 fraternal twins), 31,669 half-siblings and 214,665 cousins. They also analyzed data from 500,970 unrelated sex- and age-matched controls and determined which participants were diagnosed with insomnia or used melatonin. About 23 percent of the participants with autism had insomnia or took melatonin and only 1.1 percent of the controls had insomnia or used melatonin. The relatives of the autistic participants were also at increased odds of having insomnia – depending on how closely related they were (identical twins had about 6.6 times the usual odds compared to about 1.3 times for cousins). A second analysis of data from 30,558 identical and fraternal twins from the Child and Adolescent Twin Study in Sweden produced similar results: among 423 autistic twins, about 39 percent had insomnia or were prescribed melatonin, compared to only 4 percent of non-autistic twins.
The team also found that when one twin in a pair had autism or autism traits, the other often had insomnia. This trend was more prominent in identical twins than fraternal twins: 94 percent of the correlation. Amanda Bennett, clinical chair of the Autism Integrated Care Program at Children’s Hospital of Philadelphia, says finding a genetic correlation between autism and sleep problems confirms what we’re already seeing often and what could really change the practice is if genetic variations that help predict and address those co-occurring symptoms proactively could be identified.
Taylor’s team is examining the co-occurrence of autism and other traits with mental health conditions like anxiety, depression, schizophrenia and bipolar disorder. He says that some traits including sensory sensitivity, hyperactivity, and anxiety, can contribute to poor sleep in autistic individuals and are genetically correlated with autism, making it possible that insomnia isn’t directly correlated genetically to autism but to other co-occurring conditions.
Lack of sleep makes function more difficult for everyone. Treating insomnia as a significant factor for the ASD individual increases the chances for higher quality of life. It’s about time the medical community listened and acted.
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