RT Journal Article
SR Electronic
T1 Reduced sleep pressure in young children with autism
JF bioRxiv
FD Cold Spring Harbor Laboratory
SP 706135
DO 10.1101/706135
A1 Ayelet Arazi
A1 Gal Meiri
A1 Dor Danan
A1 Analya Michaelovski
A1 Hagit Flusser
A1 Idan Menashe
A1 Ariel Tarasiuk
A1 Ilan Dinstein
YR 2019
UL http://biorxiv.org/content/early/2019/07/22/706135.abstract
AB Importance Sleep disturbances and insomnia are highly prevalent in children with Autism Spectrum Disorder (ASD). Sleep homeostasis, a fundamental mechanism of sleep regulation that generates pressure to sleep as a function of wakefulness, has not been studied in children with ASD. It is not clear whether abnormalities in sleep homeostasis contribute to sleep disturbances in children with ASD.Objective To determine whether slow wave activity (SWA), a potent measure of homeostatic sleep pressure, is impaired in children with ASD and associated with the severity of reported sleep disturbances.Design Case-control comparison of overnight electroencephalogram (EEG) recordings that were performed during Polysomnography (PSG) evaluations between 2015 and 2018.Setting Children with autism were deeply phenotyped at the National Autism Research Center of Israel. PSG was performed at a neighboring regional sleep disorders unit that accepts children with primary care referrals.Participants Final analyses were performed with PSGs from 29 children with ASD, 8 females, mean age 4.6 years old (range 1.9 – 7.8), and 23 typically developing children, 8 females, mean age 5.3 years old (range 3.5-8.9).Exposure A single overnight PSG evaluation.Main outcome measures SWA power, SWA slope, and sleep architecture.Results Children with ASD exhibited significantly weaker SWA power, shallower SWA slopes, and a decreased proportion of slow wave sleep in comparison to controls. This difference was largest during the first two hours following sleep onset and decreased gradually during sleep. Furthermore, SWA power of children with ASD was significantly correlated with the time of sleep onset and with parental report of latency to sleep at home.Conclusions and relevance These results reveal that children with ASD exhibit reduced sleep pressure, which is a dysregulation of sleep homeostasis. The extent of dysregulation in individual children is apparent in the amplitude of their SWA power, which is indicative of the severity of their sleep disturbances. These findings motivate clinical trials with specific interventions that increase homeostatic sleep pressure.Question Are sleep disturbances in some children with autism due to disrupted sleep homeostasis?Findings In this case-control study, children with Autism Spectrum Disorder (ASD) exhibited significantly weaker slow-wave-activity power and less slow-wave-sleep, indicating a reduced pressure to sleep. The reduction in sleep pressure was significantly correlated with the severity of individual children’s sleep disturbances as observed in the sleep lab and as reported by parents at home.Meaning These findings demonstrate that disrupted sleep homeostasis manifested in reduced sleep pressure is common in children with ASD and likely to exacerbate sleep disturbances.