Why Do Kids With Autism Have Sleep Problems?

A study of over 400 young children shows that those who were diagnosed with autism had a higher likelihood of difficulty in falling asleep as infants, which has been associated with altered growth trajectories in the hippocampus.

The study, conducted by the University of Washington (UW), found that sleep issues in a baby’s first 12 months may not only precede an autism diagnosis but also affect brain development.

An infant will spend most of their first year of life sleeping, and it is essential for forming neural connections and encoding sensory memories. When sleep is disrupted, as occurs more often among children with autism, the development of the hippocampus may be affected.

“The hippocampus is critical for learning and memory, and changes in the size of the hippocampus have been associated with poor sleep in adults and older children,” said lead author Dr Kate MacDuffie, a postdoctoral researcher at the UW Autism Centre. “However, this is the first study we are aware of to find an association in infants as young as 6 months of age.”

Dr Annette Estes, director of the UW Autism Centre and senior author of the study, said that up to 80 per cent of children with autism spectrum disorder (ASD) have sleep problems, but existing research is mostly focused on behaviour and cognition.

Researchers at the multi-centre Infant Brain Imaging Study (IBIS) Network believed there was more to be studied with the critical need for children and adults to get proper sleep.

“In our clinical experience, parents have a lot of concerns about their children’s sleep, and in our work on early autism intervention, we observed that sleep problems were holding children and families back,” said Estes, who is also a UW professor of speech and hearing sciences.

The study was conducted to find out if sleep problems exacerbate the symptoms of autism, or if it was the other way round. Or could it be something else altogether?

“It could be that altered sleep is part-and-parcel of autism for some children. One clue is that behavioural interventions to improve sleep don’t work for all children with autism, even when their parents are doing everything just right. This suggests that there may be a biological component to sleep problems for some children with autism,” Estes said.

Researchers at the IBIS Network evaluated MRI scans of 432 infants to investigate any associations between brain development, sleep and autism. Their findings allowed researchers to re-examine previously collected data to identify some patterns. Difficulties with sleep were more common among the infants later diagnosed with ASD, as were larger hippocampi.

There were no other subcortical brain structures affected, including the amygdala, which is responsible for certain emotions and aspects of memory, or the thalamus, a signal transmitter from the spinal cord to the cerebral cortex.

The UW-led sleep study is the first to show an association between hippocampal growth and sleep problems in infants who are later diagnosed with autism. It is still unclear if there is a causal relationship, however.

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