Sleep in autism: A biomolecular approach to aetiology and treatment

Aug 8, 2020Sleep medicine reviews

Biological factors behind sleep problems and treatments in autism

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗

Abstract

Between 50% and 83% of individuals with autism spectrum disorder experience sleep problems or disorders.

Common sleep issues in individuals with autism spectrum disorder include insomnia and circadian rhythm sleep-wake disorders.
Insomnia is characterized by difficulties in falling asleep or staying asleep.
Circadian rhythm disorders result from a misalignment between internal biological clocks and external environmental cues.
The circadian system, which regulates sleep-wake cycles, involves complex interactions between biological processes and various neurohormones and neurotransmitters.
Altered sleep structures may be linked to neurobiological changes or genetic mutations, suggesting potential targets for pharmacological treatments.

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People with autism spectrum disorder (ASD) commonly experience other comorbidities. Studies indicate that between 50% and 83% of individuals with ASD have sleep problems or disorders. The most commonly reported sleep problems are: (a) insomnia symptoms including the inability to get to sleep or stay asleep; and (b) circadian rhythm sleep-wake disorders, defined as a misalignment between the timing of endogenous circadian rhythms and the external environment. The circadian system provides timing information for the sleep-wake cycle that is regulated by the interaction of an endogenous processes (circadian - Process C, and homeostatic - Process S) and synchronizing agents (neurohormones and neurotransmitters), which produce somnogenic activity. A clinical priority in ASD is understanding the cause of these sleep problems in order to improve treatment outcomes. This review approaches sleep in autism from several perspectives: Sleep-wake mechanisms and problems, and brain areas and molecules controlling sleep (e.g., GABA and melatonin) and wake maintenance (e.g., serotonin, acetylcholine and glutamate). Specifically, this review examines how altered sleep structure could be related to neurobiological alterations or genetic mutations and the implications this may have for potential pharmacological treatments in individuals with ASD.

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Sleep in autism: A biomolecular approach to aetiology and treatment

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