Sleep in autism may be under-researched because lack of sleep seems like a peripheral problem to many autism researchers. Comorbidities in autism — epilepsy, sleep, gastrointestinal issues and so on — haven’t received the same attention from the scientific community as the core features of autism. That may be changing — and should.
Sleep problems have a large impact on a person’s quality of life. From our work, we see that not sleeping well clearly affects daytime functioning. In a study published this year, we reported that when children sleep more, they are more attentive. They also are less aggressive, calmer, have less severe autism features and respond better to therapies. By treating sleep problems, clinicians can improve some of the core features of autism.
These effects also can be an important — but unappreciated — confound in autism research.
Say you are studying a new treatment for language delay. If half the kids getting the therapy sleep well, but the other half don’t, the ones who benefit from the treatment may be the ones who are sleeping better. A good night’s sleep may help them pay attention to the therapist.
I would like to see sleep become more mainstream in autism research. I would even like sleep to be considered a core feature of autism as it is in other developmental conditions. Once sleep problems are recognized as a fundamental issue in autism, they are likely to receive funding for research. Then the best people in the field will want to study sleep.
As with other autism research, understanding sleep in autism requires collecting data from a large, varied population. Instead of just recruiting participants from large academic medical centers, we should seek people out in community settings. Doing so will provide the data we need to have confidence in our results.