TY - JOUR
T1 - Practice guideline
T2 - Treatment for insomnia and disrupted sleep behavior in children and adolescents with autism spectrum disorder: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology
AU - Williams Buckley, Ashura
AU - Hirtz, Deborah
AU - Oskoui, Maryam
AU - Armstrong, Melissa J.
AU - Batra, Anshu
AU - Bridgemohan, Carolyn
AU - Coury, Daniel
AU - Dawson, Geraldine
AU - Donley, Diane
AU - Findling, Robert L.
AU - Gaughan, Thomas
AU - Gloss, David
AU - Gronseth, Gary
AU - Kessler, Riley
AU - Merillat, Shannon
AU - Michelson, David
AU - Owens, Judith
AU - Pringsheim, Tamara
AU - Sikich, Linmarie
AU - Stahmer, Aubyn
AU - Thurm, Audrey
AU - Tuchman, Roberto
AU - Warren, Zachary
AU - Wetherby, Amy
AU - Wiznitzer, Max
AU - Ashwal, Stephen
PY - 2020/3/3
Y1 - 2020/3/3
N2 - OBJECTIVE: To review pharmacologic and nonpharmacologic strategies for treating sleep disturbances in children and adolescents with autism spectrum disorder (ASD) and to develop recommendations for addressing sleep disturbance in this population. METHODS: The guideline panel followed the American Academy of Neurology 2011 guideline development process, as amended. The systematic review included studies through December 2017. Recommendations were based on evidence, related evidence, principles of care, and inferences. MAJOR RECOMMENDATIONS LEVEL B: For children and adolescents with ASD and sleep disturbance, clinicians should assess for medications and coexisting conditions that could contribute to the sleep disturbance and should address identified issues. Clinicians should counsel parents regarding strategies for improved sleep habits with behavioral strategies as a first-line treatment approach for sleep disturbance either alone or in combination with pharmacologic or nutraceutical approaches. Clinicians should offer melatonin if behavioral strategies have not been helpful and contributing coexisting conditions and use of concomitant medications have been addressed, starting with a low dose. Clinicians should recommend using pharmaceutical-grade melatonin if available. Clinicians should counsel children, adolescents, and parents regarding potential adverse effects of melatonin use and the lack of long-term safety data. Clinicians should counsel that there is currently no evidence to support the routine use of weighted blankets or specialized mattress technology for improving disrupted sleep. If asked about weighted blankets, clinicians should counsel that the trial reported no serious adverse events with blanket use and that blankets could be a reasonable nonpharmacologic approach for some individuals.
AB - OBJECTIVE: To review pharmacologic and nonpharmacologic strategies for treating sleep disturbances in children and adolescents with autism spectrum disorder (ASD) and to develop recommendations for addressing sleep disturbance in this population. METHODS: The guideline panel followed the American Academy of Neurology 2011 guideline development process, as amended. The systematic review included studies through December 2017. Recommendations were based on evidence, related evidence, principles of care, and inferences. MAJOR RECOMMENDATIONS LEVEL B: For children and adolescents with ASD and sleep disturbance, clinicians should assess for medications and coexisting conditions that could contribute to the sleep disturbance and should address identified issues. Clinicians should counsel parents regarding strategies for improved sleep habits with behavioral strategies as a first-line treatment approach for sleep disturbance either alone or in combination with pharmacologic or nutraceutical approaches. Clinicians should offer melatonin if behavioral strategies have not been helpful and contributing coexisting conditions and use of concomitant medications have been addressed, starting with a low dose. Clinicians should recommend using pharmaceutical-grade melatonin if available. Clinicians should counsel children, adolescents, and parents regarding potential adverse effects of melatonin use and the lack of long-term safety data. Clinicians should counsel that there is currently no evidence to support the routine use of weighted blankets or specialized mattress technology for improving disrupted sleep. If asked about weighted blankets, clinicians should counsel that the trial reported no serious adverse events with blanket use and that blankets could be a reasonable nonpharmacologic approach for some individuals.
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UR - http://www.scopus.com/inward/citedby.url?scp=85081127262&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000009033
DO - 10.1212/WNL.0000000000009033
M3 - Article
C2 - 32051244
AN - SCOPUS:85081127262
VL - 94
SP - 392
EP - 404
JO - Neurology
JF - Neurology
SN - 0028-3878
IS - 9
ER -