Sleep is a complex phenotype. Developmental problems in children, particularly those occurring during the prenatal period, can override or masquerade as genetic influences, and contribute in this phenotype. Sleep problems are especially prominent in children with hyperactivity and oppositionality. When coexisting, these behavioral problems alter the sleep pattern in an additive manner. OBJECTIVES: To determine: (1) specific developmental phenotype components associated with sleep disorders; (2) comparative sleep battery in children with autism spectrum syndromes; (3) practical implications in alleviating sleep symptomatics in autism spectrum disorders (ASD). METHODS: Of the total 148 retrieved papers, 64 studies pertaining to quantitative measures on development and sleep battery from 1823 ASD children and 1190 typically developed peers, were allocated for meta-assessment. Autism symptomatics and sleep macrostructure derived from subjective (provider and parental inventories), and objective measures (polysomnography, actigraphy) are considered as measurable outcomes. RESULTS: Fairly different in expressions, prevalence of sleep onset disorders, sleep fragmentations, nocturnal breathing disorders, and reduced sleep efficiency are twice higher in children with Autism, Rett, Tourette`s, Angelman, and Heller`s syndromes. Sleep symptomatic, especially parasomnias, are not related to children's cognitive and intellectual deficits, except of Tourette`s children whose cognitive scores are negatively related to sleep onset parameters (- 0.9017). Sleep-maintenance insomnia, and inefficient sleep have moderate associations with the central apnea, arousal index - having acceptable sensitivity (87%), but low specificity (26%). Exogenous melatonin improves sleep-wake cycles , advances sleep-onset latency, however, does not impact on arousal index. The optimal dosage and duration of treatment with melatonin remain on the table of debates. Findings inform the extensions of further research in Mozart`s effect - the natural stimulant of the endogenous melatonin.
- Nocturnal breathing,
Available at: http://works.bepress.com/negroponte/79/