International Meeting for Autism Research: Impact of a Standardized Pamphlet on Sleep In Children with Autism

Impact of a Standardized Pamphlet on Sleep In Children with Autism

Thursday, May 12, 2011
Elizabeth Ballroom E-F and Lirenta Foyer Level 2 (Manchester Grand Hyatt)
9:00 AM
K. Adkins1, C. A. Molloy2, T. E. Clemons3, S. E. Goldman1, K. L. Surdyka1, D. Wofford1, D. Fawkes1 and B. A. Malow1, (1)Neurology/Sleep, Vanderbilt Medical Center, Nashville, TN, (2)Cincinnati Children's Hospital Medical Center, Cincinnati, OH, (3)Emmes Corporation, Rockville, MD
Background: Sleep difficulties are common reasons why parents seek medical intervention in children with autism spectrum disorders (ASD).

Objectives: To determine the efficacy of a sleep education pamphlet on sleep latency (time to fall asleep) in children with ASD.

Methods: Children were ages 2- 10 years, enrolled in the Autism Treatment Network at Vanderbilt University and Cincinnati sites, with a clinical diagnosis of ASD, confirmed by the Autism Diagnostic Observation Schedule. Parents were randomly assigned to receive a sleep education pamphlet containing information about daytime habits, bedtime routine, and sleep environment. Children wore actigraphy devices, which measure activity and rest to estimate sleep parameters, prior to receiving the pamphlet (baseline) and two weeks after randomization (treatment). Sample size of 36 participants was predetermined to detect a difference in sleep latency of at least 30 minutes in children whose parents received the pamphlet. Independent t-tests were performed to compare mean sleep parameters at baseline, and mean change in sleep parameters by treatment.

Results: As shown in the Table, the group receiving the pamphlet showed improvement from baseline in all sleep parameters, although statistical significance was not reached (p > 0.10). Differences observed between treatment and control groups on mean change in sleep parameters showed significance (p = 0.04) only for sleep efficiency in the pamphlet group; this was not clinically significant.


Sleep Education Program- Treatment Results in Children with ASD


Pamphlet (n = 19)


No Pamphlet (n = 17)



Baseline (mean, SD)

Treatment (mean, SD)

Baseline (mean, SD)

Treatment (mean, SD)

Age, years

5.4 (2.4)


7.1 (2.5)


Sleep Latency, min

56.7 (27.1)

49.5 (26.7)

52.1 (25.1)

61.3 (47)

Sleep Efficiency, %

75.5 (6.1)

77.8 (7.0)

76.8 (6.0)

75.1 (6.7)

Wake Time after Sleep Onset, min

61.9 (27.4)

60.4 (32.1)

53.2 (20.2)

59.9 (24.2)

Total Sleep Time, min

465.7 (66.3)

483.0 (67.8)

461.4 (42.4)

470.8 (35.3)

Fragmentation, min

36.8 (9.0)

36.3 (10.9)

32.2 (7.2)

33.3 (7.5)

Conclusions:  Providing a sleep education pamphlet to parents of children with ASD did not significantly improve sleep latency. We are conducting studies to determine if more intensive education improves sleep patterns in this population.

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