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Sleep disorders in rare genetic syndromes: a meta-analysis of prevalence and profile / G. AGAR in Molecular Autism, 12 (2021)
[article]
Titre : Sleep disorders in rare genetic syndromes: a meta-analysis of prevalence and profile Type de document : Texte imprimé et/ou numérique Auteurs : G. AGAR, Auteur ; C. BROWN, Auteur ; D. SUTHERLAND, Auteur ; S. COULBORN, Auteur ; C. OLIVER, Auteur ; C. RICHARDS, Auteur Article en page(s) : 18 p. Langues : Anglais (eng) Mots-clés : Congenital Abnormalities/epidemiology Humans Prevalence Sleep Wake Disorders/epidemiology Syndrome Genetic syndromes Intellectual disability Meta-analysis Sleep disorders Sleep profile Index. décimale : PER Périodiques Résumé : BACKGROUND: Sleep disorders are common in people with intellectual disability (ID) and autism, with growing evidence of diverse sleep profiles across ID associated genetic syndromes. Documenting the prevalence and profile of specific sleep disorders in syndromes will quantify syndrome-driven 'risk', inform prognosis and enhance understanding of aetiology of sleep disorders. METHOD: Following PRISMA guidelines for meta-analysis, we searched Ovid PsycINFO, Ovid MEDLINE, Ovid Embase, Web of Science and PubMed Central with use of syndrome-specific keywords and 60 sleep-related search terms. We screened and extracted papers that reported sleep disorder prevalence data for five or more individuals within a genetic syndrome, and applied quality criteria to produce a quality-effects prevalence model of six types of sleep disorder across nineteen syndromes. Relative risk estimates were calculated for the prevalence of each sleep disorder in each syndrome. RESULTS: Two hundred and seventy three papers were identified, generating 463 prevalence estimates for Angelman, CHARGE, Cornelia de Lange, Down, fragile X, Prader-Willi, Rett, Smith-Magenis and Williams syndromes, mucopolysaccharidoses (MPS disorders), neurofibromatosis and tuberous sclerosis complex. Prevalence estimates were higher in genetic syndromes than published equivalents for typically developing individuals, with few exceptions. Between-syndrome differences for some disorders were evident; sleep-disordered breathing was most prevalent in MPS disorders (72-77%), while excessive daytime sleepiness was highest in Smith-Magenis syndrome (60%). Conversely, insomnia, which was reported at a higher rate than TD estimates in all syndromes except fragile X, was not associated with specific genetic risk. This suggests insomnia could emerge because of the individual's environment or associated developmental delay, rather than any specific genetic syndromes. LIMITATIONS: Due to the broad scope of the meta-analysis, only syndromes previously identified as reporting preliminary sleep research were included. Other syndromes may also experience elevated prevalence rates of specific types of sleep disorder. Only English language papers were included. CONCLUSIONS: Differing prevalence rates between types of sleep disorder suggest differing causal mechanisms, such as cranio-facial morphology in Down and Prader-Willi syndromes and the build-up of mucopolysaccharides in MPS disorders. Priorities for clinical assessment and intervention for sleep disorders are discussed. En ligne : http://dx.doi.org/10.1186/s13229-021-00426-w Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459
in Molecular Autism > 12 (2021) . - 18 p.[article] Sleep disorders in rare genetic syndromes: a meta-analysis of prevalence and profile [Texte imprimé et/ou numérique] / G. AGAR, Auteur ; C. BROWN, Auteur ; D. SUTHERLAND, Auteur ; S. COULBORN, Auteur ; C. OLIVER, Auteur ; C. RICHARDS, Auteur . - 18 p.
Langues : Anglais (eng)
in Molecular Autism > 12 (2021) . - 18 p.
Mots-clés : Congenital Abnormalities/epidemiology Humans Prevalence Sleep Wake Disorders/epidemiology Syndrome Genetic syndromes Intellectual disability Meta-analysis Sleep disorders Sleep profile Index. décimale : PER Périodiques Résumé : BACKGROUND: Sleep disorders are common in people with intellectual disability (ID) and autism, with growing evidence of diverse sleep profiles across ID associated genetic syndromes. Documenting the prevalence and profile of specific sleep disorders in syndromes will quantify syndrome-driven 'risk', inform prognosis and enhance understanding of aetiology of sleep disorders. METHOD: Following PRISMA guidelines for meta-analysis, we searched Ovid PsycINFO, Ovid MEDLINE, Ovid Embase, Web of Science and PubMed Central with use of syndrome-specific keywords and 60 sleep-related search terms. We screened and extracted papers that reported sleep disorder prevalence data for five or more individuals within a genetic syndrome, and applied quality criteria to produce a quality-effects prevalence model of six types of sleep disorder across nineteen syndromes. Relative risk estimates were calculated for the prevalence of each sleep disorder in each syndrome. RESULTS: Two hundred and seventy three papers were identified, generating 463 prevalence estimates for Angelman, CHARGE, Cornelia de Lange, Down, fragile X, Prader-Willi, Rett, Smith-Magenis and Williams syndromes, mucopolysaccharidoses (MPS disorders), neurofibromatosis and tuberous sclerosis complex. Prevalence estimates were higher in genetic syndromes than published equivalents for typically developing individuals, with few exceptions. Between-syndrome differences for some disorders were evident; sleep-disordered breathing was most prevalent in MPS disorders (72-77%), while excessive daytime sleepiness was highest in Smith-Magenis syndrome (60%). Conversely, insomnia, which was reported at a higher rate than TD estimates in all syndromes except fragile X, was not associated with specific genetic risk. This suggests insomnia could emerge because of the individual's environment or associated developmental delay, rather than any specific genetic syndromes. LIMITATIONS: Due to the broad scope of the meta-analysis, only syndromes previously identified as reporting preliminary sleep research were included. Other syndromes may also experience elevated prevalence rates of specific types of sleep disorder. Only English language papers were included. CONCLUSIONS: Differing prevalence rates between types of sleep disorder suggest differing causal mechanisms, such as cranio-facial morphology in Down and Prader-Willi syndromes and the build-up of mucopolysaccharides in MPS disorders. Priorities for clinical assessment and intervention for sleep disorders are discussed. En ligne : http://dx.doi.org/10.1186/s13229-021-00426-w Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=459 Clinical and behavioral attributes leading to sleep disorders in children on the autism spectrum / Anne MASI in Autism Research, 15-7 (July 2022)
[article]
Titre : Clinical and behavioral attributes leading to sleep disorders in children on the autism spectrum Type de document : Texte imprimé et/ou numérique Auteurs : Anne MASI, Auteur ; Mohammod Ali MONI, Auteur ; Syeda Ishra AZIM, Auteur ; Byungkuk CHOI, Auteur ; Helen S. HEUSSLER, Auteur ; Ping-I LIN, Auteur ; Antonio Mendoza DIAZ, Auteur ; Valsamma EAPEN, Auteur Article en page(s) : p.1274-1287 Langues : Anglais (eng) Mots-clés : autism spectrum disorder behavioral problems children clinical phenotypes sleep disorders Index. décimale : PER Périodiques Résumé : Sleep disorders are a common comorbid condition in children diagnosed with autism spectrum disorder ("autism"). However, the relationship between the clinical features of autism and sleep disorders remains unclear. A better understanding of the inherent autism-related characteristics linked to comorbid sleep disorders would improve comprehensive assessment and management. This study examined the relationship between sociodemographics, autism symptoms, sleep problems, cognitive status, behavioral attributes, and sensory profiles. Using data from 1268 participants who took part in the Australian Autism Biobank, sleep-related measurements using the Child Sleep Habits Questionnaire (CSHQ) were compared between autistic children aged 2 to 17 (N =?969), their siblings (N =?188), and unrelated children without an autism diagnosis (N =?111). The known relationship between sleep problems and autism was further explored by including scores from the Autism Diagnostic Observation Schedule-2, Mullen Scales of Early Learning, Vineland Adaptive Behavioral Scale-II and the Short Sensory Profile-2; which were included in analyses for autistic participants who had a completed CSHQ. Multiple regression models were used to identify clinical/behavioral variables associated with CSHQ subscales. The autism group had a significantly higher total CSHQ score than the sibling and comparison groups (p 0.001), indicating worse sleep quality. Within the autism group, lower adaptive behaviors (i.e., VABS-II) and sensory issues (i.e., SSP-2 subclass scores) were positively associated with the severity of sleep problems (i.e., the CSHQ subclass scores) (p 0.001). The significant functional impact of poor sleep on autistic children warrants an assessment of sleep as a critical part of a holistic approach to supporting autistic children and their families. LAY SUMMARY: Autistic children generally have co-occurring conditions. Sleep disorders impact approximately 50%-80% of autistic children. The impact on the quality of life for both the children and their families can be significant. This study compares sleep problems in autistic children and adolescents with their siblings and children without a diagnosis of autism, and investigates the relationship between specific autistic traits, daily life behaviors and sleep problems. The findings highlight the importance of a holistic assessment for autistic children and matching appropriate sleep intervention and supports where indicated. En ligne : http://dx.doi.org/10.1002/aur.2745 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477
in Autism Research > 15-7 (July 2022) . - p.1274-1287[article] Clinical and behavioral attributes leading to sleep disorders in children on the autism spectrum [Texte imprimé et/ou numérique] / Anne MASI, Auteur ; Mohammod Ali MONI, Auteur ; Syeda Ishra AZIM, Auteur ; Byungkuk CHOI, Auteur ; Helen S. HEUSSLER, Auteur ; Ping-I LIN, Auteur ; Antonio Mendoza DIAZ, Auteur ; Valsamma EAPEN, Auteur . - p.1274-1287.
Langues : Anglais (eng)
in Autism Research > 15-7 (July 2022) . - p.1274-1287
Mots-clés : autism spectrum disorder behavioral problems children clinical phenotypes sleep disorders Index. décimale : PER Périodiques Résumé : Sleep disorders are a common comorbid condition in children diagnosed with autism spectrum disorder ("autism"). However, the relationship between the clinical features of autism and sleep disorders remains unclear. A better understanding of the inherent autism-related characteristics linked to comorbid sleep disorders would improve comprehensive assessment and management. This study examined the relationship between sociodemographics, autism symptoms, sleep problems, cognitive status, behavioral attributes, and sensory profiles. Using data from 1268 participants who took part in the Australian Autism Biobank, sleep-related measurements using the Child Sleep Habits Questionnaire (CSHQ) were compared between autistic children aged 2 to 17 (N =?969), their siblings (N =?188), and unrelated children without an autism diagnosis (N =?111). The known relationship between sleep problems and autism was further explored by including scores from the Autism Diagnostic Observation Schedule-2, Mullen Scales of Early Learning, Vineland Adaptive Behavioral Scale-II and the Short Sensory Profile-2; which were included in analyses for autistic participants who had a completed CSHQ. Multiple regression models were used to identify clinical/behavioral variables associated with CSHQ subscales. The autism group had a significantly higher total CSHQ score than the sibling and comparison groups (p 0.001), indicating worse sleep quality. Within the autism group, lower adaptive behaviors (i.e., VABS-II) and sensory issues (i.e., SSP-2 subclass scores) were positively associated with the severity of sleep problems (i.e., the CSHQ subclass scores) (p 0.001). The significant functional impact of poor sleep on autistic children warrants an assessment of sleep as a critical part of a holistic approach to supporting autistic children and their families. LAY SUMMARY: Autistic children generally have co-occurring conditions. Sleep disorders impact approximately 50%-80% of autistic children. The impact on the quality of life for both the children and their families can be significant. This study compares sleep problems in autistic children and adolescents with their siblings and children without a diagnosis of autism, and investigates the relationship between specific autistic traits, daily life behaviors and sleep problems. The findings highlight the importance of a holistic assessment for autistic children and matching appropriate sleep intervention and supports where indicated. En ligne : http://dx.doi.org/10.1002/aur.2745 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=477 Poor sleep affects daytime functioning in typically developing and autistic children not complaining of sleep problems: A questionnaire-based and polysomnographic study / Andréane LAMBERT in Research in Autism Spectrum Disorders, 23 (March 2016)
[article]
Titre : Poor sleep affects daytime functioning in typically developing and autistic children not complaining of sleep problems: A questionnaire-based and polysomnographic study Type de document : Texte imprimé et/ou numérique Auteurs : Andréane LAMBERT, Auteur ; Sophie TESSIER, Auteur ; Annie-Claude ROCHETTE, Auteur ; Peter SCHERZER, Auteur ; Laurent MOTTRON, Auteur ; Roger GODBOUT, Auteur Article en page(s) : p.94-106 Langues : Anglais (eng) Mots-clés : Autism phenotype EEG Insomnia Sleep disorders Index. décimale : PER Périodiques Résumé : Abstract Autism spectrum (AS) is a neurodevelopmental condition associated with poor sleep, which impairs daytime functioning. Most studies of sleep in autism have been based on subjective measures, notably parental reports. A few studies have used objective, laboratory polysomnography (PSG) measures, but often include confounding factors such as intellectual disability, sleep problems, other psychiatric illnesses, and medication. To address these limitations, we examined the relationship between sleep and behavior in prototypical AS of typical level of intelligence and non-autistic children not complaining of sleep problems. We examined sleep variables with The Children’ Sleep Habit Questionnaire (CSHQ) and a daily sleep agenda, both filled out by parents, and by PSG. These subjective and objective measures both revealed that sleep latency was longer in AS than in non-autistic children. Furthermore, AS children also showed less slow-wave sleep (SWS: stages 3 + 4), fewer sleep spindles and fewer K-complexes than non-autistic children. REM sleep, including eye movement density, was similar between the two groups. The proportion of light sleep, (stage 1 non-REM sleep) was negatively correlated with IQ (Wechsler and Raven matrices) in both groups of participants. A large amount of SWS predicted low levels of internalizing behavior in both groups and typical social functioning as determined by ADOS in AS children. These results indicate that autistic children not complaining of sleep problems may nonetheless be affected by poor sleep, which in turn influences their daytime functioning. En ligne : http://dx.doi.org/10.1016/j.rasd.2015.11.010 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=282
in Research in Autism Spectrum Disorders > 23 (March 2016) . - p.94-106[article] Poor sleep affects daytime functioning in typically developing and autistic children not complaining of sleep problems: A questionnaire-based and polysomnographic study [Texte imprimé et/ou numérique] / Andréane LAMBERT, Auteur ; Sophie TESSIER, Auteur ; Annie-Claude ROCHETTE, Auteur ; Peter SCHERZER, Auteur ; Laurent MOTTRON, Auteur ; Roger GODBOUT, Auteur . - p.94-106.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 23 (March 2016) . - p.94-106
Mots-clés : Autism phenotype EEG Insomnia Sleep disorders Index. décimale : PER Périodiques Résumé : Abstract Autism spectrum (AS) is a neurodevelopmental condition associated with poor sleep, which impairs daytime functioning. Most studies of sleep in autism have been based on subjective measures, notably parental reports. A few studies have used objective, laboratory polysomnography (PSG) measures, but often include confounding factors such as intellectual disability, sleep problems, other psychiatric illnesses, and medication. To address these limitations, we examined the relationship between sleep and behavior in prototypical AS of typical level of intelligence and non-autistic children not complaining of sleep problems. We examined sleep variables with The Children’ Sleep Habit Questionnaire (CSHQ) and a daily sleep agenda, both filled out by parents, and by PSG. These subjective and objective measures both revealed that sleep latency was longer in AS than in non-autistic children. Furthermore, AS children also showed less slow-wave sleep (SWS: stages 3 + 4), fewer sleep spindles and fewer K-complexes than non-autistic children. REM sleep, including eye movement density, was similar between the two groups. The proportion of light sleep, (stage 1 non-REM sleep) was negatively correlated with IQ (Wechsler and Raven matrices) in both groups of participants. A large amount of SWS predicted low levels of internalizing behavior in both groups and typical social functioning as determined by ADOS in AS children. These results indicate that autistic children not complaining of sleep problems may nonetheless be affected by poor sleep, which in turn influences their daytime functioning. En ligne : http://dx.doi.org/10.1016/j.rasd.2015.11.010 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=282 The impact of sleep quality on quality of life for autistic adults / Kiley J. MCLEAN in Research in Autism Spectrum Disorders, 88 (October 2021)
[article]
Titre : The impact of sleep quality on quality of life for autistic adults Type de document : Texte imprimé et/ou numérique Auteurs : Kiley J. MCLEAN, Auteur ; Shaun M. EACK, Auteur ; Lauren BISHOP, Auteur Article en page(s) : 101849 Langues : Anglais (eng) Mots-clés : ASD Asperger’s Sleep disorders Sleep problems Stress Intervention Index. décimale : PER Périodiques Résumé : Background Although research demonstrates that autistic children are at risk of poor sleep quality, very little is known about sleep quality and its impact on quality of life in autistic adults. We investigated the relationships between sleep quality, perceived stress, and quality of life for autistic adults. Method Data were prospectively collected from both autistic adults (N = 40) and non-autistic adults (N = 24). Sleep Quality was measured using the Pittsburgh Sleep Quality Index, Perceived Stress was measured using the Perceived Stress Scale, and Quality of Life was measured using the Brief Version of the World Health Organization Quality of Life Scale. We ran OLS regression models to examine the association between study group, perceived stress, sleep quality, and quality of life. We tested for main effects of study group (i.e., autistic or non-autistic), sleep quality, and perceived stress, adjusting for demographic characteristics. Then, we tested the interaction between study group and sleep quality. Finally, we tested a three-way interaction between group, sleep quality, and perceived stress. Results Autistic adults reported worse sleep quality compared to non-autistic adults. Poorer sleep quality was significantly associated with lower quality of life for all participants in the study. Findings from the three-way interaction indicated that higher perceived stress further exacerbated the relationship between poorer sleep quality and lower quality of life for autistic adults. Conclusions These findings suggest that interventions that target both sleep quality and stress could effectively improve quality of life for autistic adults. En ligne : https://doi.org/10.1016/j.rasd.2021.101849 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458
in Research in Autism Spectrum Disorders > 88 (October 2021) . - 101849[article] The impact of sleep quality on quality of life for autistic adults [Texte imprimé et/ou numérique] / Kiley J. MCLEAN, Auteur ; Shaun M. EACK, Auteur ; Lauren BISHOP, Auteur . - 101849.
Langues : Anglais (eng)
in Research in Autism Spectrum Disorders > 88 (October 2021) . - 101849
Mots-clés : ASD Asperger’s Sleep disorders Sleep problems Stress Intervention Index. décimale : PER Périodiques Résumé : Background Although research demonstrates that autistic children are at risk of poor sleep quality, very little is known about sleep quality and its impact on quality of life in autistic adults. We investigated the relationships between sleep quality, perceived stress, and quality of life for autistic adults. Method Data were prospectively collected from both autistic adults (N = 40) and non-autistic adults (N = 24). Sleep Quality was measured using the Pittsburgh Sleep Quality Index, Perceived Stress was measured using the Perceived Stress Scale, and Quality of Life was measured using the Brief Version of the World Health Organization Quality of Life Scale. We ran OLS regression models to examine the association between study group, perceived stress, sleep quality, and quality of life. We tested for main effects of study group (i.e., autistic or non-autistic), sleep quality, and perceived stress, adjusting for demographic characteristics. Then, we tested the interaction between study group and sleep quality. Finally, we tested a three-way interaction between group, sleep quality, and perceived stress. Results Autistic adults reported worse sleep quality compared to non-autistic adults. Poorer sleep quality was significantly associated with lower quality of life for all participants in the study. Findings from the three-way interaction indicated that higher perceived stress further exacerbated the relationship between poorer sleep quality and lower quality of life for autistic adults. Conclusions These findings suggest that interventions that target both sleep quality and stress could effectively improve quality of life for autistic adults. En ligne : https://doi.org/10.1016/j.rasd.2021.101849 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=458 Practitioner Review: Treatment of chronic insomnia in children and adolescents with neurodevelopmental disabilities / O. BRUNI in Journal of Child Psychology and Psychiatry, 59-5 (May 2018)
[article]
Titre : Practitioner Review: Treatment of chronic insomnia in children and adolescents with neurodevelopmental disabilities Type de document : Texte imprimé et/ou numérique Auteurs : O. BRUNI, Auteur ; M. ANGRIMAN, Auteur ; F. CALISTI, Auteur ; A. COMANDINI, Auteur ; G. ESPOSITO, Auteur ; S. CORTESE, Auteur ; R. FERRI, Auteur Article en page(s) : p.489-508 Langues : Anglais (eng) Mots-clés : Sleep disorders drug effects insomnia neurodevelopmental disorders Index. décimale : PER Périodiques Résumé : BACKGROUND: Sleep disturbances, in particular insomnia, represent a common problem in children with neurodevelopmental disabilities (NDDs). Currently, there are no approved medications for insomnia in children by the US Food and Drug Administration or European Medicines Agency and therefore they are prescribed off-label. We critically reviewed pediatric literature on drugs as well as nonpharmacological (behavioral) interventions used for sleep disturbances in children with NDDs. METHODS: PubMed, Ovid (including PsycINFO, Ovid MEDLINE((R)) , and Embase), and Web of Knowledge databases were searched through February 12, 2017, with no language restrictions. Two authors independently and blindly performed the screening. RESULTS: Good sleep practices and behavioral interventions, supported by moderate-to-low level evidence, are the first recommended treatments for pediatric insomnia but they are often challenging to implement. Antihistamine agents, such as hydroxyzine or diphenhydramine, are the most widely prescribed sedatives in the pediatric practice but evidence supporting their use is still limited. An increasing body of evidence supports melatonin as the safest choice for children with NDDs. Benzodiazepines are not recommended in children and should only be used for transient insomnia, especially if daytime anxiety is present. Only few studies have been carried out in children's and adolescents' zolpidem, zaleplon, and eszopiclone, with contrasting results. Limited evidence supports the use of alpha-agonists such as clonidine to improve sleep onset latency, especially in attention deficit/hyperactivity disorder subjects. Tricyclic antidepressants, used in adults with insomnia, are not recommended in children because of their safety profile. Trazodone and mirtazapine hold promise but require further studies. CONCLUSIONS: Here, we provided a tentative guide for the use of drugs for insomnia in children with NDDs. Well-controlled studies employing both objective polysomnography and subjective sleep measures are needed to determine the efficacy, effectiveness, and safety of the currently prescribed pediatric sleep medicines in children with NDDs. En ligne : http://dx.doi.org/10.1111/jcpp.12812 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=359
in Journal of Child Psychology and Psychiatry > 59-5 (May 2018) . - p.489-508[article] Practitioner Review: Treatment of chronic insomnia in children and adolescents with neurodevelopmental disabilities [Texte imprimé et/ou numérique] / O. BRUNI, Auteur ; M. ANGRIMAN, Auteur ; F. CALISTI, Auteur ; A. COMANDINI, Auteur ; G. ESPOSITO, Auteur ; S. CORTESE, Auteur ; R. FERRI, Auteur . - p.489-508.
Langues : Anglais (eng)
in Journal of Child Psychology and Psychiatry > 59-5 (May 2018) . - p.489-508
Mots-clés : Sleep disorders drug effects insomnia neurodevelopmental disorders Index. décimale : PER Périodiques Résumé : BACKGROUND: Sleep disturbances, in particular insomnia, represent a common problem in children with neurodevelopmental disabilities (NDDs). Currently, there are no approved medications for insomnia in children by the US Food and Drug Administration or European Medicines Agency and therefore they are prescribed off-label. We critically reviewed pediatric literature on drugs as well as nonpharmacological (behavioral) interventions used for sleep disturbances in children with NDDs. METHODS: PubMed, Ovid (including PsycINFO, Ovid MEDLINE((R)) , and Embase), and Web of Knowledge databases were searched through February 12, 2017, with no language restrictions. Two authors independently and blindly performed the screening. RESULTS: Good sleep practices and behavioral interventions, supported by moderate-to-low level evidence, are the first recommended treatments for pediatric insomnia but they are often challenging to implement. Antihistamine agents, such as hydroxyzine or diphenhydramine, are the most widely prescribed sedatives in the pediatric practice but evidence supporting their use is still limited. An increasing body of evidence supports melatonin as the safest choice for children with NDDs. Benzodiazepines are not recommended in children and should only be used for transient insomnia, especially if daytime anxiety is present. Only few studies have been carried out in children's and adolescents' zolpidem, zaleplon, and eszopiclone, with contrasting results. Limited evidence supports the use of alpha-agonists such as clonidine to improve sleep onset latency, especially in attention deficit/hyperactivity disorder subjects. Tricyclic antidepressants, used in adults with insomnia, are not recommended in children because of their safety profile. Trazodone and mirtazapine hold promise but require further studies. CONCLUSIONS: Here, we provided a tentative guide for the use of drugs for insomnia in children with NDDs. Well-controlled studies employing both objective polysomnography and subjective sleep measures are needed to determine the efficacy, effectiveness, and safety of the currently prescribed pediatric sleep medicines in children with NDDs. En ligne : http://dx.doi.org/10.1111/jcpp.12812 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=359 Young Children with ASD Participate in the Same Level of Physical Activity as Children Without ASD: Implications for Early Intervention to Maintain Good Health / S. THOMAS in Journal of Autism and Developmental Disorders, 49-8 (August 2019)
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