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If sleep problems appear to be more behavioral in nature, the guideline recommends a number of behavior treatments that have been shown to be effective in children with autism. These include setting up a consistent sleep routine with regular bedtimes and wake times, choosing a bedtime close to when the child usually gets sleepy, and not allowing use of electronic devices like computers or televisions close to bedtime.
"Behavior-modification strategies are a good place to start because they do not cost anything, there are no side effects and they have been shown to work for some people," said Williams Buckley.
If behavioral strategies alone do not work, the guideline recommends that healthcare providers also consider adding melatonin.
Melatonin is a hormone that tells the brain when to fall asleep and how long to sleep. Studies suggest that the artificial form of melatonin is safe and effective for children and teens with autism in the short term, for a period of up to three months. More research is needed to determine how safe melatonin is over longer periods of time. Possible side effects include headache, dizziness, diarrhea and rash. The guideline also cautions that over the counter melatonin products may not be reliable in terms of how much melatonin they actually contain. The guideline recommends using products that are labeled "pharmaceutical grade" melatonin.
The guideline also found that melatonin use alone may be just as helpful in some patients as when melatonin is combined with behavioral strategies.
The guideline did not find that behavior treatments combined with melatonin changed daytime behavior problems or symptoms of autism.
The guideline also found no evidence that routine use of weighted blankets or specialized mattress technologies improve sleep.
"Sleep problems can make behavioral issues in children and teens with autism even worse," said Williams Buckley. "That's why it is important for parents and caregivers to work with healthcare providers to find a way to improve a child's sleep because we know that good quality sleep can improve overall health and quality of life in all children." Source:
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