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Screen Time Versus Sleep Time in Boys with Autism

A new study, published online in Pediatrics, suggests that prolonged video-game use as well as TVs and computers in the bedroom can contribute to significant sleep problems in boys with autism.

The findings are particularly important because many children with autism (50 to 80 percent) have significant problems falling asleep and staying asleep. Disturbed sleep, in turn, can worsen repetitive behaviors, daytime function and learning as well as create stress for entire households.

“Many parents report that their children with ASD suffer from problems sleeping,” comments Alycia Halladay, Autism Speaks senior director for environmental and clinical sciences.  “This study suggests at least a partial solution that may help improve sleep in at least some boys with ASD.” 

The researchers enrolled 49 boys with autism and 38 boys with attention-deficit hyperactivity disorder (ADHD) in a study at the Thompson Center for Autism and Neurodevelopmental Disorders, in Columbia, Missouri. The center is a member of Autism Speaks Autism Treatment Network (AS-ATN). For comparison, they also enrolled 41 typically developing boys. All the boys were between 8 and 17 years old.

Through parent questionnaires, the researchers totaled each boy’s daily hours of video game, TV and computer use. They also determined which boys had TVs, computers or video game consoles in their bedrooms. They found that having electronic media in the bedroom was associated with decreased sleep time in all three groups. But the decrease in sleep was significantly greater in the boys with autism. (See figures at left.)

In addition, the researchers found a large association between the total number of hours spent playing video games each day and reduced sleep in the boys with autism. They saw a smaller effect in those with ADHD and no significant effect in the typically developing boys.

Though the results indicate that the sleep-disrupting effects of electronic media are markedly greater for children with ASD, the reasons are unclear, the researchers say. The simplest explanation is that the boys with autism tended to remain engaged in electronic media past their bedtimes, they agree. Previous research has shown that children with autism tend to have difficulty disengaging from screen-based media.

It could also be that exposure to brightly lit screens disrupts production of the “sleep hormone” melatonin, they add. Research has shown that many children with ASD have low melatonin levels.

Yet another factor may be excitement, or “increased physiologic arousal,” especially with video gaming. Again, previous research has shown that many children with autism tend to have problems with over-excitability, which in turn can interfere with sleep.

“This doesn’t completely explain the reasons for sleep problems in individuals with autism,” Dr. Halladay comments. “But it does point out factors that can be changed.”

Given the relatively small number of participants, more research is needed to confirm the results, the investigators caution. Meanwhile, they encourage parents and physicians to consider the possible effects of electronic media when addressing sleep problems in children with ASD.

Autism Speaks ATN/AIR-P Sleep Tool Kit contains tips and strategies developed by AS-ATN sleep experts to help parents increase quality sleep in children with autism. Download the tool kit free of charge here. Also see “Empowering Parents to Help Children Sleep” and “My Son Has Sleep Problems. What Can Help?” in the Autism Speaks “Got Questions?” blog.