Fifteen-minute consultation: managing sleep problems in children and young people with autism spectrum disorder

Sleep disorders are highly prevalent in children and young people with autism spectrum disorder (ASD) and are associated with behavioural difficulties, impaired daytime functioning, increased caregiver stress and reduced quality of life. Despite their substantial impact, sleep disturbances in this population are frequently under-recognised and under-treated in clinical practice. This article provides practical evidence-based recommendations for clinicians on the assessment and management of sleep disorders in individuals with ASD. It describes common sleep patterns associated with ASD, including chronic insomnia, circadian rhythm sleep-wake disorders, parasomnias, restless legs syndrome and sleep-disordered breathing. Guidance is offered on comprehensive assessment strategies that consider medical, behavioural, environmental and sensory factors through structured history taking. This can be supplemented by using sleep diaries and validated questionnaires to aid assessment with further investigations if indicated. Management options are described from first-line non-pharmacological options, followed by pharmacological options including melatonin. This article also highlights resources and services which clinicians can signpost families to for additional guidance and ongoing support.