Symposia
Sleep / Wake Disorders
Lauren Asarnow, Ph.D. (she/her/hers)
Assistant Professor
University of California San Francisco
San Francisco, California
Nicole Bush, PhD (she/her/hers)
Associate Professor
University of California, San Francisco
San Francisco, California
Bennett Leventhal, MD (he/him/his)
Professor
University of California, San Francisco
San Francisco, California
Sleep problems are amongst the most common concurrent clinical disorders among children with ASD. Sleep problems are highly prevalent in children with ASD ranging from 40% to 80% 1-3 with a peak onset during the second year of life. Moreover, 63% of children with ASD and sleep problems experienced persistence of sleep difficulties over time often lasting into adulthood.4,5 Taken together data suggests that pre-school age is a critical period to target for sleep improvement.6,7Behavioral sleep treatments are known to improve sleep among preschool aged children.8 Behavioral interventions like graduated extinction, bedroom passes, sleep hygiene and behavioral therapy have demonstrated effectiveness of behavioral interventions for sleep onset and maintenance problems in preschool aged kids.9-11 However, there are few providers with expertise in behavioral sleep treatments, which limits access to care, especially for children with ASD. There are only 412 registered providers for behavioral sleep interventions in the U.S. (for all ages).12 Very few of those providers are qualified to treat children, and even fewer have training working with children with ASD. The present study aimed to fill this gap by developing and assessing the acceptability of the SweetDreams sleep intervention for youth with ASD, using existing, evidence-based behavioral sleep interventions adapted for mobile device delivery. We conducted a pilot RCT in which 20 children (12-60 months) with ASD and sleep problems were randomized to SweetDreams (n=10) or a wait-list control (n=10). We found that the treatment had a marginally significant effect on children’s sleep health, F(1,19)= 3.71, p=.07, and a significant effect on parent’s sleep quality (p < .05). While we did not find significant impact of Sweet Dreams on child adaptive behavior (all p’s >.05) we did find signals that Sweet Dreams reduced parental stress, F(1,19)=6.8, p=.02, and caregiver strain, F(1,19)= 4.49, p=.05. SweetDreams is a safe, feasible and acceptable digital health intervention to improve sleep problems in youth with ASD which can be easily disseminated. A larger trial is needed to confirm these results.