Conditions that accompany autism, explained BY HANNAH FURFARO / 25 JULY 2018

  • More than half of people on the spectrum have four or more other conditions. The types of co-occurring conditions and how they manifest varies from one autistic person to the next.
  • These conditions can exacerbate features of autism or affect the timing of an autism diagnosis, so understanding how they interact with autism is important.
  • The conditions that overlap with autism generally fall into one of four groups:
    • classic medical problems, such as epilepsy, gastrointestinal issues or sleep disorders;
    • developmental diagnoses, such as intellectual disability or language delay;
    • mental-health conditions, such as attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder or depression; and
    • genetic conditions, including fragile X syndrome and tuberous sclerosis complex.
  • between 11 and 84 percent of autistic children also have anxiety.
  • Similarly, serious sleep problems may affect anywhere between 44 and 86 percent of children on the spectrum
  • Treating a related condition may also ease autism traits. For instance, treating seizures early may decrease cognitive and behavioral problems in children with tuberous sclerosis complex.
  • Resolving sleep or gastrointestinal problems may also offer behavioral benefits. Sleep quantity and quality can affect mood and the severity of repetitive behaviors, for example.

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In some ways, the fix can be straightforward: Establishing a routine, such as an order of activities at bedtime, can often help a person fall asleep; so can changing the temperature or lighting in a bedroom. Sticking with regular bed and wake times can put the brain and body on a schedule that makes sleep more reliable.

The U.S. Food and Drug administration has approved insomnia drugs, such as Ambien, for adults with autism but not for children. For more serious problems such as sleep apnea, clinicians sometimes recommend a nighttime breathing device such as a continuous positive airway pressure (CPAP) machine or, in rare cases, surgery.

But for many sleep issues, melatonin supplements may be a good option. Some research suggests the supplements help children with autism fall asleep faster and get better-quality sleep.

Would better sleep improve quality of life for people on the spectrum?

Maybe. No large, definitive study exists on this topic. But research has shown that typical children and those with autism who undergo surgery to alleviate breathing trouble during sleep show better social communication and attention as well as fewer repetitive behaviors. Parents reported similar improvements in a small study of children with autism who took melatonin supplements.

Better sleep is “not going to cure autism,” says pediatrician Angela Maxwell-Horn, assistant professor of pediatrics at Vanderbilt University in Nashville, Tennessee. But, she says, children with autism who get back on a regular sleeping schedule seem to learn better, are less irritable and have fewer problem behaviors.


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