Understanding Sleep Problems in Children With Autism Spectrum Disorder
Condition: Sleep Problems
MeSH terms: Dyssomnias; Parasomnias; Sleep Wake Disorders; Autism Spectrum Disorder
Study type: Observational

Summary: 
      The investigators will examine whether sleep problems in children with autism spectrum
      disorder (ASD) are related to alterations in the production of melatonin (MT), a hormone that
      plays an important role in regulating sleep-wake cycle. Children with ASD experience high
      rates of sleep disturbances that potentially contribute to problems with thinking and
      behavior. It is unclear if changes in MT production cause sleep problems in children with
      ASD. MT is frequently used to treat these sleep problems; however, it has not been well
      established whether MT is an effective treatment. Our hypotheses concerning MT is children
      with ASD and sleep problems will have a delayed sleep-wake cycle and/or decreased MT
      production. This study will compare children diagnosed with ASD to "healthy" control children
      with no ASD diagnosis. All subjects will be recruited from one of three sites: Baylor College
      of Medicine, Oregon Health & Science University and Columbia University. The investigators
      will use a standardized questionnaire to determine whether the child has sleep problems. The
      investigators will measure MT levels in saliva in ASD children with sleep problems and in a
      group of control children without sleep problems. Total 24-hour MT production will be
      determined from urine samples in these same two groups.
    

Detailed description: 
      This is a proposal to study the relationship between melatonin (MT) and sleep problems in
      children with autism spectrum disorder (ASD), as part of the collaborative research structure
      of the Autism Treatment Network (ATN). A major goal of the ATN is to conduct clinical
      research that will have a significant impact on the daily lives and functioning of
      individuals with ASD and to address immediate concerns of parents. Children with ASD
      experience high rates of sleep disturbance, which likely contribute to the severity of their
      daytime cognitive and behavioral dysfunction and to poorer quality of life for them and their
      families.

      As a step toward addressing sleep problems in ASD, we propose to test the hypothesis that
      children with ASD and sleep problems will have a delay in MT onset and/or have decreased MT
      secretion over 24 hours compared to normal controls.

      Primary endpoint: Characterize the endogenous MT profiles in children with ASD:

      We predict that results from this study will reveal lower levels of metabolized MT in
      children with ASD when compared to normal children. In addition, we anticipate that children
      with ASD will have delayed MT onset or altered circadian phase.

      Data from this study will provide important information concerning circadian rhythm
      dysregulation in ASD and will support the development of future studies using MT to modify
      and correct abnormal circadian rhythms.
    

Observational model: Case-Control
Time perspective: Cross-Sectional
Sampling method: Non-Probability Sample
Study population: 
        Children with the diagnosis of ASD and that are not diagnosised with ASD (controls).
      
Biospecimen description: 
      SAMPLE: Saliva What is the purpose of the sample collection? Determination of dim light
      melatonin onset (DMLO), as measured by salivary melatonin secretion.

      SAMPLE: Urine What is the purpose of the sample collection? Measurement of secreted
      6-suplhatoxymaltonin, a metabolite of melatonin.
    
Keywords: Melatonin; Sleep; Autism; ASD; Sleep problems in children with autism spectrum disorder