Sleep Profile in Children with Pervasive Developmental Disorders

Sleep disturbances are regarded as a common clinical feature in autism and other Pervasive Developmental Disorders (PDD) that forms a great source of stress for families. Studies have shown that children with PDD exhibited qualitatively and quantitatively different sleep patterns to non autistic control children. This study aimed at describing sleep patterns in a sample of Egyptian children with pervasive developmental disorders. The study included 15 children with a pervasive developmental disorder according to DSM-IV criteria, randomly chosen from the child psychiatry out patient clinic, at the Institute of Psychiatry, Ain Shams University between the months of January and August, 2004. An age and sex matched control group, formed of 10 healthy age and sex matched children from the information bank of the sleep laboratory were obtained. All cases were clinically assessed and the severity of the PDD was further evaluated by the Childhood Autism Rating Scale (CARS). Subjective sleep assessment was obtained through the Arabic version of Children’s Sleep Habits Questionnaire (CSHQ). Sleep was also objectively assessed by a polysomnogram performed at the sleep lab of the institute of psychiatry, Ain shams University. The children were classified as mildly autistic or moderately autistic by the CARS. Epilepsy was reported in 46.7% of the patients. Normal sleep latency was reported in 60% of the patients while 26.7% reported a moderate increase in sleep latency. The children’s sleep habits questionnaire (CSHQ) showed that sleep duration was adequate in 93.3% of patients. Sleep related anxiety was seen in 53.3% of patients and night awakening in 40% of patients. Nocturnal enuresis was seen in 20% of patients (3 patients) and increased movements during sleep in 26.7% (4 patients). Sleep bruxism was seen in 20% of patients (3 patients), while sleep disordered breathing occurred in one patient. As compared to age and sex matched control, the polysomnogram has shown a significant decrease in sleep efficiency, prolongation of stage 1 and 2 NREM sleep and shortened REM sleep in patients with PDD. The arousal index and number of awakenings were significantly higher in children with PDD than in the control group. The Periodic Leg Movements during Sleep index was also significantly higher in the patient than the control group. The results of our study confirm the presence of sleep disturbances in children with PDD in the form of decreased sleep efficiency and change of sleep