S11 Sleep and autism: New developments from bench to bedside

S11 Sleep and autism: New developments from bench to bedside
Sunday, April 29 | 9:00am-10:30am | Room 341

Chair: Desaline Joseph (United Kingdom)

9:00am – 9:02am
Introduction
Desaline Joseph (United Kingdom)

9:02am – 9:22am
The interplay of sleep genes and autistic spectrum disorders: The story so far
Thomas Bourgeron (France)

9:22am – 9:42am
Sleep and circadian rhythms in autism
Carmen Schroder (France)

9:42am – 10:02am
An RCT sleep behavioural intervention for children with ASD
Emma Sciberras (Australia)

10:02am -10:22am
Pharmacology for sleep problems in ASD: New developments
Paul Gringras (United Kingdom)

10:22am – 10:30am
Question and Answer
Desaline Joseph (United Kingdom)


Summary of symposium:
Why do children with Autistic Spectrum Disorders (ASD) sleep so poorly, and what can we do to help them and their families? This symposium will take the participants on a journey from cutting-edge science to the latest behavioural and pharmacological approaches to sleep disorders in children with autism, currently estimated to affect 1% of the population.

Thomas Bourgeron is head of the Department of Neuroscience, at the Institut Pasteur. Thomas and his team have led the field for the last 14 years in identifying a number of mutations in the genes of people with ASD associated with pathways that represent risk factors for abnormal neuronal connectivity in the brain. They have also focused on biochemical impairments, including decreased melatonin and elevated platelet N-acetylserotonin (the precursor of melatonin) which have been reported as very frequent features in individuals with ASD. Thomas will present an overview on their latest work on pathophysiological pathways involved in ASD and sleep problems.

Carmen Schroder, Professor of Child and Adolescent Psychiatry at Strasbourg University, France, will build on Thomas’ genetic and pathophysiological perspectives, and present participants with vital new objective longitudinal data including melatonin profiles, actigraphy, polysomnography and sleep EEG spectral analysis in children with ASD.

Having learnt about the underlying genetic and physiological basis of sleep problems in autistic spectrum disorders, we will turn to treatment options. Whilst sleep behavioural interventions are commonly used for children with ASD, there are only a few randomised controlled trials of such interventions, and often for small numbers of children. Emma Sciberras and the team from Melbourne, Australia have already published some of the most rigorous RCT sleep interventions for infants and children with ADHD. A subgroup of children in their ADHD study also had comorbid ASD and had improvements in sleep problems and behavioural functioning. This finding inspired the team’s current randomised controlled study of a sleep behavioural intervention for children with ASD that Emma will present.

Some children still have sleep problems refractory to behavioural interventions and medications are often used despite a lack of robust evidence in some cases. Paul Gringras is Professor in Sleep Medicine at the Evelina London Children’s Hospital and over the last 5 years has led large randomised-controlled trials of pharmacological and non-pharmacological interventions for children with ASD and sleep problems. He published the MENDS immediate release melatonin study in 2012 and this year the first paper on a novel Pediatric Prolonged-Release Melatonin with important new outcomes and a longer follow-up period than any previous study. Paul will end the symposium with an update on evidence based pharmacological interventions for children with autism and severe sleep disorders.

Learning Objectives:
Upon Completion of this CME activity, participants should be able to:
1 Appreciate there is an underlying genetic and biochemical basis to many sleep problems in children with autistic spectrum disorders (ASD).
2 Understand that in addition to subjective caregiver reports of poor sleep, objective measures of sleep and circadian rhythms are different in this group.
3 Learn about evidence based sleep behavioural programmes that can improve the sleep of children with ASD.
4 Consider which pharmacological interventions are supported by robust evidence in this group and discuss potential short and long term adverse effects.

Target Audience:
All. With a prevalence of 1% of the population no sleep practitioner can afford not to have an up to date understanding of the causes and treatments of sleep disorders in this population.
Suitable for: Basic Sleep Scientists, Clinicians, Psychologists and Physiologists.