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Treatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects.

TitleTreatment for Sleep Problems in Children with Autism and Caregiver Spillover Effects.
Publication TypeJournal Article
Year of Publication2015
AuthorsJ. Tilford, M, Payakachat, N, Kuhlthau, KA, Pyne, JM, Kovacs, EA, Bellando, J, Williams, D, Brouwer, WB, Frye, R
JournalJournal of Autism and Developmental Disorders
Date Published2015 Nov

Sleep problems in children with autism spectrum disorders (ASD) are under-recognized and under-treated. Identifying treatment value accounting for health effects on family members (spillovers) could improve the perceived cost-effectiveness of interventions to improve child sleep habits. A prospective cohort study (N = 224) was conducted with registry and postal survey data completed by the primary caregiver. We calculated quality of life outcomes for the child and the primary caregiver associated with treatments to improve sleep in the child based on prior clinical trials. Predicted treatment effects for melatonin and behavioral interventions were similar in magnitude for the child and for the caregiver. Accounting for caregiver spillover effects associated with treatments for the child with ASD increases treatment benefits and improves cost-effectiveness profiles.


Lead Author
J. Mick Tilford

Study Aims/Objectives To understand the importance of sleep problems on the health of children with ASD and to measure the change in quality of life that a successful treatment may have for both the children and their primary caregiver.

Methods - Sample, Procedure, Study Measures, Analysis
A total of 224 children with ASD and their caregivers participated in this study by completing questionnaires about sleep and quality of life. Average ages of children and caregivers were 8.2 and 39.4 years old, respectively. A majority of the children were male (86.6 %) while the caregivers were mostly female (89.5 %). 94.5 % of the caregivers were the affected child’s biological parent.

Results – Main Finding(s)
A child’s sleep problems were associated with a lower quality of life for both the child and his or her caregiver. The presence of these problems was also associated with less caregiver sleep, about 25% of caregivers reported sleeping less than 5 hours per night and almost half reported sleeping less than 6 hours per night. Treatment for sleep problems including medication and behavioral therapy resulted in increased quality of life for both the children and their caregivers.

Conclusion – Summary Statement
Both treatment with medication and behavioral therapy can improve sleep habits and the health of children with ASD and their primary caregiver. This study provides new information on the quality of life gained for children and caregivers as a result of these treatments that can be used when evaluating their cost-effectiveness. In short, treatments seem to improve the quality of life to a similar extent for the children and their caregivers, so cost-effectiveness evaluations that do not include impacts on the parents understate the benefits of the treatment.

Alternate JournalJ Autism Dev Disord
PubMed ID26126749
PubMed Central IDPMC4609586
Grant ListR01 MH089466 / MH / NIMH NIH HHS / United States