Restless sleep disorder in a sample of children and adolescents with autism spectrum disorder: preliminary results from a case series

Alessandra Voci; Luigi Mazzone; Donata De Stefano; Massimiliano Valeriani; Oliviero Bruni; Romina Moavero

doi:10.5664/jcsm.10902

Restless sleep disorder in a sample of children and adolescents with autism spectrum disorder: preliminary results from a case series

J Clin Sleep Med. 2024 Mar 1;20(3):427-432. doi: 10.5664/jcsm.10902.

Authors

Alessandra Voci^{1

2}, Luigi Mazzone¹, Donata De Stefano², Massimiliano Valeriani^{2

3}, Oliviero Bruni⁴, Romina Moavero^{1

2}

Affiliations

¹ Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Italy.
² Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
³ Center for Sensory Motor Interaction, Aalborg University, Aalborg, Denmark.
⁴ Department of Developmental and Social Psychology, Sapienza University, Rome, Italy.

PMID: 37909101
PMCID: PMC11019215 (available on 2025-03-01)
DOI: 10.5664/jcsm.10902

Abstract

Study objectives: Sleep disorders are a frequent comorbidity among children with autism spectrum disorder (ASD). Among sleep-related issues of ASD, restless sleep is a common complaint. In recent years, restless sleep disorder (RSD) has been proposed as a new clinical entity, characterized by agitated sleep as its predominant manifestation. Despite the high prevalence of sleep disorders and data reporting restless sleep among ASD patients, to date no study has yet characterized RSD within patients with ASD. Therefore, the aim of our study was to assess the occurrence of RSD in a sample of children and adolescents with ASD through clinical and polysomnographic assessment.

Methods: Children and adolescents with ASD ages 6-18 years were recruited for the study. Through parental interviews, patients with a suspected RSD were selected and offered diagnostic investigation by video-polysomnography and blood tests to assess martial balance.

Results: Among the 129 participants included, 16 patients (12.4%) were found to have a suspected RSD. Only 6 (4.7%) underwent video-polysomnography due to lack of compliance or family refusal. In 6/6 participants examined, the disorder was confirmed by video-polysomnography movement analysis (total movement index ≥ 5 events/h) and ferritin values were found in the normal range.

Conclusions: RSD does not appear to be particularly frequent among patients with ASD and that of iron metabolism may not be the main factor implicated in the pathogenesis of RSD within this population. Additional evaluation is needed to confirm the result and further investigate the etiological mechanisms underlying the disorder.

Citation: Voci A, Mazzone L, De Stefano D, Valeriani M, Bruni O, Moavero R. Restless sleep disorder in a sample of children and adolescents with autism spectrum disorder: preliminary results from a case series. J Clin Sleep Med. 2024;20(3):427-432.

Keywords: autism spectrum disorder; children; neuropsychiatric disorders; restless sleep disorder; sleep disorders.

MeSH terms

Adolescent
Autism Spectrum Disorder* / complications
Autism Spectrum Disorder* / epidemiology
Child
Humans
Research Design
Sleep
Sleep Disorders, Intrinsic*
Sleep Wake Disorders* / complications
Sleep Wake Disorders* / epidemiology

Supplementary concepts

restless sleep disorder