SleepSpectrum.Rmd

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title: "Sleep and the spectrum"
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## How frequently do sleep problems occur on the spectrum? 

**Anywhere from 40-80% of individuals with autism have sleep problems (Cohen et al., 2014)**

One review (Devnani & Hegde, 2015) surveyed research from 1995-2015 and found that:  

54% of autistics had bedtime resistance problems

56% had insomnia

53% experienced parasomnias

25% had sleep disordered breathing

45% had morning arising problems and 

31% reported daytime sleepiness.



```{r alien, echo=FALSE,  out.width = '60%'}
knitr::include_graphics("Smiley_green_alien_deep_sleep.png")
```



## Why are sleep problems more common for autistics? 

Some researchers believe sleep problems are an additional symptom of ASD. For example, they may stem from differences in the brain or brain structures,  increased activity levels, or decreased sensitivity to external cues like time of day and bedtime routine. 

Others think that disrupted sleep is a byproduct of other, co-occuring disorders such as gastrointestinal disorders or seizures. Sleep may also be impacted by medications. 
(Cohen et al., 2018)

The severity of sleep problems are related to severity of ASD symptoms. However, the direction of this relationship is unclear- more severe symptoms may trigger disordered sleep or vice versa. 


## What are the effects of disrupted sleep? 

Poor sleep negatively effects physical health, emotion regulation, cognition, and behavior. 

It can exacerbate symptoms of ASD including 
restricted and repetitive behaviors, insistence on sameness, and externalizing behaviors