Causes of autism: Difference between revisions

One study found that gestational sleep apnea was associated with low reading test scores in children and that this effect may be mediated by an increased risk of the child having sleep apnea themselves.<ref>{{cite journal | vauthors = Bin YS, Cistulli PA, Roberts CL, Ford JB | title = Childhood Health and Educational Outcomes Associated With Maternal Sleep Apnea: A Population Record-Linkage Study | journal = Sleep | volume = 40 | issue = 11 | date = November 2017 | pmid = 29029347 | doi = 10.1093/sleep/zsx158 | doi-access = free }}</ref> Another study reported low social development scores in 64% of infants born to mothers with sleep apnea compared to 25% of infants born to controls, suggesting sleep apnea in pregnancy may have an effect on offspring neurodevelopment.<ref name="Tauman_2015">{{cite journal | vauthors = Tauman R, Zuk L, Uliel-Sibony S, Ascher-Landsberg J, Katsav S, Farber M, Sivan Y, Bassan H | display-authors = 6 | title = The effect of maternal sleep-disordered breathing on the infant's neurodevelopment | journal = American Journal of Obstetrics and Gynecology | volume = 212 | issue = 5 | pages = 656.e1–656.e7 | date = May 2015 | pmid = 25576821 | doi = 10.1016/j.ajog.2015.01.001 }}</ref> There was also an increase in the amount of snoring the mothers with sleep apnea reported in their infants when compared to controls.<ref name="Tauman_2015" /> Children with sleep apnea have "hyperactivity, attention problems, aggressivity, lower social competency, poorer communication, and/or diminished adaptive skills".<ref name="pmid235439012">{{cite journal | vauthors = Perfect MM, Archbold K, Goodwin JL, Levine-Donnerstein D, Quan SF | title = Risk of behavioral and adaptive functioning difficulties in youth with previous and current sleep disordered breathing | journal = Sleep | volume = 36 | issue = 4 | pages = 517–525B | date = April 2013 | pmid = 23543901 | pmc = 3595180 | doi = 10.5665/sleep.2536 }}</ref> One study found significant improvements in ADHD-like symptoms, aggression, social problems and thought problems in autistic children who underwent [[Tonsillectomy|adenotonsillectomy]] for sleep apnea.<ref>{{cite journal | vauthors = Murata E, Mohri I, Kato-Nishimura K, Iimura J, Ogawa M, Tachibana M, Ohno Y, Taniike M | display-authors = 6 | title = Evaluation of behavioral change after adenotonsillectomy for obstructive sleep apnea in children with autism spectrum disorder | journal = Research in Developmental Disabilities | volume = 65 | pages = 127–139 | date = June 2017 | pmid = 28514706 | doi = 10.1016/j.ridd.2017.04.012 | doi-access = free }}</ref> Sleep problems in autism have been linked in a study to brain changes, particularly in the hippocampus, though this study does not prove causation.<ref>{{cite journal | vauthors = MacDuffie KE, Shen MD, Dager SR, Styner MA, Kim SH, Paterson S, Pandey J, St John T, Elison JT, Wolff JJ, Swanson MR, Botteron KN, Zwaigenbaum L, Piven J, Estes AM | display-authors = 6 | title = Sleep Onset Problems and Subcortical Development in Infants Later Diagnosed With Autism Spectrum Disorder | journal = The American Journal of Psychiatry | volume = 177 | issue = 6 | pages = 518–525 | date = June 2020 | pmid = 32375538 | pmc = 7519575 | doi = 10.1176/appi.ajp.2019.19060666 }}</ref> A common presentation of sleep apnea in children with autism is insomnia.<ref>{{Cite journal |last=Santapuram |first=Pooja |last2=Chen |first2=Heidi |last3=Weitlauf |first3=Amy S. |last4=Ghani |first4=Muhammad Owais A. |last5=Whigham |first5=Amy S. |date=2022-07 |title=Investigating differences in symptomatology and age at diagnosis of obstructive sleep apnea in children with and without autism |url=https://pubmed.ncbi.nlm.nih.gov/35636082/#:~:text=Children%20with%20OSA%20can%20present,in%20children%20with%20both%20conditions. |journal=International Journal of Pediatric Otorhinolaryngology |volume=158 |pages=111191 |doi=10.1016/j.ijporl.2022.111191 |issn=1872-8464 |pmid=35636082}}</ref> All known genetic syndromes which are linked to autism have a high prevalence of sleep apnea. The prevalence of sleep apnea in Down's Syndrome is 50% - 100%<ref>{{Cite journal |last=Maris |first=Mieke |last2=Verhulst |first2=Stijn |last3=Wojciechowski |first3=Marek |last4=Van de Heyning |first4=Paul |last5=Boudewyns |first5=An |date=2016-03-01 |title=Prevalence of Obstructive Sleep Apnea in Children with Down Syndrome |url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4763351/ |journal=Sleep |volume=39 |issue=3 |pages=699–704 |doi=10.5665/sleep.5554 |issn=0161-8105 |pmc=4763351 |pmid=26612391}}</ref>. Sleep problems and OSA in this population have been linked to language development.<ref>{{Cite journal |last=Lee |first=Ni-Chung |last2=Hsu |first2=Wei-Chung |last3=Chang |first3=Lih-Maan |last4=Chen |first4=Yi-Chen |last5=Huang |first5=Po-Tsang |last6=Chien |first6=Chun-Chin |last7=Chien |first7=Yin-Hsiu |last8=Chen |first8=Chi-Ling |last9=Hwu |first9=Wuh-Liang |last10=Lee |first10=Pei-Lin |date=2020-01 |title=REM sleep and sleep apnea are associated with language function in Down syndrome children: An analysis of a community sample |url=https://pubmed.ncbi.nlm.nih.gov/31378642/ |journal=Journal of the Formosan Medical Association = Taiwan Yi Zhi |volume=119 |issue=1 Pt 3 |pages=516–523 |doi=10.1016/j.jfma.2019.07.015 |issn=0929-6646 |pmid=31378642}}</ref> Since autism manifests in the early developmental period, sleep apnea in Down's Syndrome and other genetic syndromes such as Fragile X start early (at infancy or shortly after), and sleep disturbances alter brain development, it's plausible that some of the neurodevelopmental differences seen in these genetic syndromes are atleast partially caused by the effects of untreated sleep apnea.