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Hanging out daydreaming (lolz) in the sleep and circadian panel session at #INSAR2019 #circadianrhythms #sleepwakecycle #timeisasocialconstruct #exceptwhenitsbiobasedandinyourbody #sleepdependent
Sleep in those with Tuberous sclerosis have changed in the mTOR pathway that can make or brake translation of protein synthesis. Turns out that causes wonky circadian rhythms. AND changing BMAL1 ("a core clock driver") levels got sleep cycles back in order.
Now Olivia Veatch on genetics of sleep in #autism. #genesgenesgenes or as @amandaseales would say #denimondenimondenim #ha
So Dr. Veatch is focusing on the melatonin pathway. In kids with sleep onset insomnia melatonin was useful but they already have levels comparable 2 neurotypicals. Turns out they were slow metaboliziers. So adding more maybe helped anxiety not endo-levels if melatonin #INSAR2019
Oh lordt she she said maybe we arent looking at enough genes. #halp apparently we have many genes to look at but not in sleep. A meta-analysis found 487 chronotype genes. But all those genes are related to onset time not duration.
Turns out lots of genes in insomnia are implicated in #autism behavior domains. What OV finds super interesting are the ones related to synaptic signaling. Sleep helps us control and prune synapses. Which means dysregulated sleep in autism can make things way more difficult.
Sleep is essential for neuron development & connectivity. In fruit flies, sensor attenae shrink w sleep deprivation. In mice, 🔽 connectivity in thalamus & hypothalamus r reduced later in life w/ early sleep deprivation. Meaning messed up sleep, messes u up long-term. #insar2019
The chronotype gene targets for ASD are age dependent. So measuring in childhood may not == changes in adulthood. AND these genes oscillate so they aren't always on & working.
Next up: Amanda Richdale on poor sleep quality. Sleepiness comes from recuperative factors (time since last sleep) + circadian factors. Melatonin plays the the circadian clock. And sleep has an architecture with 3stages which are developmental. #INSAR2019
Sleep biology relevant to ASD: for neurotransmitters we are looking at norepinephrine, serotonin, acetylcholine, GABA, & histamine. Sleep in autism is not super present at insar says the presenter.
Sleep difficulties are common (50-80%) in tiny humans and poor sleep quality is present in 60% of autistic adults. But the history of sleep research in ASD is only 54 years old. First study by ornitz using EEG. #INSAR2019
The type of sleep problems we see in autistics are many a few are: restlessness, bedwetting, sleep onset, Freq waking, not enough sleep. In adults sleep quality becomes 💩 in late 30s worsening to middle and plateauing in 60+.
#autisticadults also have loads od circadian rhythm problems. And most are going in wee early hours of the morning and sleep into the afternoon. Other groups are late sleepers AND early risers. When these are together they average each other out cause duh heterogeneity.
Psychological correlates of insomnia hits all your faves: ADHD, self injury, rrbs, anxiety, emotional regulation. The list is real long.
Takeaway: sleep is alifespan issue regardless of IQ. Poor sleep maybe present regardless of reporting sleep difficulties. What we don't know is why sleep is 💩. Like no idea. Which isn't really useful anyone dealing with these issues. #sciencebesoslowsometimes #INSAR2019
And while there is a relationship between sleep and autism but sleep doesn't predict autism. So you may see weird sleep in wee tiny babes but that doesn't mean they are autistic.
Richdale says moving forward we really need to understand sleep mechanisms of poor sleep need to be made clear. And what exactly melatonin is doing when it's useful for sleep in autism humans.
Ok last panel session is by Dr. Beth Mallow. On improving sleep! #fingerscrossedforusefulinfo
To treat sleep the whole fambam is happier. Parent training is critical for better sleep outcomes with sleep hygiene behavior improvements. The child sleep habits questionnaire has been modified to be short and clarify what is the biggest issue in sleep for kiddos.
Sleep habits and hygiene can be improved with visual schedules or checklists esp in minimally verbal humans. (This works for typically developing kids too).
For sleep resistance: the rocking hair method is super useful. And phases out parental presence. The sleep pass is also useful - you can keep it or keep it all night for a reward. In an acedote Malow says her son felt like it his reward was for "not being scared".
Parental sleep education super super helped with sleep latency/time to falling asleep. And this education is useful for community based partners too! There is a video 4 how 2 use the tools by Margaret Soulder. Apparently Soulder went to actual households to find best practices.
But when do you turn to meds? When beahvior things aren't helping and only use limited drugs. Also we must be sure to address any medical problems that may be exacerbating the sleep issues in autism. #insar2019.
Med options r: melatonin, gabapentin, trazadone, hydroxyzine, benzos (only for sleep walking present) , tricyclic antidepressants, mitzapine. But there are only like 5 rigorous studies to date on meds and sleep and autism. Malow says we need trials not related to drug companies.
Someone is asking about bright light therapy (helps reset circadian rhythms) and sleep onset. Malow says it has potential. Especially since it's supposed to phase advance you so when done in the morning it late helps go to bed earlier that night.
That's a wrap on the sleep panel y'all! Will go through and answers q's on my rundown in a bit.
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