Tuesday, October 18, 2016

A 7 Year Old Boy With Autism Has Trouble Falling Asleep.



A 7 year old boy , a known case of autism is brought to his pediatrician with trouble falling asleep. The pediatrician checks his clinical record which shows normal growth and no significant past medial or surgical histories. On further questioning mother says that the child has been under the care of multiple caregivers as she herself is busy with her tough job.It is very likely that the caregivers have been putting the child to bed with no consistent timing and routine.

Q 1. What is your Diagnosis?


Answer: Behavioral sleep avoidance.(the child has no consistent bed timings due to multiple  caregivers) .

Q 2. How would you manage this case?

Answer: The management is usually conservative with improving sleep hygiene. take following measures to improve sleep hygiene:

  • Establish a fixed sleeping time.
  • Develop bedtime routine
  • Use bed only for sleeping.
  • Limit stimuli like computer and TV before going to bed.
  • Avoid exercise, playing and eating a few hrs before going to bed.
If improving the sleep hygiene fails then consider Circadian rhythm disorder which can be managed by :
  • Melatonin at bed time
  • Exposure to bright light on waking in morning. 

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