Preparing Children With Autism Spectrum Disorders for Overnight Sleep Studies: A Case Series

Children with neurodevelopmental disorders (NDD) are at increased risk for having sleep problems, including sleep-related breathing disorders such as obstructive sleep apnea (OSA). Because of their increased risk for OSA, children with NDD may require a polysomnogram (PSG, or sleep study). PSG involves a number of sensors that may be difficult for children with NDD to tolerate because of their difficulties with anxiety, behavioral regulation, communication, and increased sensitivity to environmental stimulation. When trying to help a child complete a PSG, sedation and restraint are not preferred ways to gain cooperation and compliance. Behavioral interventions using simulated medical procedures, exposure therapy, distraction, and counterconditioning can help children succeed with a variety of challenging medical procedures. This case series describes a behavioral intervention used to help 3 children with autism spectrum disorders learn to tolerate PSG without the use of sedation or restraint. All 3 participants successfully completed the behavioral desensitization sessions, as well as their PSG. The results are discussed in terms of their apparent utility, limitations of the case studies presented, need for empirical validation in future experimental studies, and recommendations for future practice and research.