Non- Pharmacological Approaches on the Improvement of Sleep Disturbances in Patients with Autism Spectrum Disorder (ASD).

Autism is a type of neurodegenerative disorder, caused by genetic and environmental factors. Children with autism spectrum disorder (ASD) have symptoms of attention deficit and behavioral problems. Child's sleep pattern has a significant effect on mood. Sleep problems are more common in children with ASD. The current study aimed to investigate the effect of non-pharmacological approaches on the improvement of sleep disturbances in patients with ASD. Materials & Methods We systematically searched PubMed, EMBASE, Web of Science, Scopus, and Science Direct to identify relevant articles published from January 2009 to May 2019. All original articles from observational and interventional studies were reviewed. The CONSORT Statement and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist were used to assess the quality of selected papers. Results Reviewing 18 eligible articles according to the CONSORT checklist (for interventional studies) and STROBE (for descriptive studies) demonstrated that behavioral interventions, such as cognitivebehavioral therapy, bedtime fading with response cost, and functional behavioral assessment, physical activity such as aerobic exercise, swimming, and aquatic exercise and weighted blankets can improve sleep disturbances. Conclusion Restlessness, tantrums, increased stereotypic activities, and reduced learning level and speaking power in children with autism were caused by poor sleep quality and sleep deficiency, which may affect other dimensions of life. Non- pharmacological approaches to sleep disturbances could improve both sleep quality and quality of life of children with ASD with no adverse effect.