Sleep and Neurobehavioral Outcomes in Children with Fetal Alcohol Spectrum Disorders

San Diego State University, San Diego CA

Investigators

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Abstract

Project Summary/Abstract Prenatal exposure to alcohol is a major public health issue that can result in a spectrum of disorders characterized by neurobehavioral impairments and physical abnormalities. The term fetal alcohol spectrum disorders (FASD) encompasses the range of these effects and is estimated to affect 2-5% of American school children, making prenatal alcohol exposure the leading preventable cause of birth defects, intellectual disability, and developmental disorders. These effects have lifelong consequences and place a significant burden on individuals and their families, communities, and society as a whole. However, in spite of extensive research and efforts to prevent the consumption of alcohol during pregnancy, more than 10% of women still report drinking alcohol while pregnant. Therefore, research has focused on early identification of affected children and development of effective interventions to ameliorate the adverse outcomes of prenatal alcohol exposure. Caregivers of children with FASD often report that their child has problems sleeping; however, little research has been done to characterize these sleep disturbances and their consequences. Sleep is crucial to normal brain development, and given the negative impact of poor sleep on neurobehavioral functioning, health, and quality of life, this is an important and clinically relevant issue that is not well understood in individuals with FASD. Additionally, many symptoms of sleep deprivation overlap with the cognitive and behavioral deficits characteristic of FASD, resulting in missed diagnosis of sleep disorders and an over-reliance on medications, particularly for treatment of ADHD. In other populations with neurodevelopmental disorders, sleep problems have been associated with greater severity of neurobehavioral deficits, suggesting that sleep disturbance has a synergistic effect on cognitive and behavioral problems. Thus, this study aims to (1) characterize sleep quality in children with FASD, and (2) elucidate potential relationships between sleep quality and neurobehavioral deficits. Actigraphy, sleep diaries, and sleep questionnaires will be used to provide objective and subjective measures of sleep in children with FASD and typically developing controls. Standardized neuropsychological measures and validated behavior questionnaires will be administered to assess neurobehavioral functioning. Findings from this study will provide clinically valuable information that will lay the foundation for future interventions to improve sleep quality in children with FASD. Ultimately, if sleep problems adversely affect or contribute to neurobehavioral outcomes, then sleep interventions may also ameliorate deficits in these domains.