Using pharmacotherapy to address sleep disturbances in autism spectrum disorders

INTRODUCTION. Sleep disorders are the second most common medical comorbidity in autism spectrum disorder (ASD), with effects on daytime behavior and functioning, mood and anxiety, and autism core features. In children with ASD, insomnia has also a negative impact on the whole family quality of life. Therefore, treatment of sleep disturbances should be considered as a primary goal in the management of ASD patients, and it is important to clarify the scientific evidence to avoid not recommended treatments. AREAS COVERED. We review the current literature concerning the pharmacological treatment options for the management of sleep-related disorders in patients with ASD (aged 0-18 years) using the PubMed and Cochrane Library databases with the search terms: autism, autistic, autism spectrum disorder, ASD, drug, drug therapy, drug intervention, drug treatment, pharmacotherapy, pharmacological treatment, pharmacological therapy, pharmacological intervention, sleep, sleep disturbance, sleep disorder. EXPERT OPINION. Based on this review, it is possible to suggest the use of compounds that have proven effective for sleep disorders in ASD, according to reports by psychiatrists and pediatricians and expert opinion. The only compound for which there is sufficient evidence is melatonin, but antihistamines, trazodone, clonidine, ramelteon, gabapentin, or suvorexant can also be considered in selected