Health

Tips for managing insomnia in children with autism spectrum disorder (ASD)

Highlights

Up to 80% of children with ASD have sleep difficulties
This could last into adulthood if left untreated, says Cleveland Clinic Children’s researcher.
Certain behavioural-based approaches suggested alongside short-term use of medications, including melatonin and iron supplements, recommended.

Dubai: Behavioural therapy and certain short-term medication could help alleviate insomnia in children with autism spectrum disorder (ASD), according to an expert.

Cynthia Johnson, PhD, Director of Cleveland Clinic Children’s Center for Autism and Professor of Paediatrics, said insomina affects 8 out of 10 children ASD. She explained that behavioural-based approaches and short-term use of medications, such as melatonin supplements, may be helpful.

Behavioural approaches

Behavioural-based approaches, she said, involve the following:

· Environmental modification,

· Establishment of stimulus control,

· Skill building, and

· Leveraging principles of reinforcement.

The good news, said Dr. Johnson, is that several research projects where she has been involved in show behavioural strategies can make a significant difference in reducing insomnia.

“Short-term use of medications such as melatonin supplements might also be considered,” she added.

Sleep problems in individuals with ASD have been associated with poor social interaction, problems in communication, and overall autistic behaviour.

Family involvement

Many of the strategies can be successfully delivered by the child’s family, said Dr Johnson, who made the remarks on the occasion of World Autism Day (April 2).

The specialist says insomnia in kids with ASD can have a negative impact on both the wellbeing of sufferers and the wellbeing of their families.

What is autism spectrum disorder (ASD)?

ASD is a chronic nervous system condition brought on by genetic, metabolic, or other biological causes. The World Health Organisation (WHO) estimates that one in 160 kids worldwide has ASD. As a developmental disability, autism can cause significant emotional, social and behavioural dysfunction. Sleep disorders co-occur in a huge portion of the patients with ASD.

Insomnia: Common in children with ASD

“Insomnia is significantly more common in children with ASD compared with the general paediatric population, and also persists for a longer period, carrying through to adolescence and adulthood, if left untreated,” says Dr Johnson.

She lists a number of behavioural traits of children with ASD, which may raise the risk of sleeplessness, including:

· Rigidity and insistence on sameness,

· Inadequate communication,

· Anxiety, and

· Hyperactivity.

Biological risk factors

Biological risk factors can also lead to certain effects — such as variations in brain development, changed melatonin secretion, or mutations in genes that control circadian rhythms.

In addition, clinical variables including untreated gastrointestinal issues and negative pharmaceutical side effects might also worsen sleep disorders.

Commenting on the impact of insomnia on a child, Dr. Johnson says, “Sleep plays an important role in the growth, development and wellbeing of children.”

Studies have shown a lack of adequate, quality sleep can have negative effects on attention, daytime behaviour and the regulation of emotions, and could even impact children’s cardiovascular, metabolic and immune systems.

In addition to the child, the family will be impacted, Dr. Johnson adds.

“The child’s insomnia can affect other family members’ ability to function because, if the child is not sleeping, everyone’s sleep can be disturbed. This adds to parental stress in the long term, with parents dedicating a great deal of time to strategizing on how to get the child to sleep.”

Varying presentation

Insomnia presents in children with ASD varies from child to child, she said, adding: “Sleep problems may be irregular, cyclical or constant and they can take many forms.

For example, the child might resist bedtimes, or insist on elaborate bedtime routines, or might have difficulty falling asleep or staying asleep, or the child might wake up too early.”

Low ferritin levels is also a factor seen behind insomnia in children with ASD.

What can be done?

Interventions are not “one size fits all” solutions, she said.

“As each child responds differently to treatment strategies, parents should work together with an expert in ASD sleep disorders and behavioural interventions.

“The aim is to approach the problem collaboratively and systematically, exploring the day and nighttime routines of the child and family, and testing various preventative and skill-building strategies until the best solution is found.”

Dr. Johnson points out that treatment approaches are continuing to evolve, and new therapies have been found over the past decade and a half.

Behavioural-based approaches, supplements

Behavioural-based approaches involve environmental modification, establishment of stimulus control, skill building and leveraging principles of reinforcement.

Short-term use of medications such as melatonin supplements might also be considered, she says.

Studies also show that low ferritin levels can also be a factor in sleep disorders.

In 2013, a retrospective chart review of data involving 9,791 children with ASD conducted by researchers led by Julie Youssef, of the Department of Neurology, Boston Children’s Hospital, Harvard Medical School, found that significantly low serum ferritin levels were associated with several sleep disorders — including:

· Periodic limb movements during sleep,

· Sleep fragmentations, and

· Poor sleep efficiency.

Ferritin is a storage form of iron. The sudy found that iron supplementation was be effective in the treatment of low ferritin with sleep disorders.

Also, in a 2012 study led by Lynn M. Trotti, of the Department of Neurology, Emory University School of Medicine in Atlanta recommends iron therapy for low ferritin level below 50 ng/mL for children with ASD facing sleep disorders.

Further research

A study, published in 2007 in Paediatric Neurology, conducted an open-label trial of oral iron supplement (6 mg elemental iron/kg/day) for 8 weeks in children with autism and showed improvement in sleep, with an increase in serum ferritin level.

However, potential side effects were cited, including “metallic” taste, vomiting, nausea, constipation, diarrhoea, and black/green stools.

Antipsychotics, antidepressants, and alpha (α) agonists have also generally been used alongside melatonin.

Experts, however, said that given the limited evidence for psycho-pharmacological treatments in autism, behavioural interventions are considered a primary mode of treatment.

Still, further research and information are needed to guide and individualise treatment for this population group.

Gulf News

Health

Safe Blood Donation Before, During, and After Ramadan – Medical Guidelines by Dr. Ganesh Dhanuka

By Dr. Ganesh Dhanuka
Specialist Internal Medicine and Nephrology
International Modern Hospital

Blood donation remains one of the most impactful humanitarian acts, capable of saving multiple lives with a single unit of blood. However, during the holy month of Ramadan, many individuals question whether it is safe to donate while fasting and how to properly prepare for donation.

From a medical standpoint, blood donation is generally safe for healthy individuals. Nevertheless, appropriate preparation — especially in the context of fasting — is essential to minimize risks such as dizziness, dehydration, or hypotension.

This article outlines evidence-based recommendations for blood donation before, during, and after Ramadan, along with its physiological, psychological, and societal benefits.

Preparing for Blood Donation Before Ramadan

Proper preparation significantly reduces the risk of adverse effects during donation. Individuals planning to donate should:

Nutritional Preparation

Consume a balanced meal rich in iron and protein approximately 2–3 hours before donating. Iron-rich foods such as lean red meat, spinach, lentils, beans, and fortified cereals help maintain adequate hemoglobin levels. Protein supports plasma volume and recovery.

Avoid donating on an empty stomach, as this increases the likelihood of lightheadedness and vasovagal reactions.

Hydration Status

Adequate hydration is critical. Donors should:

Increase water intake the day before donation.
Drink extra fluids on the day of donation.

Proper hydration helps maintain blood pressure and reduces the risk of fainting.

Sleep and Lifestyle Factors

Ensure 6–8 hours of quality sleep the night before.
Avoid alcohol for at least 24 hours prior to donation.
Refrain from strenuous physical activity before donation.

Medical Disclosure

Bring valid identification and honestly disclose:

Any chronic medical conditions.
Current medications.
Recent illnesses or procedures.

Transparency ensures donor safety and protects recipients.

What to Expect During Blood Donation

The blood donation process is generally straightforward and takes about 10–15 minutes for the actual collection.

During donation:

Stay calm and breathe normally.
Avoid sudden movements.
Inform medical staff immediately if you experience dizziness, nausea, sweating, blurred vision, or weakness.
Follow all staff instructions carefully.

Most temporary reactions, when they occur, are mild and resolve quickly with rest and hydration.

Post-Donation Care and Recovery

The post-donation period is crucial for safe recovery.

Immediate Aftercare

Rest at the donation center for 10–15 minutes.
Accept fluids and light refreshments provided.
Avoid standing up abruptly.

The Next 24 Hours

Increase fluid intake significantly.
Consume iron-rich foods to replenish red blood cell production.
Avoid heavy lifting for 24 hours.
Avoid strenuous exercise on the same day.
Avoid alcohol for several hours after donation.

If dizziness occurs, lie down and elevate your legs until symptoms resolve.

Food

Foods That Look Healthy for Weight Loss (But Actually Aren’t)

By Dr. Yara Husein (Food and Nutrition Expert)

Companies often use specific buzzwords on food labels to market products as healthy and weight-loss friendly options. In reality, these options can sometimes have the opposite effect. Here are some common foods and drinks that might be holding you back:

Fat-free dairy products

Many think that fat-free dairy products are ideal for dieting and do not contribute to weight gain. However, in truth, these products can cause weight gain because fat-free products are less satiating than their full-fat counterparts; fat is a nutrient that supports feelings of fullness and makes food more enjoyable. Furthermore, food manufacturers often replace fat with sugar in low-fat and fat-free products to compensate for the lost flavour. Beyond that, skimmed dairy products provide the body with fewer nutrients than full-fat products, because vitamins such as A, D, E, and K are fat-soluble vitamins that require fat to enter the body, be absorbed, and be utilized.

Gluten-free foods

While it is essential for people with gluten-related disorders to avoid gluten, gluten-free foods are not necessarily healthier than foods containing gluten. Some processed gluten-free foods and desserts contain the same amount of calories and added sugar—if not more—as other snacks. Studies, including a study published in the journal PeerJ, indicate that gluten-free snack foods tend to be lower in protein, fiber, and certain vitamins and minerals compared to their gluten-containing counterparts. They are also generally more expensive.

Breakfast cereals

Many people think that breakfast cereals are an ideal and healthy breakfast to start their day, but in reality, many cereals are made from refined grains that lack nutrients like protein and fiber, and they can contain a high percentage of added sugar. For example, Honey Nut Cheerios, which are marketed as heart-healthy, contain 12 grams of added sugar per cup. Eating large quantities of these and other cereals high in added sugar may lead to an increased risk of heart disease, high blood pressure, high triglyceride levels, and weight gain.

Energy and sports drinks

Companies market sports and energy drinks as ways to boost energy and athletic performance, but these drinks can contain a massive amount of sugar. Consequently, they can contribute to weight gain for people who consume them without performing intense physical exercise. For instance, a popular energy drink like Monster (473 ml) contains 54 grams of added sugar—a quantity much higher than the amount recommended by the American Heart Association (25g for women and 36g for men). Research, including a study published in the journal Pediatric Obesity, has linked the consumption of sweetened beverages to health problems, including high blood pressure, fatty liver, and obesity in children and adolescents.

Diet soda

When following a diet, many people may turn to sugar-free or calorie-free drinks, thinking they contribute to weight loss. However, studies indicate that diet soda may contribute to certain health problems by altering brain responses to food and increasing the desire to eat high-calorie foods such as sweets and fast food. A study published in the journal Nutrients linked the consumption of these drinks to a higher risk of metabolic syndrome, which is a group of symptoms that include increased belly fat, blood sugar, blood pressure, and blood lipid levels.

Health

Excessive Screen Time in Children: Digital Eye Strain, Myopia Risk, and Long-Term Vision Health

By Dr. Tahere Rezaei
Ophthalmologist
International Modern Hospital Dubai

In today’s digital era, children are spending unprecedented hours on tablets, smartphones, and social media platforms. From a clinical perspective, the impact of excessive screen exposure on pediatric eye health is becoming increasingly evident.

Ophthalmology clinics are witnessing a clear rise in complaints linked directly to prolonged device use. Children often hold screens very close to their eyes and remain intensely focused for extended periods without taking breaks. This sustained near work places continuous strain on the visual system, particularly on the eye muscles responsible for focusing.

The most immediate and common consequence is digital eye strain. Symptoms typically include:

Headaches
Eye fatigue
Blurred vision
Burning sensation
Dryness due to reduced blinking

When children concentrate on screens, their blink rate significantly decreases. Reduced blinking leads to tear film instability, which contributes to dryness and irritation. Over time, persistent strain can affect visual comfort and academic performance.

Rising Concern: Childhood Myopia

Beyond temporary discomfort, there is a more serious long-term concern — the increasing prevalence of childhood myopia (short-sightedness).

Extended near work combined with limited outdoor exposure has been strongly associated with faster progression of myopia. Natural daylight and distance viewing play a protective role in visual development. When children spend most of their time indoors focusing on close objects, the eye adapts by elongating, leading to blurred distance vision.

Early-onset myopia is not simply about needing glasses. Higher degrees of myopia later in life increase the risk of:

Retinal detachment
Glaucoma
Myopic macular degeneration
Early cataracts

Preventing rapid myopia progression during childhood is therefore critical for long-term ocular health.

Screen Use and Sleep Disruption

Another clinically observed issue is the effect of screen exposure before bedtime. Blue light emitted from digital devices can suppress melatonin production, disrupting the natural sleep cycle. Poor sleep quality affects not only overall health but also visual comfort, concentration, and cognitive performance.

Children who use screens late at night frequently report:

Difficulty falling asleep
Morning eye discomfort
Increased fatigue during the day

Sleep plays a vital role in ocular surface recovery and overall neurological health.

Supporting Healthy Visual Development

For optimal eye development, children require balanced visual habits. Key preventive measures include:

Limiting continuous screen time
Encouraging daily outdoor activity
Maintaining proper room lighting
Ensuring appropriate screen distance
Practicing scheduled visual breaks (such as the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds)

Parents play a crucial role in modeling healthy screen behavior and establishing structured digital routines.

As Dr. Tahere Rezaei emphasizes, eye health in childhood directly influences long-term vision outcomes. Early awareness, prevention, and regular eye examinations are essential to protect children from avoidable visual complications in adulthood.

Healthy eyes today mean clearer vision for life.