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
NMC Royal Hospital, Mohammed Bin Zayed City, Successfully Treats Lifelong Complications from Childhood Surgery
Advanced Reconstructive Surgery Helps Patient Regain Normal Urinary Function After Years of Complications
Abu Dhabi, UAE – A specialist urology team at NMC Royal Hospital, Mohammed Bin Zayed City, led by Dr. Rami Labib, Urologist, has successfully helped a 30-year-old patient regain normal urinary function after years of complications linked to a surgery he underwent as a child.
For many years, the patient experienced difficulty urinating and persistent urine leakage through small openings along the penis. The condition significantly affected his daily life, causing discomfort, embarrassment and a loss of confidence.
The complications were related to hypospadias, a condition present at birth in which the opening of the urethra is not located at the tip of the penis. While hypospadias is commonly corrected during childhood and most patients achieve excellent long-term results, a small number may develop complications later in life that require further treatment.
After a detailed assessment, Dr. Labib identified narrowing of the urethra, known as a urethral stricture, along with abnormal passages that were causing urinary leakage. Imaging tests confirmed the diagnosis and helped the team plan the most appropriate treatment.
To restore normal function, Dr. Labib performed a highly specialised reconstructive procedure known as a buccal mucosal graft urethroplasty. The surgery used a small piece of tissue taken from the inside of the patient’s cheek to rebuild the damaged section of the urethra and close the abnormal openings responsible for the leakage.
Commenting on the case, Dr. Rami Labib said:
“Patients who experience complications years after hypospadias repair often face significant physical and emotional challenges. Every case is different and requires careful planning to achieve the best outcome. Modern reconstructive techniques allow us to restore normal urinary function and help patients return to their daily lives with greater comfort and confidence.”
The operation was completed successfully, and the patient made a good recovery. During follow-up visits, he reported being able to urinate normally without any leakage and described a substantial improvement in his overall quality of life.
Expressing his gratitude, the patient said:
“After years of struggling with urinary problems following multiple surgeries, I can finally urinate normally again without any leakage. I am extremely grateful to Dr. Rami and the entire medical team for restoring my confidence and giving me my life back.”
Dr. Labib noted that advances in reconstructive urology continue to improve outcomes for patients with even the most complex conditions. With expert assessment, personalised treatment plans, and modern surgical techniques, many patients can achieve long-lasting relief and return to everyday activities with confidence.
About NMC Royal Hospital
NMC Royal Hospital is one of Abu Dhabi’s leading tertiary healthcare institutions, providing comprehensive medical and surgical services through highly specialised clinical teams and advanced technology. The hospital offers expertise across a wide range of specialties, including reconstructive urology, with a commitment to delivering safe, high-quality, patient-centred care.
Health
Fakeeh University Hospital Brings New Hope to Patients with Complex Brain Conditions Through Advanced MRI-Guided Laser Neurosurgery
Russian teenager with high-risk brainstem tumour successfully undergoes minimally invasive laser treatment in Dubai
Dubai, UAE – June 2026 – Fakeeh University Hospital has successfully performed an advanced MRI-guided Laser Interstitial Thermal Therapy (LITT) procedure on a 15-year-old patient from Russia suffering from a brainstem glioma, one of the most challenging and high-risk brain tumours encountered in neurosurgery.
The young patient travelled to Dubai after conventional oncology treatments failed to halt the progression of the disease. The tumour, located deep within the brainstem, had caused progressive neurological deterioration, including worsening motor deficits and paralysis, significantly affecting his quality of life and presenting a complex therapeutic challenge.
Following extensive multidisciplinary discussions involving neurosurgery, neuro-oncology, radiology, and rehabilitation specialists, the medical team at Fakeeh University Hospital carefully evaluated all available treatment options. Given the tumour’s location within one of the most delicate regions of the brain, traditional open surgery was associated with exceptionally high risks.
The brainstem controls many of the body’s most vital functions, including movement, breathing, heart rate, and consciousness. Surgical intervention in this area has historically carried substantial risks, including permanent paralysis, respiratory failure, and even cardiac arrest.
To minimize these risks while offering a potential treatment option, the team elected to perform MRI-guided Laser Interstitial Thermal Therapy (LITT), a highly advanced minimally invasive neurosurgical technique increasingly used worldwide for carefully selected patients with deep-seated brain lesions.
The procedure was led by Dr. Tommaso Tufo, Consultant Neurosurgeon – Brain and Spine Surgery at Fakeeh University Hospital, using a stereotactic robotic-assisted approach. Through a small skin incision measuring only a few millimetres, a laser fibre was precisely implanted into the target area using advanced robotic guidance and neuronavigation technology.
The implantation phase lasted just over one hour, after which the patient was transferred to the MRI suite. Under continuous real-time MRI monitoring, laser thermal therapy was delivered over the course of approximately one to two hours, allowing surgeons to visualize the thermal effect in real time and precisely control the treatment zone throughout the procedure.
One of the most significant advantages of MRI-guided laser therapy is its ability to reach deep and difficult-to-access areas of the brain while minimizing disruption to surrounding healthy tissue. Real-time MRI thermal mapping provides exceptional precision, allowing surgeons to perform controlled volumetric reduction of tumours without the need for extensive surgical exposure.
Commenting on the case, Dr. Tommaso Tufo said:
“Brainstem tumours represent some of the most challenging conditions in neurosurgery because of their location within structures that control critical neurological and physiological functions. In this particular case, conventional treatment options had become limited, and traditional open surgery carried considerable risks. MRI-guided laser therapy allowed us to reach the lesion through a minimally invasive approach while maintaining a very high degree of precision and safety.”
He added:
“The successful treatment of this patient demonstrates the potential of modern laser neurosurgery to expand therapeutic options for carefully selected patients who may previously have had very limited alternatives. However, the true significance of this technology extends far beyond a single case.”
While the patient continues to undergo physiotherapy and additional oncological treatment as part of his ongoing care, he tolerated the procedure well and was able to resume mobility following treatment.
Dr. Tufo emphasized that MRI-guided Laser Interstitial Thermal Therapy should be viewed within the broader context of modern neurosurgery rather than as a solution limited to rare brainstem tumours.
“Laser neurosurgery represents an important advancement in the treatment of selected brain tumours, drug-resistant epilepsy, radiation necrosis, and other complex intracranial conditions,” he explained. “The technology allows us to treat lesions located deep within the brain through a very small incision while minimizing trauma to surrounding tissue. Both adult and pediatric patients may benefit from this approach when conventional surgery presents excessive risk.”
Historically, many patients with drug-resistant epilepsy required open cranial surgery to access and remove seizure-causing areas of the brain. Today, in selected cases, MRI-guided laser ablation offers a less invasive alternative that combines precision, safety, and shorter recovery times.
For appropriately selected patients, the minimally invasive nature of the procedure may significantly reduce hospitalization and recovery periods, with some individuals able to return home on the same day or within 24 hours. More complex cases, particularly those involving critical brain structures, may require extended monitoring to ensure optimal neurological recovery.
The introduction of advanced MRI-guided laser neurosurgery further strengthens Fakeeh University Hospital’s position as a regional center of excellence for complex neurological and neurosurgical care. By combining advanced imaging, robotic guidance, and minimally invasive techniques, the hospital continues to expand access to innovative treatment options for patients facing some of the most challenging brain conditions.
About Fakeeh University Hospital
Fakeeh University Hospital is a leading academic medical center located in Dubai Silicon Oasis and part of Fakeeh Health. The hospital combines advanced clinical care, medical education, research, innovation, and digital health technologies to deliver world-class healthcare services. Through continuous investment in cutting-edge medical technologies and multidisciplinary expertise, Fakeeh University Hospital remains committed to advancing patient care and improving outcomes across a wide range of complex medical conditions.
For more information, visit: Fakeeh Health – Advancing Healthcare with Excellence
Health
Paris Hilton Optimizes Home for ADHD
Ever since being diagnosed with ADHD in her twenties, Paris Hilton has chosen to see her neurodiversity as her “superpower.”
“I wouldn’t be the person that I am today without it,” Hilton, 44, tells PEOPLE. The DJ, model, Parívie founder, TV star, author, fashion designer, and founder of the next-gen media company, 11:11, is a champion for neurodiversity and inclusion. It’s why she opened her front doors — literally — for a three-part video series on how she optimized her home and office for herself and team members with ADHD.
In Inclusive by Design, Hilton teams up with experts Sarah Greenberg and Dr. Andrew Kahn from Understood.org, a leading nonprofit that supports people with learning differences, as well as Android and the nonprofit arm of her company, 11:11 Media Impact. The series explains how she made her closet, craft room, and home office workable for herself and members of her 11:11 team, many of whom have neurodiversity.
Hilton shares with PEOPLE why she’s chosen to be so open about her ADHD journey — and what drives her to be an advocate.
What made you decide to share such an intimate part of your life for this series?
“I just really wanted to share strategies and different things that I’ve learned from managing my ADHD, both in my personal and professional life, and I really hope by sharing my experiences it can help reduce the stigma of ADHD and make neurodiversity relatable,” Hilton tells PEOPLE.
“I’ve just seen how so many people who think differently feel so alone, so I really wanted to create space and just show how I’m embracing and harnessing my ADHD, and they can, too.”
What can parents of a neurodivergent child do at home to help?
“You come out in the world, there’s just so many distractions and things happening, and it’s a lot on someone,” Hilton says, sharing that a person with neurodivergence will appreciate “a space that makes them feel happy and just able to decompress and feel their best.”
She tells PEOPLE that her own motherhood journey — she shares son Phoenix Barron, 2, and daughter London Marilyn, 23 months, with husband Carter Reum, 44 — has influenced her advocacy.
“Motherhood has given me a whole new purpose and I want my kids to grow up feeling celebrated for who they are. I feel like the only way to do that is to fully embrace myself first so that I can be the best, most authentic mom for them.”
Was there anything that surprised you as being helpful to ADHD as you worked on these spaces?
“With ADHD there’s something called object permanence, where, like, if you don’t see something, it basically doesn’t exist in your mind. So visual organization is so important.”
So she organized her craft room with clear drawers so she can see what’s inside. And in her closet, the cabinets and drawers that aren’t glass-paneled have labels explaining what’s inside.
As Hilton explains, she needs to “have it labeled so I can see everything and then my brain will start to remember where each thing is.”
When you redesigned your office, you found a chair that helps people with ADHD. How does a small touch like that make a difference?
“It’s comfortable, it can move around in any position, so you could just be like sitting on it, you could be leaning on it … sometimes with ADHD it’s hard to like just sit still,” she explains. “You just like feel more relaxed, you can focus easier.”
What is the biggest misconception about ADHD?
“People need to understand the positive parts about it,” she says, adding that many artists, actors, singers, creators, and scientists have been diagnosed with ADHD. “There’s so many brilliant people in the community that I think should be celebrated more, and people need to know because that’s such an inspiration to other kids. I want to continue getting that message out as well, so people can feel celebrated and not feel bad about something that they shouldn’t feel bad about.”
You’ve talked about masking your ADHD when you were younger. Can you explain why masking can be so hard?
“For me growing up, like no one was talking about ADHD,” Hilton says, explaining that when she was in school, “it was so difficult for me to remember things. I would constantly lose my homework get in trouble with the teachers.”
“I just felt like something was wrong with me and I’d just be sad, but then I would just mask or, like, kind of try to act like nothing’s wrong on the inside … I was just going through so many emotions, and after speaking to so many others with ADHD, I can totally understand it now. It’s exhausting having to do that and to feel that way.”
Now, she says, “I’m learning so much and I just wish that I knew all I know now, back when I was a kid growing up in school, but I’m doing this for the little girl in me … now I see it as a superpower, and I wouldn’t be the person that I am today without it. I’m such a creator. I’m constantly thinking of new ideas.”
As Hilton says, “I just want people to understand that you’re not broken. It’s just your brain is wired for something different and something very special, so I just want people to know that. It’s not a weakness. It can actually be a superpower if you can harness it in the right way.”
People
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