Journal article
Evaluating the effect of repetitive transcranial magnetic stimulation on sleep difficulties in children with autism spectrum disorder: a randomized controlled trial
Sleep Advances, Vol.6(4), pp.1-14
2025
PMID: 41445722
Abstract
Study Objectives
Evaluate the effect and safety of alpha rhythm-guided repetitive transcranial magnetic stimulation (α-rTMS) on sleep difficulties in children with autism spectrum disorder (ASD).
Methods
Twenty children (6–12 years old; 16 males; 4 females) with ASD level 2 were randomly assigned (1:1 ratio) to a treatment group (TG) or a waitlist control group (WLCG) (T1). The TG received ten α-rTMS sessions over two weeks, while the WLCG acted as control for that period (T2). Next, the WLCG received α-rTMS for two weeks (T3). All study participants were followed up at one (T4) and four (T5) months. Sleep difficulties were measured using the Children’s Sleep Habit Questionnaire (CSHQ), Actigraphy, and Polysomnography (PSG).
Results
Group-by-time interactions indicated that the TG had greater improvements than the WLCG in total CSHQ score (p=.008) and, bedtime resistance (p=.003), sleep onset delay (p=.004), and sleep duration (p=.003) subdomain scores. When the WLCG received the α-rTMS, there were improvements in their sleep-disordered breathing (p=.001), parasomnia (p=.002) and sleep duration (p=.018) subdomain scores, while PSG data showed improved Waking After Sleep Onset (WASO) (p=.014), Sleep efficiency (p=.046), and N2 stage (p=.039). The improved CSHQ scores persisted, with actigraphy data showing significant improvement in WASO at T4 and T5. Side effects of α-rTMS were mild and transient.
Conclusions
This RCT study presents preliminary evidence on the effect and safety of α-rTMS in improving subjective sleep difficulties in children with ASD, with effects lasting up to four months post-intervention. Further studies using a larger sample size and sham-controlled group are warranted.
Clinical Trial Registration
The trial was registered on July 11, 2023 within the Australian New Zealand Clinical Trials Registry (ANZCTR) https://www.anzctr.org.au/TrialSearch.aspx with registration number: ACTRN12623000757617.
Details
- Title
- Evaluating the effect of repetitive transcranial magnetic stimulation on sleep difficulties in children with autism spectrum disorder: a randomized controlled trial
- Authors
- Uchenna Ezedinma (Corresponding Author) - University of the Sunshine Coast, Queensland, Thompson InstituteScott Burgess - Queensland Children's Lung and Sleep Specialists (Australia)Evan JonesJyoti Singh - Brain Treatment Centre AustraliaAndrew Ladhams - The University of QueenslandGary Campbell - University of the Sunshine Coast, Queensland, School of Health - Public HealthShauna Fjaagesund - University of the Sunshine Coast, Queensland, Thompson InstitutePiotr SwierkowskiAdewuyi A Adeyinka - Southern Cross UniversityAlexandra P Metse - University of the Sunshine Coast, Queensland, School of Health - PsychologyTerri Downer - University of the Sunshine Coast, Queensland, School of Health - MidwiferyFlorin Oprescu - University of the Sunshine Coast
- Publication details
- Sleep Advances, Vol.6(4), pp.1-14
- Publisher
- Oxford University Press
- Date published
- 2025
- DOI
- 10.1093/sleepadvances/zpaf088
- ISSN
- 2632-5012
- PMID
- 41445722
- Copyright note
- © The Author(s) 2025. Published by Oxford University Press on behalf of Sleep Research Society. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
- Data Availability
- Mediated access to non-identifiable study data is available from the corresponding author on written approval from funders to further protect the privacy and sensitivity of the health information of child participants.
- Grants
- Evaluating an alternative therapy to sleep disorders in children with autism spectrum disorder, 0980027787, University of the Sunshine Coast (Australia, Sunshine Coast) - UniSC
- Grant note
- The study received funding from TMS IP Pty, Queensland’s Children Sleep Specialist Clinic, Australia.
- Organisation Unit
- School of Business and Creative Industries; Healthy Ageing Research Cluster; Centre for International Development, Social Entrepreneurship and Leadership; School of Health; Thompson Institute; Engage Research Lab; School of Health - Psychology; School of Health - Midwifery; School of Health - Public Health
- Language
- English
- Record Identifier
- 991192532802621
- Output Type
- Journal article
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