Novel Adaptive Cognitive Training in Autistic Adults With Co-occurring Insomnia

Prior treatment

• psychotropic or other medications (e.g., beta-blockers) that alter sleep

Other illness

• diagnosis of sleep disorder other than insomnia \[i.e., sleep apnea (apnea/hypopnea index, AHI \>15), Periodic Limb Movement Disorder (myoclonus arousals per hour \>15)\],
• comorbid bipolar or seizure disorder (due to risk of sleep restriction treatment)
• other major psychopathology except depression or anxiety (e.g., suicidal ideation/intent, psychotic disorders)
• severe untreated psychiatric comorbidity

Other

• unable to provide informed consent
• participation in non-pharmacological treatment (including CBT) for pain, sleep or mood outside current trial.

• 18+ years of age
• Diagnosed with ASD (see 2a).
• Verbal IQ \>= 70 (Measured via the Weschler Abbreviated Scale of Intelligence 2nd Edition28); to ensure verbal skills sufficient to participate in treatment
• Able to undergo actigraphy assessment
• Can read and understand English
• Diagnosed with insomnia (See 3a).
• No prescribed or OTC sleep medications for 1+ month, or stabilized on medications for 6+ weeks.
  • 2a) ASDb: a) previous DSM diagnosis of ASD (self-reported by ASD adult and guardian; confirmed by clinical documentation provided to project coordinator), 2) evaluation using gold-standard diagnostic tools (i.e., Autism Diagnostic Observation Schedule (ADOS) and/or Autism Diagnostic Interview -Revised \[ADI-R\]).
  • 3a) Insomnia: a) insomnia complaints for 6+ months that b) occur despite adequate opportunity and circumstances for sleep, c) consist of 1 or more of the following: difficulty falling asleep, staying asleep, or waking up too early, d) daytime dysfunction (mood, cognitive, social, occupational) due to insomnia, f) baseline diaries and actigraphy indicate \>30 minutes of sleep onset latency or wake after sleep onset on 6 or more nights.