Sleep and Behavioral Problems in Children with Autism Spectrum Disorder
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Children with autism spectrum disorder (ASD) are at high risk for sleep disturbance and behavioral dysregulation. However, the relationships between these difficulties are not fully understood. The current study examined the relationships between specific types of sleep and behavioral problems among 81 children with ASD. Sleep problems were significantly associated with physical aggression, irritability, inattention, and hyperactivity. In multivariate analyses, distinct sets of sleep problems accounted for between 22 and 32 % of the variance in behavior problems across models. These results indicate that sleep disturbance is associated with behavioral dysregulation among children with ASD. Of note, night awakenings had the most consistently strong association with daytime behavior problems, even after controlling for the effects of age and sex.
KeywordsAutism Autism spectrum disorder Sleep Aggression Hyperactivity Inattention Behavior problems
The authors are extremely grateful to all the families who participated in this study, and would also like to thank Christopher Engelhardt and Joseph Hilgard for their help with data collection and project implementation. This project was supported by Autism Speaks and cooperative agreement UA3 MC11054 through the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program to the Massachusetts General Hospital. This work was conducted through the Autism Speaks Autism Treatment Network.
MM and KS conceptualized and designed the study and coordinated and supervised data collection. MM conducted the analyses and drafted the initial manuscript. KS critically reviewed and edited the manuscript, and both authors approved the final manuscript as submitted.
Compliance with Ethical Standards
Conflict of interest
Dr. Mazurek declares that she has no conflict of interest. Dr. Sohl declares that she has no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Washington, DC: American Psychiatric Association.Google Scholar
- Couturier, J. L., Speechley, K. N., Steele, M., Norman, R., Stringer, B., & Nicolson, R. (2005). Parental perception of sleep problems in children of normal intelligence with pervasive developmental disorders: Prevalence, severity, and pattern. Journal of the American Academy of Child and Adolescent Psychiatry, 44(8), 815–822.CrossRefPubMedGoogle Scholar
- Dahl, R. E. (1996). The impact of inadequate sleep on children’s daytime cognitive function. Paper presented at the Seminars in pediatric neurology.Google Scholar
- Frazier, J. A., Biederman, J., Bellordre, C. A., Garfield, S. B., Geller, D. A., Coffey, B. J., & Faraone, S. V. (2001). Should the diagnosis of attention-deficit/hyperactivity disorder be considered in children with pervasive developmental disorder? Journal of Attention Disorders, 4(4), 203–211. doi: 10.1177/108705470100400402.CrossRefGoogle Scholar
- Gregory, A. M., Van der Ende, J., Willis, T. A., & Verhulst, F. C. (2008). Parent-reported sleep problems during development and self-reported anxiety/depression, attention problems, and aggressive behavior later in life. Archives of Pediatrics and Adolescent Medicine, 162(4), 330–335.CrossRefPubMedGoogle Scholar
- Krakowiak, P., Goodlin-Jones, B., Hertz-Picciotto, I., Croen, L. A., & Hansen, R. L. (2008). Sleep problems in children with autism spectrum disorders, developmental delays, and typical development: A population-based study. Journal of Sleep Research, 17(2), 197–206.CrossRefPubMedPubMedCentralGoogle Scholar
- Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., & Lainhart, J. E. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861.CrossRefPubMedGoogle Scholar
- O’Brien, L. M., Holbrook, C. R., Mervis, C. B., Klaus, C. J., Bruner, J. L., Raffield, T. J., & Tuell, A. (2003). Sleep and neurobehavioral characteristics of 5-to 7-year-old children with parentally reported symptoms of attention-deficit/hyperactivity disorder. Pediatrics, 111(3), 554–563.CrossRefPubMedGoogle Scholar
- Richdale, A. L., & Baglin, C. L. (2013). Self-report and caregiver-report of sleep and psychopathology in children with high-functioning autism spectrum disorder: A pilot study. Developmental Neurorehabilitation, 0, 1–8.Google Scholar
- Shanahan, L., Copeland, W. E., Angold, A., Bondy, C. L., & Costello, E. J. (2014). Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 53, 550–558.CrossRefPubMedPubMedCentralGoogle Scholar
- Simonoff, E. M., Pickles, A. P., Charman, T. P., Chandler, S. P., Loucas, T. O. M. P., & Baird, G. F. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47(8), 921–929.CrossRefPubMedGoogle Scholar