Abstract
Purpose
Developmental changes in sleep in youth with autism spectrum disorder (ASD) are understudied. In non-ASD youth, adolescents exhibit a “night owl chronotype” (i.e., later sleep/wake timing) and social jetlag (i.e., shifts in sleep timing across school nights and weekends), with corresponding sleep problems. The purpose of this study is to evaluate age trends in chronotype, social jetlag, and sleep problems in high-risk youth with ASD.
Methods
Youth with ASD (N = 171), ages 5–21 years old, were enrolled at the time of admission to specialized psychiatric units. Caregivers reported children’s demographic information, habitual sleep timing, and sleep problems. Multivariate analyses evaluated the effect of age on chronotype, social jetlag, and sleep problems and the effects of chronotype and social jetlag on sleep problems. Covariates and moderators included sex, race, verbal ability, autism symptom severity, supplemental melatonin, and pubertal status.
Results
Older age was associated with later chronotype, more social jetlag, fewer sleep anxiety/co-sleeping problems, fewer night waking and parasomnia problems, and more daytime alertness problems. The effect of age on chronotype was stronger for youth with greater social affective symptom severity. Mediation analyses showed that later chronotype statistically mediated the association between age and daytime alertness problems.
Conclusions
Youth with ASD may exhibit night owl chronotype behavior and social jetlag as they enter adolescence. Shifts toward a later chronotype may be exacerbated by autism severity and may contribute to alertness problems and sleepiness during the day. Chronotype is modifiable and may be leveraged to improve daytime functioning in youth with ASD.
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Acknowledgements
The funding for this research was provided by a grant from The Simons Foundation (SFARI 296318, 618037), The Nancy Lurie Marks Family Foundation, and The National Institute of Child Health and Human Development (K99 HD102586 and R00 HD102586). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Data were collected in partnership with the Autism and Developmental Disorders Inpatient Research Collaborative (ADDIRC) during the Autism Inpatient Collection (AIC) study. We thank the study staff for their time and energy in this work. Special thanks also to the AIC research participants and their families who made this research possible.
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Taylor, B.J., Pedersen, K.A., Mazefsky, C.A. et al. From Alert Child to Sleepy Adolescent: Age Trends in Chronotype, Social Jetlag, and Sleep Problems in Youth with Autism. J Autism Dev Disord (2023). https://doi.org/10.1007/s10803-023-06187-0
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DOI: https://doi.org/10.1007/s10803-023-06187-0