Sleep in Children with Autism Spectrum Disorder: What Matters?

• In Event: Poster Session 06
  In Poster Session: PS 06 Topic - Developmental Disabilities

Abstract

Children with autism spectrum disorder (ASD) are particularly prone to sleep problems, with 50-80% experiencing significant sleep disturbances (Couturier et al., 2005; Richdale & Schreck, 2009). In children with ASD, sleep problems have been associated with negative outcomes such as more severe ASD symptoms, aggression, and internalizing and externalizing behaviors (Mazurek & Sohl, 2016; Sikora et al., 2012). However, most studies that examine sleep in ASD have focused on mental and physical health conditions and not on other mental health related factors such as peer difficulties or adverse childhood experiences (ACEs), which have been shown to be associated with sleep difficulties in typically developing children (Chapman et al., 2013; Hunter et al., 2014; Sansone & Sansone, 2008). The aim of this study is to examine which mental-health related factors are associated with getting the recommended amount of sleep, in children with ASD.

The sample included 1,131 children with parent-reported ASD from 3-17 years old (M = 11.22, SD = 4.07) from the 2016 National Survey of Children’s Health (NSCH). A hierarchical binary logistic regression was used to examine factors associated with getting the recommended sleep amount in children with ASD in four blocks. The first step included demographic variables such as age, race, family income and overall level of child’s health. The second step included parent-reported mental health conditions (i.e. anxiety, depression, behavior problems, intellectual disability, attention deficit/hyperactivity disorder, or other mental health concerns). The third step included variables related to peer difficulty (i.e. difficulty making friends, being bullied, bullying others). Finally, the final step included the presence of two or more adverse childhood experiences (ACEs). Wald test was used to determine whether each block of variables contributed significantly to the model.

Results indicated that the overall model had a better fit than a null model (χ2(9) = 31.67, p < .001). Wald tests indicated that the demographic variables block and adverse childhood experiences blocks were significantly associated with getting recommended amount of sleep. In the final model, with all four blocks, African American children were 52% less likely to get the recommended amount of sleep than White children (OR = 0.47, 95% CI: 0.28-0.81). Additionally, children with worse overall physical health were 18% less likely to get the recommended amount of sleep (OR = 0.82, 95% CI: 0.70-0.96). Children who have had two or more ACEs were 20% less likely to get the recommended amount of sleep (OR = 0.80, 95% CI: 0.67-0.97).

No study has yet identified that ACEs may be associated with sleep quality in children with ASD. It may be important to consider potential adverse and traumatic experiences when assessing and treating sleep problems in children with ASD. Furthermore, it may be important to recognize the effect of potential stressors related to systemic racism as well as overall health on sleep in children with ASD.

Authors

• Eleonora Sadikova, University of Virginia - Charlottesville
  Presenting Author

• Michelle Menezes, University of Virginia
  Non-Presenting Author

• Micah Mazurek, University of Missouri
  Non-Presenting Author