Bad Nights and Biting Bed Bugs: The Effect of a Bad Night's Sleep on Children with Autism's Day-Time Behavior

Background:  Preliminary research indicates that a variety of day-time behaviors (e.g., intensified symptoms of autism, stereotypic body movements, self-injurious behavior, communication problems, and social difficulties) significantly relate to sleep problems for people with an autism spectrum disorder.  In most of these studies, day-time behavior or sleep problems are defined generally.  Sufficiently more research needs to be done to clarify the specific relationships of these day-time problems and sleep disorders in this population.

Objectives: This paper identifies the specific relationships among day-time behavior (e.g., anxiety/depression and aggression) and sleep disorders. 

Methods:   Archival assessment data (i.e., sleep problem scores or diagnoses and day-time behavior) from an autism assessment clinic were recorded for N = 255 children diagnosed with an autism spectrum disorder by clinical psychologists.  Parental report of sleep problems on the Behavioral Evaluation of Disorders of Sleep was correlated with Child Behavior Check List domain scores.

Results: Fewer total hours of sleep per night significantly related to increased rates of day-time aggression. Children more sensitive to night-time environmental stimuli who awoke confused during the night were more likely to experience higher levels of day-time anxiety and depression. However, night waking significantly impacted aggression and attention difficulties more than the environmental stimuli and confusion.

Conclusions: Disturbed sleep at night significantly relates to day-time behavior difficulties for children with autism spectrum disorders.  Until research specifies the relationships between sleep and day-time behavior for these children, day-time treatments may be significantly hindered by disregarding the night-time influences on behavior.