27335
Sleep Disturbance in Children and Adults with ASD in the EU-AIMS LEAP Cohort: Association with Symptomatology, Comorbidities, Quality of Life, and Intellectual Ability
Objectives: 1) To investigate the type and severity of sleep problems in individuals with and without ASD in relation to age, and ability level; 2) To study the associations of sleep problems on ASD core symptoms and psychiatric comorbidities (i.e. depression, anxiety, ADHD) as well as quality of life and adaptive functioning.
Methods: 294 individuals with ASD and 204 individuals with typical development or mild intellectual disability, with IQ ranging from 40-148 and aged 6-30 years were recruited as part of the multi-centre EU-AIMS Longitudinal European Autism Project (Charman et al., 207; Loth et al., 2017). Autism symptomatology was characterized with the ADOS, ADI-R, Social Responsiveness Scale, Short Sensory Profile, and Repetitive Behaviours Scale. Sleep disturbances were studied with the Child Sleep Habits Questionnaire (parent report version for 6-11 years-olds) or the self-report adolescent version in individuals over 11 years of age of IQ above 75, and parent reported for those below. Quality of life was measured with the Columbia Impairment Scale, and adaptive functioning with the Vineland adaptive behaviour interview. Comorbidities were characterized using the ADHD DSM-5 checklist, and Beck questionnaires for Anxiety and Depression.
Results: Children with ASD showed significantly greater overall sleep disturbances than controls, in particular, anxiety around sleep time, quality of waking (e.g. feeling rested, difficulties waking up, etc.), parasomnias, and daytime sleepiness (all pcorrected < .037). Adolescents and adults with ASD reported poorer quality of waking than controls (pcorrected = .004). Repetitive behaviours and sensory abnormalities correlated moderately with the total sleep time across ages, as reported by parents (all r > .44, all pcorrected < .004), but not on self-reports. In children, sleep correlated to adaptive behaviour (r = -.35, pcorrected = .005). Across ages, the total sleep time was moderately correlated to anxiety, depression and ADHD (all r > .42, all pcorrected < .005), as well as quality of life (all r > .36, all pcorrected < .004), but only on individuals of IQ > 75.
Conclusions: Sleep problems are linked to ASD core symptoms and adaptive behaviour in children with ASD, but sensory anomalies, and frequent comorbidities across the ages. Future analyses will examine whether the effect of sleep on clinical symptoms may be mediated by differences in cognitive or emotional processes.
See more of: Medical and Psychiatric Comorbidity