Examining the Relationship between Sleep Patterns and Rrbs in Individuals with 16p11.2 Deletion with and without ASD

Background:

Restrictive and Repetitive Behaviors (RRBs) can be extremely impairing for individuals and their families (Richler, Huerta, Bishop, & Lord, 2010). RRBs are necessary for a diagnosis of Autism Spectrum Disorder (ASD) and are also present in other disorders of development (Harrop et al., 2015). Previous research has shown gender differences in RRBs, with males reported to have greater numbers of these behaviors than females (Attar et al., submitted, 2017). In addition, past research has shown an increase in sleep difficulties in individuals with ASD (Cohen et al., 2014) as well as individuals with 16p11.2 deletion (Girirajan et al., 2010). Research has not yet been conducted to examine whether the presence of RRBs in individuals with 16p11.2 is related to sleep disturbance and, if so, if this is impacted by ASD and gender.

Objectives:

We hypothesized that sleep difficulties would be related to a higher presence of RRBs for children with 16p11.2 deletion with and without ASD.

Methods:

Data was used from the Simons Variation on Individuals Project on individuals with 16p11.2 deletion (N=117) with ASD (n=30) and without (n=87). Participants ranged from 1 year to 22 years old (m=8). Inclusion criteria included a completed Behavior and Sensory Interest Questionnaire (BSIQ, Hanson et al., 2016), which measures type and severity of 74 RRBs and the Pediatric Sleep Questionnaire (PSQ, Chervin, Hedger, Dillon & Pituch, 2000), which assesses disordered sleep patterns. Three items were used to measure sleep difficulty (SD) from the PSQ: difficulty falling asleep, waking up during the night, and difficulty falling asleep after waking up.

Results:

Of the 74 RRBs measured on BSIQ, five were found to be most prevalent in our sample and used in our preliminary analysis: delayed echolalia (35.67%), sensitivity to loud noises (58.92%), pushing face (35.14%), hitting caregivers or family members (70.27%), and difficulty with changes in school routine (41.62%).

RRBs were observed in 52 out of 59 (88.14%) of the male participants. Preliminary results suggest that there was a positive but not significant correlation between SD and presence of the five RRBs (r =.070, p = .357). When looking separately at individual RRBs and SD, two behaviors reached significance: pushing face (r =.353, p =.006) and hitting caregivers (r =.306, p =.018). Delayed echolalia, sensitivity to loud noises and difficulty with changes in school routine did not reach significance.

RRBs were observed in 46 out of 58 (79.31%) of the female participants. Preliminary results reveal that there was a positive but not significant correlation between SD and presence of the five RRBs (r =.094, p = .216). When looking separately at individual RRBs and SD, none reached significance.

Conclusions:

This preliminary data analysis supports the hypothesis that disordered sleep disturbances may be related to some common RRBs in male but not female individuals with 16p11.2 deletion with and without ASD. Further analysis will examine the relationship between sleep difficulties and severity as well as amount of a range of RRBs controlling for gender, IQ and diagnostic status.