Sensitivity to Sounds and Touch and Sleep Concerns in Children with ASD

Background: Sleep problems are commonly reported in children with ASD. Hyper or hypo-reactivity to sensory input is one of the diagnostic criteria for ASD, and may play a role in severity of sleep problems.

Objectives: To examine the relationship of sensitivity to sounds and touch with sleep problems in children and adolescents with ASD as measured by the Composite Sleep Disturbance Index (CSDI).

Methods: U.S.-based primary caregivers of children with ASD were recruited from a validated and verified national autism registry. Parents completed an online survey on co-occurring conditions that incorporated family and child demographic information including the CSDI, a validated tool that scores the frequency and duration of six sleep habits (scored 0-2) over the previous month; total score range=0-12; score≥4 indicates a severe sleep problem. Parents were asked to rate their child’s sensitivity to sounds and to touch on a scale from 0 to 3 with 0 = absent and 3 representing most severe. Descriptive statistics, Pearson chi-square, and logistic regression were performed.

Results: 604 parent/child dyads with responses about both sound sensitivity and touch sensitivity were analyzed. Responding parents were the primary caregiver, primarily female (94%), white (89%), and non-Hispanic (92%); mean age of 43.35 (SD 7.26; range 25-65) years. Children were primarily male (81%), white (83%), and non-Hispanic (88%); mean age of 12.1 (SD 3.61; range 3-17) years. Median household income was $70,000-$79,000. On the CSDI, parents rated their child’s sleep problems as Severe (score≥4)=374 (61.9%) vs. Not Severe (score<4)=230 (38.1%). Caregivers of children with severe sleep problems reported a higher rate of sound sensitivity (χ2(3)= 35.112, p=0.000) or touch sensitivity (χ2(3)= 27.8749, p=0.000) when compared with children without severe sleep problems (see Figures 1 and 2). Children with severe sleep problems had higher rates of moderate or severe sound and touch sensitivity when compared with children without severe sleep problems - Severe vs. Not Severe Sleep Problems: Moderate Sound-Touch Sensitivities 46% vs. 31%, Severe 14% vs 7% (χ2(3)= 42.8942, p=0.000). Sound-Touch Sensitivity were highly correlated (r=0.488, p=0.000). Being female (OR 1.64, p=0.036) and younger age (OR 0.94, p=0.020) were weakly predictive of having combined sound-touch sensitivity.

Conclusions: The prevalence of reported severe sleep problems increases as parents report severity of either sound sensitivity or touch sensitivity indicating that sleep problems and touch/sound hypersensitivities are associated. Sleep problems are known to be associated with increased behavioral problems and can have negative impact on both child and family functioning. Further study is needed to determine causality, namely, if sleep problems exacerbate sensitivity to sound or touch, or if sound or touch sensitivity exacerbate sleep problems. The presence of parent reported sound or touch sensitivity in their child with ASD should prompt screening for other comorbid conditions such as sleep problems.

Acknowledgement: This study was supported by a research grant from Neurim Pharmaceuticals Ltd.