Objectives: The goal of this analysis was to identify the sleep factors associated with problematic daytime behavior.
Methods: The study population was 1056 children, ages 3 – 18, participating in the Autism Treatment Network (ATN). The ATN is a registry collecting data on children with ASD across 14 sites in the United States and
Descriptive statistics were calculated for all major variables. Pearson product-moment correlation coefficients were calculated to identify associations between sleep and behavior. We chose a correlation coefficient value of ≥0.30 and p-value <0.05 to represent significance.
CSHQ surveys were completed by 1056 parents (564 ages 2-5 and 492 ages 6-18). Across all ages, the CSHQ total score was associated with the total CBCL score (r =0.47) and CBCL affective problems subscale (r = 0.55). The CSHQ total score and sleep anxiety domains were both associated with the CBCL anxiety subscale (r = 0.34 for both). The CSHQ sleep duration domain was associated with the CBCL affective problems scale (r = 0.46), and the parasomnia domain was associated with the total problem scale (r = 0.36). In the older children the CSHQ sleep total domain was associated with the CBCL total problem scale (r = 0.43) and the CBCL affective problems scale (r = 0.50).
Our findings support the hypothesis that sleep factors are associated with problematic daytime behaviors in a large cohort of children with well-defined ASD. We showed that the behavioral domains of affective disorders and anxiety are associated with problematic sleep. The high rates of association call for longitudinal studies to demonstrate cause and effect as well as pharmacological and behavioral trials to define the effects of improving sleep on daytime behaviors.
SUPPORT: Grant support received from the Autism Treatment Network, Health Resources and Services Administration (UA3 MC11054).