Sleep Quality and Parent-Adolescent Relationships

Background:  Pediatric sleep debt, with a recent estimate prevalence of 45% for mild sleep disturbances in a typically developing sample, ranks as a public health problem of concern (Souders et al., 2009). Even high prevalence rates characterize children with autism spectrum disorders (ASD); recent estimates of at least moderately severe sleep problems among children with ASD have reached 66% (Souders et al., 2009).  Symptoms of poor sleep quality among children with ASD have included difficulty falling asleep, restlessness during sleep, frequent night-waking, and early waking (Mayes & Calhoun, 2009).  Children with ASD with problematic sleep demonstrate greater communication impairment as well as aggression and hyperactivity compared to children with ASD without problematic sleep (Goldman et al., 2011).  Links between sleep quality and social relationships in the context of ASD demand empirical investigation.

Objectives:  To examine the associations between the quality of sleep of adolescents with ASD and the quality of family relationships.

Methods:  Participants were 31 adolescents who had been clinically diagnosed with ASD and their married mothers and fathers.  Adolescents’ age ranged from 12-18 years.  Full-scale IQ scores averaged 95.48 (SD =18.63). There were more adolescent boys (90%) compared to adolescent girls in the sample. Data collection took place in family homes; adolescents and parents completed questionnaires.  Sleep quality was measured using two questionnaires: (1) the Children’s Sleep Habits Questionnaire (CSHQ; Owens et al., 2000) is a parent-report measure designed to assess sleep functioning in children; (2) the School Sleep Habits Survey (SSHS; Wolfson & Carskadon, 1998) is an adolescent self-report, which asks about typical sleeping and waking behaviors.  Quality of family relationships was measured using the Network of Relationships Inventory-Relationship Qualities Version (NRI-RQV; Buhrmester & Furman, 2008), which is an adolescent and parent measure assessing supportive and discordant parent-adolescent relationship quality.  ASD symptoms were measured using the Social Communication Questionnaire (SCQ; Rutter, Bailey, & Lord, 2003), a brief parent-report instrument.

Results:  When controlling for symptoms of ASD, parental reports of poorer adolescent sleep quality were significantly related to adolescent reports of less mother-adolescent closeness (r=-.404, p=.027) and marginally less father-adolescent closeness (r=-332, p=.073).  When controlling for symptoms of ASD, adolescent reports of greater daytime sleepiness were related to greater maternal reports of mother-adolescent discord (r=.456, p=.015) and marginally greater paternal reports of father-adolescent discord (r=.360, p=.060).

Conclusions:  Parents of children with ASD report adolescent sleep issues as a major concern (Guinchat et al., 2012). Results from the current study, while not addressing temporal ordering, confirm that parents and adolescents with ASD perceive less closeness and more discord in their relationships when adolescents with ASD have sleep disturbances and daytime sleepiness.  The findings from the current study have clinical implications for understanding physiological correlates of impaired fundamental social relationships—mother-adolescent and father-adolescent relationships.