Longitudinal Examination of Sleep Problems and Symptom Severity in Children with Autism Spectrum Disorder
Abstract
Up to 80% of children with autism spectrum disorder (ASD) experience sleep problems, which have been associated with more severe presentations of ASD symptoms. We examined the bidirectional link between sleep problems and specific ASD symptoms at two time points within 5 years in a well-characterized sample (659 children with ASD). Using cross-lagged panel analyses, we found evidence for a unidirectional link between baseline ASD symptoms (specifically repetitive behaviors, atypical behaviors, communication, and peer interactions) and future sleep problems, but did not find evidence of a bidirectional relationship. We did not find any longitudinal association between social reciprocity and sleep problems. It is important for providers and caregivers to understand and monitor the link between ASD symptoms and sleep problems.
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Left untreated, co-occurring neuropsychiatric conditions can have detrimental and potentially catastrophic impacts on ASD individuals and their families, including decreased quality of life, increased stress, hindered educational and employment opportunities, and increased risk of suicidality.
“Left untreated, these co-occuring conditions can have detrimental and potentially catastrophic impacts on ASD individuals and their families, such as decreased quality of life and increased stress, hindered educational and employment opportunities and increased risk of suicidality [12–21].”
From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [13]
Sleep disorders have been correlated with daytime sleepiness, cognitive, attentional, behavioral, and emotional challenges, as well as poorer health-related quality of life for children with ASD.
“Sleep disorders have been correlated with daytime sleepiness, cognitive, attentional, behavioral, and emotional challenges, as well as poorer health-related quality of life for children with ASD [12, 13, 46].”
From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [13]
Cites
Owens, J. A., Spirito, A., & McGuinn, M. (2000) · Sleep · doi:10.1093/sleep/23.8.1d · Cited by 2,535 · cited 1× · see citing works
“The children’s sleep habits questionnaire (CSHQ) total score was used to measure levels of sleep problems (Owens et al., 2000).”
MethodAdachi, P., & Willoughby, T. (2015) · European Journal of Developmental Psychology · doi:10.1080/17405629.2014.963549 · Cited by 448 · see citing works
The Autism Impact Measure (AIM): Initial development of a new tool for treatment outcome measurement
Kanne, S. M., Mazurek, M. O., Sikora, D., Bellando, J., Branum-Martin, L., Handen, B., Katz, T., Freedman, B., Powell, M. P., & Warren, Z. (2014) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-013-1862-3 · Cited by 114 · see citing works
Self-citationInfluence of sleep disorders on the behavior of individuals with autism spectrum disorder
Fadini, C. C., Lamônica, D. A., Fett-Conte, A. C., Osório, E., Zuculo, G. M., Giacheti, C. M., & Pinato, L. (2015) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2015.00347 · Cited by 82 · see citing works
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Manter, M. A., Birtwell, K. B., Bath, J., Friedman, N. D. B., Keary, C. J., Neumeyer, A. M., Palumbo, M. L., Thom, R. P., Stonestreet, E., Brooks, H., et al. (2025) · BMC Medicine · doi:10.1186/s12916-024-03814-0 · Cited by 51 · see citing works
“Sleep disorders have been correlated with daytime sleepiness, cognitive, attentional, behavioral, and emotional challenges, as well as poorer health-related quality of life for children with ASD [12, 13, 46].”
- Authors
- Sadikova, E., Dovgan, K., & Mazurek, M. O.
- Affiliations
- University of Virginia (US)
- Marist University (US)
- Corresponding author
- Sadikova, Eleonora
- Venue
- Journal of Autism and Developmental Disorders
- Published
- 2022-04-06
- Volume
- 53
- Issue
- 4
- Pages
- 1673-1681
- ISSN
- 0162-3257 (ISSN-L)
- 1573-3432
- OpenAlex
- W4223456893
- Cited by
- 10
- References
- 4
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 2 · 2023: 1
- FWCI
- 0.77
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- Locations
- Journal of Autism and Developmental Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Health Resources and Services Administration (UA3 MC11054)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- autism spectrum disorder, sleep disorders, ASD severity, repetitive behavior, atypical behavior, communication, peer interaction, social reciprocity, bidirectional relationship, children
- MeSH terms
- Autism Spectrum Disorder, Child, Communication, Humans, Sleep Wake Disorders
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