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Cited by 92Sleep and related disordersAutism Spectrum Disorder ResearchSleep and Wakefulness Research

Sleep in adults with Autism Spectrum Disorder: a systematic review and meta-analysis of subjective and objective studies

Morgan, Bethany, Nageye, Fatuma, Masi, Gabriele, Cortese, Samuele·2020·Sleep Medicine
DOI 10.1016/j.sleep.2019.07.019
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Abstract

Background/objective Sleep problems are commonly reported by individuals with Autism Spectrum Disorder (ASD). However, to date, no quantitative evidence synthesis of available studies has been performed to quantify sleep alterations in adults with ASD. We performed a systematic review and meta-analysis of objective (ie, based on actigraphy or polysomnography [PSG]) and subjective (ie, based on sleep diaries/questionnaires) studies comparing sleep parameters in adults with ASD and in a typically developing (TD) control group. Methods PubMed, OVID databases and Web of Knowledge were systematically searched up to February 2019 with no language restrictions. Original studies including adults with a diagnosis of ASD according to DSM, ICD, or based on standard diagnostic tools (eg, ADOS), and a TD control group were included. Random-effects models were used. Study quality was evaluated with the Newcastle Ottawa Scale (NOS). Analyses were conducted using Comprehensive Meta-Analysis. Results From initial pool of 1948 references, 14 publications including 8 datasets, (194 ASD and 277 controls) met the inclusion criteria. Compared to controls, individuals with ASD were significantly more impaired in six out of 11 subjective parameters, including lower sleep efficiency (SE, SMD = -0.87, CI = -1.14 - 0.60) and in 10 out of 17 objective outcomes, including longer sleep onset latency (PSG) (SMD = 0.86, CI = 0.29-1.07) and wake after sleep onset (WASO, actigraphy) (SMD = 0.57, CI = 0.28-0.87). The mean NOS score was 4.88/6. Conclusions Individuals with ASD demonstrated impaired sleep compared to controls in most subjective and objective measures.

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  • A systematic review and meta-analysis of sleep parameters found that adults with ASD also demonstrate significantly impaired sleep compared to controls in most subjective and objective measures of sleep.

    “A systematic review and meta-analysis of sleep parameters found that adults with ASD also demonstrate significantly impaired sleep compared to controls in most subjective and objective measures of sleep [40].”

    From Pharmacological treatment in autism: a proposal for guidelines on common co-occurring psychiatric symptoms (2025) · cites this paper as [40]

  • Insomnia and disturbed sleep are more common in autistic adults compared with nonautistic adults.

    “Insomnia and disturbed sleep are more common in autistic adults compared with nonautistic adults, contributing to significant social, psychological and health burdens.”

    From ACT-i, an insomnia intervention for autistic adults: A pilot study (2023) · cites this paper as Morgan et al., 2020

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Authors
Morgan, B., Nageye, F., Masi, G., & Cortese, S.
Affiliations
  • University of Southampton (GB)
  • University of Nottingham (GB)
Corresponding author
Cortese, Samuele
ORCID
Venue
Sleep Medicine
Publisher
Elsevier BV
Published
2020-01
Volume
65
Pages
113-120
ISSN
1389-9457 (ISSN-L)
DOI
10.1016/j.sleep.2019.07.019
OpenAlex
W2966550280
Cited by
92
References
51
Citations by year
2026: 14 · 2025: 18 · 2024: 15 · 2023: 14 · 2022: 13 · 2021: 8 · 2020: 10
FWCI
1.14
Type
journal article
Language
en
Open access
closed
Licence
Locations
  • Sleep Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
autism spectrum disorder, sleep disorders, autistic adults, sleep efficiency, sleep latency, wake after sleep onset, actigraphy, polysomnography, subjective sleep measures, objective sleep measures
MeSH terms
Autism Spectrum Disorder, Sleep Latency, Adult, Humans, Surveys and Questionnaires, Sleep Wake Disorders, Polysomnography, Actigraphy

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