Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

Giacomo Distefano1, Sara Calderoni1,2, Fabio Apicella2

  • 1Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.

Insights

Children with Autism Spectrum Disorder (ASD) frequently experience sleep disorders, which are linked to increased behavioral and emotional problems. Early screening and intervention for sleep issues in ASD are recommended for better clinical practice.

Area of Science:

  • Pediatric Neurology
  • Developmental Psychology
  • Sleep Medicine

Background:

  • Sleep disorders are prevalent in children with Autism Spectrum Disorder (ASD) but often underdiagnosed.
  • Clinical practice frequently misdiagnoses or undertreats sleep problems in this population.

Purpose of the Study:

  • Identify sleep disorders in preschool children with ASD.
  • Examine the relationship between sleep disorders and core autism symptoms, developmental level, and psychiatric comorbidities.

Main Methods:

  • Recruited 163 preschool children diagnosed with ASD.
  • Assessed sleep using the Children's Sleep Habits Questionnaire (CSHQ).
  • Evaluated cognitive abilities, repetitive behaviors (Repetitive Behavior Scale-Revised), and emotional-behavioral problems (Child Behavior Checklist -CBCL 1½-5).

Main Results:

  • Children with ASD and sleep disorders scored higher on CSHQ and CBCL across all domains.
  • Severe sleep disorders correlated with increased internalizing, externalizing, and total problems on CBCL.
  • Anxiety symptoms mediate the association between sleep disorders and restricted and repetitive behaviors (RRBs).

Conclusions:

  • Sleep problems are significantly associated with broader challenges in children with ASD.
  • Routine screening and early intervention for sleep issues are crucial in ASD clinical practice.
Abstract

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