Autism Spectrum Disorder Phenotypes Based on Sleep Dimensions and Core Autism Symptoms

Area of Science:

• Neurodevelopmental Disorders
• Sleep Medicine
• Autism Spectrum Disorder (ASD) Research

Background:

• Autism spectrum disorder (ASD) is characterized by diagnostic heterogeneity.
• Previous research on ASD subgroups relied solely on core autism symptoms.
• Sleep disturbances are common in ASD but their clustering with core symptoms is not well understood.

Purpose of the Study:

• To identify distinct sleep phenotypes in youth diagnosed with autism.
• To examine how these sleep phenotypes cluster with core autism symptoms.
• To understand the relationship between these combined phenotypes and clinical characteristics.

Main Methods:

• Principal Component Analysis (PCA) was used to identify sleep clusters from 10 items on the Pediatric Behavior Scale.
• Latent Class Analysis (LCA) was employed to determine phenotypes based on core ASD symptoms and identified sleep clusters.
• Analyses accounted for covariates including age, sex, IQ, and medication use.

Main Results:

• PCA identified three sleep clusters: disturbed sleep, insufficient sleep, and hypersomnolence.
• LCA revealed four distinct phenotypes characterized by varying combinations of core ASD symptoms and sleep clusters.
• These phenotypes differed in sleep profiles, clinical characteristics, demographics, and functional outcomes.

Conclusions:

• Four unique clusters of core autism symptoms and sleep problems were identified in youth with ASD.
• These findings underscore the significant heterogeneity of ASD, particularly concerning sleep-wake disturbances.
• Personalized interventions targeting specific sleep-wake profiles are recommended for improved therapeutic outcomes.