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Gastrointestinal and Sleep Disorders in Children With and Without Autism

Lisa Bashore1,2,3,4, Andrea M Smith1,2,3,4, Ann H Johnson1,2,3,4

  • 1Lisa Bashore, PhD, APRN, CPNP-PC, CPON, Advance Practice Registered Nurse, Hematology/Oncology Department, Cook Children's Health Care System, Fort Worth, Texas; and Adjunct Faculty, Harris College of Nursing and Health Sciences, Texas Christian University, Fort Worth, Texas.

Gastroenterology Nursing : the Official Journal of the Society of Gastroenterology Nurses and Associates
|September 23, 2025
PubMed

Insights

Children with autism experience frequent gastrointestinal (GI) issues, which are strongly linked to sleep problems. Constipation, diarrhea, and nausea/vomiting significantly predict sleep disturbances in this population.

Area of Science:

  • Pediatric Sleep Medicine
  • Neurodevelopmental Disorders
  • Gastroenterology

Background:

  • Gastrointestinal (GI) disorders are common in children, and can significantly impact sleep quality.
  • Autism Spectrum Disorder (ASD) is often associated with co-occurring medical conditions, including GI issues and sleep disturbances.
  • The relationship between GI disorders and sleep problems in children with ASD requires further investigation.

Purpose of the Study:

  • To describe GI diagnoses and their frequency in children with and without autism referred for polysomnography.
  • To examine the association between GI disorders and sleep disorders in children with ASD.
  • To identify GI disorders that are most predictive of sleep disorders in children with and without ASD.

Main Methods:

  • Secondary data analysis of de-identified polysomnography encounter data from Nationwide Children's Hospital Sleep DataBank (2017-2019).
  • Descriptive statistics were used to characterize a sample of 3053 unique pediatric participants.
  • Chi-square tests and multiple regression analyses were employed to assess associations and predictive relationships.

Main Results:

  • Gastrointestinal disorders were prevalent in children with autism.
  • A significant association was found between having autism and experiencing sleep disorders.
  • Constipation, diarrhea, and nausea/vomiting were identified as significant predictors of sleep problems in children with autism, more so than in children without autism.

Conclusions:

  • Findings highlight the increased prevalence of co-occurring GI symptoms and sleep problems in children with autism.
  • There is a clinical need for sleep evaluations in children presenting with gastrointestinal symptoms, particularly those with autism.
  • Further research into the gut-brain axis interactions in children with autism is warranted.

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