Sleep disturbances, sensory processing difficulties, and emotional dysregulation in preschool children with autism...

Sensory sensitivity and avoidance may contribute to sleep disturbances in preschool children with autism spectrum disorder (ASD) through elevated emotional dysregulation. While these interrelations have been documented in Western populations, little is known about their manifestation in East Asian cultural contexts. This study examined the relationships among sensory processing difficulties, emotional dysregulation, and sleep disturbances in Taiwanese preschoolers with ASD. Fifty children (40 boys, 10 girls; mean age = 55 months) were assessed using caregiver-reported questionnaires and seven nights of actigraphy. Objective actigraphy data showed that Taiwanese preschool children with ASD sleep 493 min per night (8.2 h), which is approximately 107 min less than the American Academy of Sleep Medicine guideline. Subjective caregiver reports indicated high prevalence rates of sleep disturbances (98 %), sensory sensitivity (82 %), sensory avoidance (84 %), and emotional dysregulation (66 %). Greater sensory processing difficulties were associated with more severe caregiver-reported sleep problems and higher emotional dysregulation, while objective actigraphy measures did not show significant associations with emotional dysregulation. Mediation analyses using subjective caregiver-reported data further revealed that emotional dysregulation significantly mediated the associations between sensory sensitivity/avoidance and sleep disturbances. These findings underscore the importance of integrating sensory-focused and emotional regulation strategies into sleep interventions for young autistic children, particularly in cultures where co-sleeping is normative.