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Sleep pattern consistency and autism spectrum disorder in U.S. children: Associations and identification of high-risk
Md Roungu Ahmmad1, Md Tareq Ferdous Khan2, Sahil Hareshbhai Kothiya3
1USF-Health, College of Nursing, University of South Florida, Tampa, FL, USA.
Insights
Consistent sleep patterns are linked to autism spectrum disorder (ASD) risk in children. Poor sleep routines increase ASD likelihood, while regular, long sleep decreases it, suggesting sleep health
Area of Science:
- Pediatric Health
- Neurodevelopmental Disorders
- Sleep Medicine
Background:
- Sleep behavior is closely linked to autism spectrum disorder (ASD) and may influence neurological development.
- This study examines the association between sleep pattern consistency (SPC) and ASD in children aged 6-17 years.
Purpose of the Study:
- To investigate the relationship between sleep pattern consistency (SPC) and autism spectrum disorder (ASD) in children.
- To identify specific sleep patterns associated with increased or decreased likelihood of ASD.
- To explore high-risk subgroups for ASD based on sleep patterns and demographic factors.
Main Methods:
- Utilized data from 63,866 children (2022-2023 National Survey of Children's Health).
- ASD status determined by parent-reported provider diagnoses; SPC derived from sleep duration and bedtime regularity.
- Employed relative risks, multivariable logistic regression, and machine learning for analysis and subgroup identification.
Main Results:
- Children with poor sleep routines (PSR) showed a significantly higher likelihood of ASD (aOR: 1.92).
- Long sleep with regularity (LSR) was associated with a lower likelihood of ASD (aOR: 0.81).
- Factors like male sex, underweight, and overweight also correlated with ASD; PSR heightened predicted ASD probability in specific female subgroups.
Conclusions:
- Sleep pattern consistency (SPC) is significantly associated with autism spectrum disorder (ASD).
- Sleep health is relevant for developmental outcomes and ASD screening, especially in higher-risk populations.
- Findings underscore the importance of addressing sleep routines in ASD assessment and intervention strategies.
Background:
Sleep behavior is closely linked to autism spectrum disorder (ASD) and may influence behavioral and neurological development. This study examined the association between sleep pattern consistency (SPC) and ASD among children aged 6-17 years.
Methods:
This study used data from 63,866 children from the 2022-2023 National Survey of Children's Health (NSCH). ASD status was based on parent-reported provider diagnoses. SPC was constructed from sleep duration and bedtime regularity. Associations between SPC and ASD were examined using relative risks and multivariable logistic regression. Machine learning methods predicted individualized ASD profiles and identified high-risk subgroups. Model performance was evaluated using discrimination and calibration metrics.
Results:
The cohort showed 4.41 % ASD prevalence, mean age 11.9 years, 51.8 % male, 62.4 % healthy weight, 28.9 % poor sleep routines, 28.8 % lower income, 40.5 % co-occurring disorders, and 42.4 % with medication. Children with poor sleep routines (PSR) demonstrated a significantly higher likelihood of ASD (aOR: 1.92; 95 % CI: 1.64-2.25), whereas long sleep with regularity (LSR) was associated with a lower likelihood (aOR: 0.81; 95 % CI: 0.70-0.94). Other correlated factors included male sex (aOR: 3.83, p < 0.001), underweight (aOR: 1.28, p < 0.001), and overweight (aOR: 1.39, p < 0.001). Among female children from low-income households with co-occurring conditions, PSR patterns were associated with higher predicted ASD probability (∼12 %, p = 0.002), whereas healthy sleep routine (HSR) showed substantially lower predicted probabilities.
Conclusion:
SPC was significantly associated with ASD. These findings highlight the potential relevance of sleep health in relation to developmental outcomes and ASD screening, particularly among higher-risk subgroups.
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