Latent Profile Analysis of Sleep Patterns in Children With Autism Spectrum Disorder

Area of Science:

• Neurodevelopmental Disorders
• Pediatric Sleep Medicine
• Autism Spectrum Disorder Research

Background:

• Sleep disturbances are common and impactful in children with autism spectrum disorder (ASD).
• The diverse nature of sleep problems in ASD necessitates a deeper understanding of specific sleep phenotypes.
• Previous research has not fully characterized the heterogeneity of sleep disturbances in young children with ASD.

Purpose of the Study:

• To identify distinct sleep phenotypes in young children with ASD using latent profile analysis.
• To compare sleep profiles between children with ASD and typically developing (TD) children.
• To investigate the relationship between identified sleep phenotypes and treatment response over one year.

Main Methods:

• A multicenter prospective cohort study involving 631 children with ASD and 768 TD children (aged 3-6 years).
• Latent profile analysis applied to data from the Children's Sleep Habits Questionnaire.
• One-year follow-up data collected to assess changes in core ASD symptoms.

Main Results:

• Three distinct sleep phenotypes were identified in children with ASD: severe multi-domain disturbances (Cluster 1), mixed profile with elevated sleep-disordered breathing (Cluster 2), and elevated night waking/bedtime resistance with reduced sleep-disordered breathing (Cluster 3).
• Children with ASD generally exhibited poorer sleep patterns compared to TD controls.
• Children in Cluster 3 showed significant improvements in core ASD symptoms, particularly social cognition and communication, after one year, while Clusters 1 and 2 showed modest changes.

Conclusions:

• Distinct sleep phenotypes exist in young children with ASD, varying in severity and type of sleep disturbance.
• Early identification of these sleep phenotypes may serve as a predictor for treatment response in ASD.
• Personalized sleep management strategies tailored to specific phenotypes are crucial for improving core symptoms in children with ASD.