Short Report: Divergent Sleep-Wake Regularity in U.S. Children With Autism Spectrum Disorder: Bedtime vs Wake-up...

Area of Science:

• Sleep science
• Neurodevelopmental disorders
• Public health

Background:

• Sleep-wake regularity is a key aspect of sleep health.
• Autism spectrum disorder (ASD) is associated with sleep disturbances, but regularity is understudied in large, representative samples.
• Distinct components of sleep timing (bedtime vs. wake-up) in relation to ASD are not well understood.

Purpose of the Study:

• To examine the association between ASD diagnosis and irregular bedtime and wake-up timing in a nationally representative sample of U.S. children.
• To investigate age-related differences in these associations.
• To identify potential targets for improving sleep health in autistic children.

Main Methods:

• Utilized parent-reported data from 11,462 U.S. children aged 5-17 years from the 2022 and 2024 National Health Interview Survey.
• Employed multivariable logistic regression models, adjusted for sociodemographic, family, and mental health factors.
• Applied survey weights to ensure representativeness and account for complex sampling design.

Main Results:

• ASD was associated with more regular bedtimes (aOR=0.64) but more irregular wake-up times (aOR=1.60).
• Irregular wake-up timing remained significantly associated with ASD in children (aOR=2.27) but not in adolescents.
• No significant association between ASD and bedtime regularity was observed in either age group.

Conclusions:

• Sleep-wake regularity associations with ASD differ by timing component and age group.
• Irregular wake-up timing is a notable concern for autistic children, particularly younger ones.
• Wake-up timing presents a promising target for interventions aimed at enhancing sleep health in autistic youth.