Interval-Based Aerobic Exercise and Behavioral Intervention for Sleep Disturbances in Children With Autism Spectrum...

Sleep disturbances affect 40%-80% of children with autism spectrum disorder (ASD) and are associated with impaired attention and daytime functioning. We conducted a preliminary randomized controlled trial to evaluate the effects of a short-term interval-based aerobic exercise combined with parent behavioral education (IAE-PBE) program on sleep and related outcomes in children with ASD and sleep disturbances. Twenty-eight children were randomly assigned to either the IAE-PBE group or the parent behavioral education (PBE)-only group for a 2-week intervention. Sleep was assessed using actigraphy, and attention was evaluated using age-appropriate Conners' Continuous Performance Tests. The primary outcome was sleep efficiency. Secondary outcomes included caregiver-reported sleep disturbances, attention, autism-related symptoms, and adaptive behavior. Compared with the PBE-only group, the IAE-PBE group showed greater improvement in sleep efficiency (group × time interaction, p = 0.035; within-group p = 0.026, Hedges' g = 0.89). Significant group × time interactions were also found for caregiver-reported sleep disturbances (p = 0.003) and perseverative responses on the attention test (p < 0.001), with greater improvements in the IAE-PBE group. Favorable changes were also observed in autism-related symptoms, whereas adaptive behavior did not differ between groups. These preliminary findings suggest that a short-term interval-based aerobic exercise program combined with parent behavioral education is feasible and may improve objectively measured sleep efficiency while also providing benefits for attention in children with ASD. Further studies with larger samples and longer follow-up are needed to confirm these findings. Trial Registration: ClinicalTrials.gov identifier: NCT07381504.