Parent stress reduction interventions and sleep problems in autistic youth

Sleep problems in autistic children are associated with behavioral difficulties and elevated parenting stress even after accounting for autistic symptoms and demographics. This study evaluated whether two caregiver stress-reduction interventions had collateral benefits in improving parent-reported sleep in autistic children.

Participants included families of autistic children aged 3-5 years (N = 51, 80.39 % child ethnic minority) enrolled in a larger randomized control trial examining the efficacy of two different parent stress reduction interventions: Mindfulness-Based Stress Reduction (MBSR) and Psychoeducation and Support (PE). Parent-reported child sleep problems were measured by the behaviorally-based subscales (bedtime resistance, sleep duration, sleep onset delay) of the Children's Sleep Habits Questionnaire and parenting stress was measured using the PSI-4 Short Form Parental Distress subscale, both at baseline, post-intervention, and 6- and 12-months post intervention.

Using multilevel modeling, bedtime resistance significantly improved over time, with no significant differences between intervention groups. Sleep duration and sleep onset delay improved over time; however, these outcomes were no longer significant when the effect of the intervention group or its interaction with change over time was added to the model. Less within-individual parenting stress was associated with fewer problems with bedtime resistance and sleep duration, but not with sleep onset delay.

Improvement in parenting stress appears to correspond with improvement in aspects of children's sleep, particularly bedtime resistance. Clinicians may consider the benefits of addressing parenting stress in the context of behavioral sleep interventions for autistic youth.