Variables Related to Sleep Problems in Children with Autism.

Abstract Our study of 477 children with autism (1–15 years, IQs 9–146) showed that parent reported sleep problems are found in most children with autism and are not significantly related to age, IQ, gender, race, parent occupation, neuropsychological functioning, and learning ability. However, sleep problems increased with severity of autistic symptoms and with severity of parent reported symptoms known to be associated with autism (i.e., oppositional behavior, aggression, explosiveness, attention deficit, impulsivity, hyperactivity, anxiety, depression, and mood variability). This suggests that sleep disturbance is part of the autism symptom complex and increases with increasing autism severity. The strongest predictors of sleep disturbance were parent ratings of autism severity, hyperactivity, mood variability, and aggression. The most frequent sleep problems were difficulty falling asleep and restlessness during sleep. Daytime sleepiness was not significantly correlated with sleeping less than normal, but was associated with sleeping more than normal. Children who were sleepier during the day were also sleepier at night. Medical practitioners and clinicians should be aware of the risk of sleep disturbance in children with autism and should routinely screen for this. Empirically proven interventions (e.g., behavior therapy and melatonin) are available to improve sleep in children with autism.