title: Sleep problems are more frequent and associated with problematic behaviors in preschoolers with autism spectrum disorder.
abstract: BACKGROUND
  Children with autism spectrum disorder (ASD) often suffer from sleep problems that in turn correlate with behavioral problems. However, in Japan, there have been few studies of sleep problems in children with ASD.
  
  
  OBJECTIVE
  This study compared sleep problems in preschoolers from the community and preschoolers with ASD in Japan, and examined whether sleep problems were related to problematic behaviors in ASD preschoolers.
  
  
  METHODS
  Sleep problems were assessed in 965 community and 193 ASD preschoolers using the Japanese Sleep Questionnaire for Preschoolers, which was developed to assess sleep problems in Japanese preschoolers. Behavioral problems were assessed in 107 ASD preschoolers using the Child Behavior Checklist.
  
  
  RESULTS
  Compared with community preschoolers, ASD preschoolers experienced significantly more sleep problems, including obstructive sleep apnea and parasomnias. ASD preschoolers with sleep problems exhibited more behavioral problems than those without sleep problems. The severity of sleep problems, especially insomnia, was significantly correlated with behavioral problems in ASD preschoolers.
  
  
  CONCLUSIONS
  The present study suggests that sleep problems, especially obstructive sleep apnea, are more common in ASD preschoolers than in community preschoolers. The study also shows that sleep problems, especially insomnia, are related to problematic behavior in ASD preschoolers.
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Hirata
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan; Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan; Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Ikuko
authors.initials: I
authors.lastname: Mohri
authors.affiliation: Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Kumi
authors.initials: K
authors.lastname: Kato-Nishimura
authors.affiliation: Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Masaya
authors.initials: M
authors.lastname: Tachibana
authors.affiliation: Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Ayano
authors.initials: A
authors.lastname: Kuwada
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan; Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Kuriko
authors.initials: K
authors.lastname: Kagitani-Shimono
authors.affiliation: Department of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ozono
authors.affiliation: Department of Pediatrics, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan; Department of Child Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan; Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan. Electronic address: masako@kokoro.med.osaka-u.ac.jp.
authors.forename: Masako
authors.initials: M
authors.lastname: Taniike
mesh_terms: D000067877:Autism Spectrum Disorder / Q000453:epidemiology* / Q000523:psychology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D020447:Parasomnias / Q000453:epidemiology*; D015995:Prevalence; D000066553:Problem Behavior / Q000523:psychology*; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology*; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology*; D012893:Sleep Wake Disorders / Q000453:epidemiology; D011795:Surveys and Questionnaires
keywords: Autism spectrum disorder (ASD); Behavioral problem; Japanese Sleep Questionnaire for Preschoolers; Obstructive sleep apnea (OSA); Preschool children; Sleep problem