title: Shorter sleep duration is associated with social impairment and comorbidities in ASD.
abstract: Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Understanding the causes and consequences of sleep disturbances in children with ASD is an important step toward mitigating these symptoms. To better understand the connection between sleep duration and ASD severity, we analyzed ASD-related symptoms using the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), IQ scores, and parent reports of the average amount of time slept per night that were available in the medical histories of 2,714 children with ASD in the Simons Simplex Collection (SSC). The mean (SD) sleep duration was 555 minutes. Sleep duration and severity of core ASD symptoms were negatively correlated, and sleep duration and IQ scores were positively correlated. Regression results indicated that more severe social impairment, primarily a failure to develop peer relationships, is the core symptom most strongly associated with short sleep duration. Furthermore, increased severity for numerous maladaptive behaviors assessed on the Child Behavior Checklist, as well as reports of attention deficit disorder, depressive disorder, and obsessive compulsive disorder were associated with short sleep duration. Severity scores for social/communication impairment and restricted and repetitive behaviors (RRB) were increased, and IQ scores were decreased, for children reported to sleep ≤420 minutes per night (lower 5th percentile) compared to children sleeping ≥660 minutes (upper 95th percentile). Our results indicate that reduced amounts of sleep are related to more severe symptoms in children with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1221-1238. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
authors.affiliation: Department of Neurology, Sleep Disorders Division, Vanderbilt University Medical Center, Nashville, Tennessee.|Department of Medicine, Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Olivia J
authors.initials: OJ
authors.lastname: Veatch
authors.affiliation: Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: James S
authors.initials: JS
authors.lastname: Sutcliffe
authors.affiliation: Department of Pediatric Nashville, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Zachary E
authors.initials: ZE
authors.lastname: Warren
authors.affiliation: Department of Medicine, Center for Sleep and Circadian Neurobiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Brendan T
authors.initials: BT
authors.lastname: Keenan
authors.affiliation: Department of Psychiatry, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Potter
authors.affiliation: Department of Neurology, Sleep Disorders Division, Vanderbilt University Medical Center, Nashville, Tennessee.
authors.forename: Beth A
authors.initials: BA
authors.lastname: Malow
mesh_terms: D000293:Adolescent; D000067877:Autism Spectrum Disorder / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D012720:Severity of Illness Index; D012890:Sleep; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012919:Social Behavior; D013997:Time Factors
keywords: comorbid conditions; neurology; sleep (disorders); social cognition; subtypes (of ASD)