Introduction Children and adults with autism spectrum disorder (ASD) often have sleep, circadian, and executive function impairments, which can affect daytime quality. Yet, the relationship between sleep or circadian traits and ASD traits is still unknown. Thus, we aimed to determine if sleep and circadian traits were associated with ASD traits, including executive function. Methods We studied data from participants with and without ASD enrolled in the family-based study Autism Spectrum Program of Excellence (ASPE), University of Pennsylvania. We used GGIR to analyze actigraphy-derived sleep and circadian traits from 250 participants (219 adults ages 18–87 years, mean 44.2 ± 17.3 years; 31 children ages 4–17 years, mean 11.3 ± 3.9 years). These traits were compared to ASD traits (social impairment and restricted/repetitive behavior via Social Responsiveness Scale, Second Edition) and executive function (Behavior Rating Inventory of Executive Function) using linear multivariate regression models adjusted for age, age2, and sex via Sequential Oligogenic Linkage Analysis Routines. Results In adults, earlier start time of the 10 hours of highest activity in a 24-hour day (M10 start time; p = 0.02), decreased robustness of the rest/activity rhythm (relative amplitude; p = 0.03), and increased intradaily variability of rest/activity rhythm (p = 0.04) were associated with more social impairment. In children, earlier M10 start time (p = 0.02) and decreased relative amplitude (p = 0.03) were associated with more social impairment. In adults, higher average 5-hour period of lowest activity in a 24-hour day (L5 average; p = 0.03), lower average 10-hour period of highest activity in a 24-hour day (M10 average; p = 0.005), earlier M10 start time (p = 0.02), decreased relative amplitude (p = <0.001), increased intradaily variability (p = <0.001) and decreased sleep efficiency (p = 0.04) were associated with increased executive function impairment. In children, earlier M10 start time (p = 0.006) and intradailty variability (p = 0.008) were associated with increased executive function impairment. Conclusion Circadian traits are significantly associated with ASD traits, including executive function, suggesting the importance of sleep-wake rhythm dysfunction in ASD. Support (if any) Anonymous donor; NIH T32HL07713; University of Pennsylvania’s Institute for Translational Medicine and Therapeutics
OBJECTIVES/GOALS: Autism spectrum disorder (ASD) is characterized by difficulties in communication and social interaction as well as restricted and repetitive behaviors. Sleep problems are a common concern in children with ASD that can persist into adulthood. This study aims to further explore sleep in ASD without intellectual disability (ASD w/o ID). METHODS/STUDY POPULATION: We recruited individuals of both sexes with ASD w/o ID (probands) and relatives as part of the Autism Spectrum Program of Excellence (ASPE) at the University of Pennsylvania. Actimetry data were collected via a wrist-worn tri-axial accelerometer for 21 days. Data from 212 participants were considered. We analyzed sleep data using the algorithms GGIR, ChronoSapiens, and PennZzz. The sleep traits of proband and sibling pairs were compared using paired t-test or Wilcoxon signed-rank test. We used the Social Responsiveness Scale, Second Edition (SRS-2) to assess social impairment and restricted/repetitive traits. We compared SRS-2 scores to sleep traits using partial Spearman or Pearson correlations adjusting for age (171 participants). RESULTS/ANTICIPATED RESULTS: Probands demonstrated later sleep onset (p = 0.03), decreased M10 average (10-hour period of highest activity/day; p = 0.006), decreased relative amplitude (measure of rest-activity rhythm; p <0.001), and decreased total daytime activity (p = 0.005) compared to siblings. Regarding social function and restricted/repetitive traits, adult males showed an inverse correlation between SRS-2 total score and sleep efficiency (r = −0.2, p = 0.04) and a positive correlation between SRS-2 total score and intradaily variability (r = 0.3, p = 0.02). Adult females showed an inverse correlation between SRS-2 total score and M10 average (r = −0.3, p = 0.02) and between SRS-2 total score and relative amplitude (self-report r = −0.4, p = 0.001; informant r = −0.3, p = 0.005). DISCUSSION/SIGNIFICANCE OF IMPACT: This study focuses on the analysis of sleep traits in ASD including the relationship between social function and sleep. Thus far, the most robust findings are decreased daytime activity and relative amplitude in individuals with ASD w/o ID compared to siblings. We have also shown that ASD social impairment may be related to sleep dysfunction.
Introduction Sleep dysfunction is prevalent in autism spectrum disorder (ASD) and can have major daytime behavioral consequences. Emerging evidence suggests that physical activity may be associated with improved sleep in children, including those with ASD. We aimed to determine if there was an association between physical activity and sleep duration in American youth and if the association was consistent in children with and without ASD. Methods We analyzed data from children ages 6–17 years whose caregivers completed the 2018 National Survey of Children’s Health (N=20,980). ASD was self-reported (N=687), and we determined if reported ASD was mild, moderate, or severe, and if reported ASD occurred with intellectual disability (ID). Participants self-reported their weekday sleep duration and days of physical activity in the past week. We classified children as sleep sufficient or insufficient based on age-specific recommendations. Logistic regression was used to determine if physical activity and ASD were associated with sleep sufficiency. Physical activity-by-ASD interaction terms were used to determine if any physical activity association was modified by ASD status. Covariates included: age, sex, race, Hispanic ethnicity, highest caregiver education level, and overweight status. Results Compared to children without ASD, children with ASD were 29% less likely to have sufficient sleep (OR=0.71; 95% CI: 0.52–0.99), but this association attenuated to the null after adjusting for physical activity (OR=0.77; 95% CI: 0.55–1.07). Compared to zero days, being physically active for 1–3, 4–6 or 7 days in the past week was associated with increased odds of sufficient sleep, even with adjustment for ASD status (e.g., 4–6 days: OR=1.85; 95% CI: 1.48–2.32). We did not observe a statistically significant interaction between physical activity and ASD status with respect to sleep sufficiency (P-interaction=0.571), which remained consistent when using ASD severity and ASD with ID exposure variables. Conclusion Physical activity was associated with increased odds of meeting age-specific sleep duration recommendations in children with and without ASD. Our observations support pursuing physical activity in future studies as a potential intervention target to improve sleep duration in children, including those with ASD. Support (if any) NIH T32HL07713 and University of Pennsylvania’s Institute for Translational Medicine and Therapeutics
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