Effects of Sleep Disturbances on Behavioral Problems in Preschool Children With Autism Spectrum Disorder

Wang, Ying; Lin, Jingjing; Zeng, Ying; Liu, Yanan; Li, Yamin; Xia, Kun; Zhao, Jingping; Shen, Yidong; Ou, Jianjun

doi:10.3389/fpsyt.2020.559694

Cited by 7 publications

(6 citation statements)

References 31 publications

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“…Overall, evidence suggests that children with ASD and sleep difficulties have higher rates of Attention and Hyperactivity Disorder and Defiant Oppositional Disorder compared to children without sleep problems (7,25,57,58). Generally, emotional or behavioral issues, including hyperactivity, aggression, anxiety, or mood disorders, may be the cause or consequence of sleep issues in children with ASD.…”

Section: Discussionmentioning

confidence: 99%

“…We used the CSHQ parent questionnaire to assess the prevalence and severity of sleep problems through a quantitative measure. The use of parent-filled questionnaires such as the CSHQ has been shown to be a quick and easy-to-use tool for the early identification of sleep problems in both ASD and TD children ( 12 , 13 , 16 , 25 ). According to previous investigations ( 11 , 23 ), the established cut-off of 41 on the CSHQ could overestimate SD.…”

Section: Discussionmentioning

confidence: 99%

“…The vast majority of studies investigating the correlation between SD and daytime behavior in ASD are conducted with school-aged samples, while only a few have focused on the pre-school population. Among these, a recent study using the CSHQ and the CBCL found a remarkable difference in the effect of parasomnias on internalizing, externalizing, and total problems in children with ASD ( 25 ).…”

Section: Introductionmentioning

confidence: 99%

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Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

et al. 2023

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BackgroundSleep disorders are one of the most common problems in children with Autism Spectrum Disorder (ASD). However, they often tend to be underdiagnosed and incorrectly treated in clinical practice. This study aims to identify sleep disorders in preschool children with ASD and to explore their relationship with the core symptoms of autism, the child’s developmental and cognitive level as well as the psychiatric comorbidities.MethodsWe recruited 163 preschool children with a diagnosis of ASD. The Children’s Sleep Habits Questionnaire (CSHQ) assessed sleep conditions. Multiple standardized tests were used to evaluate intellectual abilities, the presence of repetitive behaviors (through the Repetitive Behavior Scale-Revised), as well as the emotional-behavioral problems and the psychiatric comorbidities (through the Child Behavior Checklist -CBCL 11/2-5).ResultsThe results showed that poor disorders had consistently higher scores in all areas assessed by the CSHQ and on the CBCL across all domains. The correlational analysis showed that severe sleep disorders were associated with higher scores in internalizing, externalizing, and total problems at the CBCL syndromic scales, and in all DSM-oriented CBCL subscales. Moreover, we found that the association between sleep disorders and restricted and repetitive behaviors (RRBs) is explained by the anxiety-related symptoms.ConclusionBased on these findings, the study recommends that screening for sleep problems followed by early intervention should constitute a routine part of clinical practice for children with ASD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

et al. 2023

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“…Most of the existing research tends to focus on general sleep disturbances, leaving unclear which specific type is most likely to be associated with EBDs. Several behavioral sleep disturbances (eg, sleep anxiety, night waking, insufficient sleep, and insomnia) have been associated with concurrent internalizing problems and later anxiety or depressive symptoms in children, whereas parasomnias or sleep-disordered breathing (SDB) have been linked to increased externalizing problems. In addition, studies have shown more temperamental difficulties in children with SDB than in their counterparts with behavioral insomnia .…”

Section: Introductionmentioning

confidence: 99%

Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children

Deng,

Zhang,

Gui

et al. 2023

JAMA Netw Open

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ImportanceSleep disturbances and mental health problems are highly comorbid and bidirectionally correlated across childhood. The association between the natural history of sleep disturbances and the transition of mental health problems has not been quantified.ObjectiveTo examine the association between the natural history of sleep disturbances and resolved and incident emotional and behavioral difficulties (EBDs).Design, Setting, and ParticipantsThis cohort study used data from the Shanghai Children’s Health, Education and Lifestyle Evaluation–Preschool (SCHEDULE-P), a prospective and population-based longitudinal cohort study of children enrolled in preschools in Shanghai, China, from November 10 to 24, 2016. A total of 20 324 children aged 3 to 4 years were recruited from the junior class of 191 kindergartens, of whom 17 233 (84.8%) participated in the 2-year follow-up. A multilevel regression model was used to evaluate the association between the development of sleep disturbances and the occurrence of resolved and incident EBDs. The data analysis spanned from August 4, 2021, to October 31, 2023.ExposuresSleep disturbances were assessed using the Children’s Sleep Habit Questionnaire; EBDs were assessed using the Strengths and Difficulties Questionnaire.Main Outcomes and MeasuresOccurrence of incident and resolved EBDs at the 2-year follow-up.ResultsThe cohort included 17 182 participants, with a mean (SD) age of 3.73 (0.29) years at enrollment; 52.0% were boys. The prevalence of EBDs at school entry and graduation years was 27.8% and 18.7%, respectively, while the prevalence of sleep disturbances was 41.3% and 31.5%, respectively. Among those with EBDs at the entry year, 35.0% maintained stability in the graduation year, while sleep disturbances were stable in 50.0% of those with sleep disturbances. After controlling for confounding factors, the odds ratio (OR) for resolved EBDs was lower in the incident sleep disturbance (ISD) group (OR, 0.50 [95% CI, 0.41-0.62]; P &lt; .001) and stable sleep disturbance (SSD) group (OR, 0.47 [95% CI, 0.40-0.56]; P &lt; .001) compared with the group with no sleep disturbances. The ORs for incident EBDs among the ISD group (OR, 2.58 [95% CI, 2.22-3.01]; P &lt; .001) and SSD group (OR, 2.29, [95% CI, 1.98-2.64]; P &lt; .001) were higher than among the group with no sleep disturbances.Conclusions and RelevanceIn this prospective cohort study, the natural history of sleep disturbances among preschool-aged children was associated with both resolved and incident EBDs. Routine screening and precise intervention for sleep disturbances may benefit the psychosocial well-being of this population.

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“…Sleep as an important physiological function impacts many aspects of early childhood development ( 13 ). For ASD children, sleep problems not only exacerbate certain core symptoms, such as restricted and repetitive behaviors and problematic behaviors, but may also affect the effectiveness of rehabilitation training ( 14 – 16 ). Previous studies have found that the sleep problems in ASD children are age-specific ( 12 ).…”

Section: Introductionmentioning

confidence: 99%

Analysis of sleep problem in children aged 1–3 years with autism spectrum disorder in Zhejiang province, China

Yao

Wang

et al. 2022

Front. Psychiatry

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BackgroundHigh prevalence of sleep problems have been founded in children with Autism Spectrum Disorder (ASD), with rates ranging from 50 to 80%. We aimed to study the sleep status and the occurrence of sleep problems in children with autism spectrum disorder (ASD) aged 1–3 years, and to provide reference for guiding early comprehensive intervention for ASD children from the perspective of sleep.MethodsFrom January 1 to December 31, 2021, 74 ASD children who met the diagnostic criteria of “Diagnostic and Statistical Manual of Mental Disorders-5 (DSM-V)” served as case group while 84 typically-developing children of the same sex and age served as control group. An original Children's Sleep Habit Questionnaire was adopted to compare the sleep status of children in the two groups and to conduct statistical analysis on related factors.ResultsThe incidence of sleep problems in the case group (78.4%) was significantly higher than that in the control group (34.5%) (P < 0.001). Compared with the children in the control group, children in the case group had later bedtime (P < 0.05) and less sleep duration (P < 0.05), and required longer time to fall asleep (P < 0.001) The incidence of sleep problems in children who could fall asleep autonomously in the case group was significantly lower than that in children who needed parental help (P < 0.05). In the case group, the longer the screen exposure time, the higher the incidence of sleep problems (P < 0.05).ConclusionsThe incidence of sleep problems in ASD children aged 1–3 years is also high, mainly manifested in late bedtime, difficulty falling asleep, frequent night awakenings and less sleep duration. Both sleep patterns and screen exposure can impact their sleep. In the early comprehensive intervention of ASD children, it is necessary to pay full heed to their sleep status and take timely intervention measures in order to improve the quality of life for the ASD children and their families.

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Effects of Sleep Disturbances on Behavioral Problems in Preschool Children With Autism Spectrum Disorder

Cited by 7 publications

References 31 publications

Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

Impact of sleep disorders on behavioral issues in preschoolers with autism spectrum disorder

Sleep Disturbances and Emotional and Behavioral Difficulties Among Preschool-Aged Children

Analysis of sleep problem in children aged 1–3 years with autism spectrum disorder in Zhejiang province, China

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