Employment status is related to sleep problems in adults with autism spectrum disorder and no comorbid intellectual impairment

Abstract

Both sleep problems and unemployment are common in adults with autism spectrum disorder; however, little research has explored this relationship in this population. This study aimed to explore factors that may be associated with the presence of an International Classification of Sleep Disorders-Third Edition defined sleep disorder in adults with autism spectrum disorder (IQ > 80). A total of 36 adults with autism spectrum disorder and 36 controls were included in the study. Participants completed a 14-day actigraphy assessment and questionnaire battery. Overall, 20 adults with autism spectrum disorder met the International Classification of Sleep Disorders-Third Edition criteria for insomnia and/or a circadian rhythm sleep-wake disorder, while only 4 controls met criteria for these disorders. Adults with autism spectrum disorder and an International Classification of Sleep Disorders-Third Edition sleep disorder had higher scores on the Pittsburgh Sleep Quality Index and were more likely to be unemployed compared to adults with autism spectrum disorder and no sleep disorder. The findings demonstrate, for the first time, that sleep problems are associated with unemployment in adults with autism spectrum disorder. Further research exploring the direction of this effect is required; sleep problems that have developed during adolescence make attainment of employment for those with autism spectrum disorder difficult, or unemployment results in less restrictions required for optimal and appropriate sleep timing.

Sleep determines quality of life in autistic adults: A longitudinal study

“…Our findings highlight the importance of comorbid conditions for both subjective QoL and level of daily activities. The latter has been related to poor sleep in autistic adults in a recently published report [Baker, Richdale, & Hazi, ]. In addition, although our findings are correlational, sleep problems may in fact be causally associated with autism symptoms, rendering possibilities for causal intervention.…”

Sleep problems in adults with autism spectrum disorder and intellectual disability

“…All participants with ASD in our study were unemployed, and unemployment has been related to the presence of a sleep disorder in high‐functioning ASD [Baker & Richdale, ]. However, most unemployed individuals in their study met criteria for delayed sleep wake rhythm disorder [Baker, Richdale, & Hazi, in press]. Nevertheless, adults with ASD in these studies did not have an ID and were not institutionalized [Baker & Richdale, ; Hare et al, ] and thus presumably were able to self‐select bed and wake times.…”

How Do Adults with Autism Spectrum Disorder Participate in the Labor Market? A German Multi-center Survey

“…One of the largest societal cost components of supporting an individual with ASD in the UK and the USA is productivity loss as a result of lost or disrupted employment (Buescher et al, 2014). Furthermore, unemployment leads to a low quality of life in adults with ASD and is associated with social isolation, stress, mental health problems and an increased risk of homelessness (Baker et al, 2019;Kamio et al, 2013;Paul & Moser, 2009;Stone, 2019;Taylor & Hodapp, 2012).While the few mentioned studies are a first important examination of the employment status of adults with ASD in Germany, the samples consisted of clinically mostly late-diagnosed individuals, who predominately present high psychosocial adjustments only (Lehnhardt et al, 2012). Further, existing studies did not address adults with co-occurring ID in their surveys.…”