Six-Month Sleep–Wake Organization and Stability in Preschool-Age Children With Autism, Developmental Delay, and Typical Development

Abstract

This study examined sleep–wake patterns in 3 matched comparison groups of preschool-aged children: children with autism (AUT), children with developmental delay (DD) without AUT, and children who are developing typically (TYP). Sleep was assessed via actigraphy and parent-report diaries for 7 consecutive 24-hr periods across 3 time points: at enrollment (n = 194), 3 months later (n = 179), and 6 months after enrollment (n = 173). At each recording period, children in the AUT group slept less per 24-hr period, on average, and were less likely to awaken at night than children in the other two groups. In contrast, children in the DD group had more frequent and longer duration nighttime awakenings than children in the AUT group. Overall, children in the 2 neurodevelopmentally disordered groups demonstrated more night-to-night variability in their sleep–wake measures than children in the TYP group.

Intraindividual variability of sleep/wake patterns in relation to child and adolescent functioning: A systematic review

“…The three studies examining sleep IIV in children with autism and other developmental disabilities were drawn from the same sample of children [73–75]. An initial cross-sectional study did not find differences in sleep IIV (i.e., onset IIV, duration IIV, waking IIV, quality IIV) between children with autism, children with a developmental delay (but not autism), or typically developing children [74].…”

“…Further analyses found no differences in sleep IIV when children in these three groups were subdivided into those with and without elevated ADHD symptoms [75]. A follow-up study examined sleep IIV over a six-month period and found that children in either of the neurodevelopmental disorder groups had greater duration IIV and quality IIV than their typically developing peers, though within-child variability was greater than between-child variability for all three groups [73]. Less mature developmental age was also associated with greater waking IIV, duration IIV, and quality IIV [74].…”

Parent’s Physical Activity Associated With Preschooler Activity in Underserved Populations

“…28 Accelerometry recordings from 7:00 am to 8:59 pm were used to capture the typical daily wake time cycle for young children. 29,30 …”

Sleep in Neurodevelopmental Disorders

“…Sleep problems are not a constant in the development of individuals with ASD, but are fairly stable with sleep problems noted across the life course (Cohen, Conduit, Lockley, Rajaratnam, & Cornish, 2014; Croen et al, 2015). Only a few studies directly assess the stability of sleep problems/behaviors in ASD noting short-term stability for 3–6 months without intervention (Anders, Iosif, Schwichtenberg, Tang, & Goodlin-Jones, 2011; Goodlin-Jones et al, 2009) but numerous studies document elevated rates of sleep problems in children, adolescents, and adults using cross-sectional designs (Croen et al, 2015). Sleep problems are more common in individuals with ASD who also have comorbid ADHD, anxiety, depression, or gastrointestinal problems (Klukowski, Wasilewska, & Lebensztejn, 2015).…”