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

Abstract

Many individuals with autism report generally low quality of life (QoL). Identifying predictors for pathways underlying this outcome is an urgent priority. We aim to examine multivariate patterns that predict later subjective and objective QoL in autistic individuals. Autistic characteristics, comorbid complaints, aspects of daily functioning, and demographics were assessed online in a 2‐year longitudinal study with 598 autistic adults. Regression trees were fitted to baseline data to identify factors that could predict QoL at follow‐up. We found that sleep problems are an important predictor of later subjective QoL, while the subjective experience of a person's societal contribution is important when it comes to predicting the level of daily activities. Sleep problems are the most important predictor of QoL in autistic adults and may offer an important treatment target for improving QoL. Our results additionally suggest that social satisfaction can buffer this association. Autism Research 2019, 12: 794–801. © 2019 International Society for Autism Research, Wiley Periodicals, Inc. Lay Summary Many individuals with autism report generally low quality of life (QoL). In this study, we looked at factors that predict long‐term QoL and found that sleep problems are highly influential. Our results additionally suggest that social satisfaction can buffer this influence. These findings suggest that sleep and social satisfaction could be monitored to increase QoL in autistic adults.

Cross-sectional and longitudinal predictors of quality of life in autistic individuals from adolescence to adulthood: The role of mental health and sleep quality

“…This is contrary to Deserno et al (2019), who reported that sleep problems interfering with daily function predicted subjective QoL 2 years later. However, Deserno et al (2019) used a single question to measure subjective QoL, while our study has investigated QoL across four domains. Furthermore, Deserno et al (2019) did not control for baseline QoL when examining longitudinal predictors.…”

“…However, Deserno et al (2019) used a single question to measure subjective QoL, while our study has investigated QoL across four domains. Furthermore, Deserno et al (2019) did not control for baseline QoL when examining longitudinal predictors.…”

“…Factors which are implicated in QoL for autistic individuals include bullying and stress (Hong et al, 2016), co-occurring mental health conditions (Knüppel et al, 2018; Mason et al, 2018), poor sleep (Deserno et al, 2019; Knüppel et al, 2018), poor executive functioning (Dijkhuis et al, 2017), involvement in daytime activity, living arrangements (Knüppel et al, 2018) and autism symptomatology (Knüppel et al, 2018; Mason et al, 2018). Most recently, an examination of a comprehensive range of variables found that insomnia severity was the best predictor of self-reported QoL in autistic adults, using a single QoL question at a 2-year follow-up (Deserno et al, 2019). However, this study only used a single, Likert-type scale item to measure QoL and did not control for baseline QoL in their longitudinal analyses.…”

Sleep Quality in Autism from Adolescence to Old Age

“…The primary sleep parameters reported as problematic in autistic adults include reduced total sleep time (TST) and sleep efficiency (SE; the proportion of time in bed spent sleeping), and increased sleep onset latency (SoL) and night waking, which are associated with insomnia, circadian rhythm sleep disorders, and daytime fatigue. [8][9][10][11][12][13][14][15][16][17] A considerable amount is now known about sleep difficulties in autistic children, but the body of sleep research for autistic adolescents and adults remains limited.…”

Examining the Relationship Between Autism Traits and Sleep Duration as Predictors of Suicidality

“…Sleep difficulties in people with autism have been found to extend into adulthood (Matson et al 2008 ) and are negatively associated with aspects of well-being, including; health-related quality of life (Delahaye et al 2014 ) and quality of life generally (Deserno et al 2019 ). This can lead to challenging behaviour (Goldman et al 2011 ; Wiggs and Stores 1996 ), daytime functional impairments (Richdale et al 2014 ), and a higher risk of meeting criteria for a circadian rhythm sleep–wake disorder compared to control age- and sex-matched adults (Baker and Richdale 2017 ).…”