Sleep behaviors in children with autism spectrum disorders

Objective: To explore the sleep behavior in preschool and school-age children with autism spectrum disorders(ASD).Methods: Totally 84 children with ASD meeting the Diagnostic and Statistical Manual of Mental Disorders,Fourth Edition(DSM-IV) and 91 age-,sex-matched healthy children were selected.Their sleep behaviors and habits were obtained from their parents by the Chinese version of Children' s Sleep Habits Questionnaire(CSHQ) and an one-week sleep diary.A cutoff point of 41 in CSHQ was applied to define poor sleep.Abnormal sleep behavior occurred more than 2 nights per week was defined as a problem.ASD children divided into two age groups(3~5 years and 6~12 years) were separately compared with normal control group of their sleep habits and behaviors.Results: ASD children aged 3~5 years scored higher than normal control group in sleep latency[(2.1±0.8) vs.(1.6±0.7),P0.05] and sleep duration [(5.4±1.7) vs.(4.8±1.3),P0.05].A higher proportion of them had "difficulties in falling asleep in 20 min"(77.6% vs.49.0%),"slept less"(63.3% vs.42.9%),"struggled after night wakings"(34.7% vs.12.2%),and "felt fatigue at daytime"(36.7% vs.10.2%),Ps0.05.ASD children aged 6~12 years slept less than control group during weekdays [(8.68±0.76) h vs.(9.33±1.00) h,P0.05].They scored higher than control group in bedtime resistance [(10.1±2.8) vs.(8.6±2.5)],sleep latency [(1.7±0.7) vs.(1.4±0.6)] and sleep anxiety [(5.4±2.0) vs.(4.5±1.9),Ps0.05].More of them had "difficulties in falling asleep in 20 min"(54.3% vs.31.0%),"slept less"(60.0% vs.35.7%),"slept with parents"(65.7% vs.38.1%) and "needed company during bedtime"(68.6% vs.35.7%),Ps0.05.Conclusion: It suggests that ASD children may have less sleep amount and more difficulties in falling asleep.Preschool ASD children may struggle after night-waking and suffer from fatigue during the day,while school-age ASD children may have more sleep anxiety.