Abstract
INTRODUCTION: Co-occurring conditions like sleep disturbances are prevalent in autism spectrum disorder (ASD) and have been linked to greater variability in clinical presentation, including social communication and behavioral challenges. This study examined the relationship between sleep disturbances and ASD characteristics in school-aged children. METHOD: In this descriptive, observational study, 24 children with ASD (ages 6-12) wore actigraphy monitors for up to seven nights to provide objective data on sleep onset latency, total nighttime sleep, and nighttime awakenings. Parents completed sleep diaries and the Autism Spectrum Rating Scale to assess impairments in social and communication, behaviors associated with ASD, and self-regulation. RESULTS: Of the 24 participants, 23 wore actigraphy monitors. Twenty-two children experienced at least one sleep disturbance, and of these, 21 had usable actigraphy data, with an average of 6.43 nights analyzed. A greater number of sleep disturbances was associated with increased parent-reported social-communication difficulties but lower parent-reported behavioral dysregulation scores. CONCLUSIONS: Findings suggest that sleep disturbances may differentially influence the expression of ASD characteristics across social-communication and behavior. Considering sleep patterns in ASD research and clinical care may enhance understanding of variability in ASD and support the development of targeted interventions.