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Shorter sleep duration is associated with social impairment and comorbidities in ASD.

ABSTRACT: Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Understanding the causes and consequences of sleep disturbances in children with ASD is an important step toward mitigating these symptoms. To better understand the connection between sleep duration and ASD severity, we analyzed ASD-related symptoms using the Autism Diagnostic Interview-Revised (ADI-R), Autism Diagnostic Observation Schedule (ADOS), IQ scores, and parent reports of the average amount of time slept per night that were available in the medical histories of 2,714 children with ASD in the Simons Simplex Collection (SSC). The mean (SD) sleep duration was 555 minutes. Sleep duration and severity of core ASD symptoms were negatively correlated, and sleep duration and IQ scores were positively correlated. Regression results indicated that more severe social impairment, primarily a failure to develop peer relationships, is the core symptom most strongly associated with short sleep duration. Furthermore, increased severity for numerous maladaptive behaviors assessed on the Child Behavior Checklist, as well as reports of attention deficit disorder, depressive disorder, and obsessive compulsive disorder were associated with short sleep duration. Severity scores for social/communication impairment and restricted and repetitive behaviors (RRB) were increased, and IQ scores were decreased, for children reported to sleep ?420 minutes per night (lower 5th percentile) compared to children sleeping ?660 minutes (upper 95th percentile). Our results indicate that reduced amounts of sleep are related to more severe symptoms in children with ASD. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1221-1238. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.

SUBMITTER: Veatch OJ

PROVIDER: S-EPMC7923457 | biostudies-literature | 2017 Jul

REPOSITORIES: biostudies-literature

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Shorter sleep duration is associated with social impairment and comorbidities in ASD.

Veatch Olivia J OJ Sutcliffe James S JS Warren Zachary E ZE Keenan Brendan T BT Potter Melissa H MH Malow Beth A BA

Autism research : official journal of the International Society for Autism Research 20170316 7

Sleep disturbance, particularly insomnia, is common in children with autism spectrum disorders (ASD). Furthermore, disturbed sleep affects core symptoms and other related comorbidities. Understanding the causes and consequences of sleep disturbances in children with ASD is an important step toward mitigating these symptoms. To better understand the connection between sleep duration and ASD severity, we analyzed ASD-related symptoms using the Autism Diagnostic Interview-Revised (ADI-R), Autism Di ...[more]

PMID: 28301091

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Project description:Children with attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) often experience social impairments. These children also frequently struggle with emotion regulation, and extant literature suggests that emotion dysregulation predicts social impairment in both clinical and neurotypical populations. However, the evidence base linking ADHD/ASD with social impairment comes primarily from samples meeting full diagnostic criteria for ADHD and/or ASD despite evidence that both syndromes reflect extreme ends of natural continuums that are normally distributed across the general population. To our knowledge, the present study is the first to concurrently examine unique and overlapping relations among ADHD/ASD symptoms, emotion regulation, and social difficulties using multi-informant measures (parent, teacher) with a clinically-evaluated sample of 108 children ages 8-13 (40 girls; 66% White/Non-Hispanic) with and without clinically-elevated ASD and ADHD symptoms and other common clinical disorders. Bias-corrected, bootstrapped conditional effects modeling revealed that ADHD-inattentive (β=-0.23) and ASD-social communication (β=-0.20) symptoms predicted social impairment directly, whereas ADHD-hyperactive/impulsive (β=-0.06) and ASD-restricted/repetitive behavior/interests (β=-0.06) symptoms predicted social impairment only via their shared associations with emotion dysregulation. Sensitivity analyses revealed that most relations were robust to control for item overlap across measures. In contrast, only the ADHD-inattention/social impairment link was robust to control for mono-informant bias, highlighting the importance of multi-informant methods and the potential for different determinants of social functioning across settings. Overall, this study implicates emotion regulation skills and all four ADHD/ASD symptom clusters as potential influences on children's social functioning, albeit with a more nuanced and potentially setting-specific pattern than suggested by prior work.

Project description:ObjectivesCognitive impairment is a leading cause of disability worldwide, and cardiometabolic conditions are key contributors to its development. Short sleep is also a potential contributor to brain health; however, its role in predicting mortality remains poorly understood. We investigated whether objective short sleep duration increases the risk of all-cause mortality associated with coexisting cognitive impairment and cardiometabolic conditions, i.e., possible vascular cognitive impairment (VCI).DesignThis is a longitudinal study.SettingThis is a population-based, in-lab study.ParticipantsA total of 1,524 adults (aged 48.9±13.4 years, 53.4% women) from the Penn State Adult Cohort were included in the study.MeasurementsAll-cause mortality was estimated after 19.1±5.1 years of follow-up. Neuropsychological testing was performed to ascertain cognitive impairment. Clinical history and physical examination were performed to ascertain stage 2 hypertension, type 2 diabetes, heart disease, and stroke. Possible VCI was defined as the presence of any of these cardiometabolic conditions and cognitive impairment. In-lab, 8-hour polysomnography (PSG) was performed to ascertain short sleep duration (i.e., <6 hours).ResultsMultivariable-adjusted Cox proportional-hazard models showed that the risk of all-cause mortality associated with cardiometabolic conditions (n=864) and possible VCI (n=122) was significantly increased in those who slept <6 hours at baseline (hazards ratio [HR] = 1.79, 95% confidence interval [CI] = 1.28-2.51 and HR = 4.01, 95% CI = 2.66-6.05, respectively), while it was negligible in those who slept ?6 hours (HR = 1.44, 95% CI = 0.99-2.09 and HR = 1.41, 95% CI = 0.70-2.83, respectively).ConclusionsObjective short sleep duration predicts the mortality prognosis of adults with possible VCI. Sleep duration and cognition should be objectively evaluated in patients presenting with a cluster of cardiometabolic conditions and sleep and cognitive complaints. Short sleep is a useful risk factor in the prediction of adverse cardiometabolic and brain health outcomes.

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Shorter sleep duration is associated with social impairment and comorbidities in ASD.

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Shorter sleep duration is associated with social impairment and comorbidities in ASD.

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