Understanding sleep difficulties in children on the autism spectrum

Sleep is now recognised as a fundamental factor contributing to the quality of life of autistic people, estimated at affect 50-80% of people. By understanding the biological and behavioural attributes of sleep difficulties as a comorbidity in children on the autism spectrum, we can provide the right supports to improve quality of life.

The project aimed to:

1. define the sleep difficulties in children on the autism spectrum
2. comprehensively evaluate the relationship between sleep difficulties and clinical phenotype (physical makeup of a person) including autism traits, cognitive level, gender, adaptive behaviour and sensory profile
3. measure the biological determinants including melatonin and melatonin metabolites in urine samples and any associated genetic variants.

The project team examined a range of clinical and behavioural data from 969 children on the autism spectrum, 188 siblings and 111 non-related, non-autistic children (controls) from the Australian Autism Biobank. 

Consistent with our hypothesis that children on the autism spectrum may experience more severe sleep difficulties, our results showed that children and adolescents with a diagnosis of autism were more likely to have greater severity of sleep difficulties compared to both siblings and unrelated children without an autism diagnosis. Specifically, children on the autism spectrum had more bedtime resistance, greater sleep onset delay, reduced sleep duration, increased levels of sleep anxiety, more night awakenings and parasomnias and greater levels of daytime sleepiness than both siblings and unrelated children without an autism diagnosis. 

A range of other findings and recommendations can be found in the Final Report.