Low threshold to Vestibular and Oral Sensory stimuli might affect quality of sleep among children with autism spectrum disorder

Abstract

Aims: The current study aimed to validate the relationship between sensory characteristics and sleep dynamics among children with autism spectrum disorder (ASD) using an actigraph, which is an objective assessment device used for sleep monitoring. Methods: A total of 40 children (age range, 3-6 years) participated in this study (n = 20, with ASD and n = 20, age-matched children with typical development [TD]). We examined sleep dynamics using actigraph for 7 consecutive days, and the relationship between sleep parameters and sensory characteristics was analyzed using the Japanese Version of Sensory Profile (SP-J). Results: Significant differences were observed in terms of activities per minute during sleep (p = 0.02), sleep efficiency (SE) (p = 0.005), and wake after sleep onset (WASO) (p = 0.02) between the two groups. In the ASD group, significant positive correlations were observed between activities per minute during sleep and low thresholds for Vestibular Sensory stimuli (p = 0.046) and Oral Sensory stimuli (p = 0.006) using the SP-J. Based on a multiple regression analysis, the activities per minute during sleep were associated with low thresholds for Oral Sensory stimuli (b = 0.51, t = 2.29, p = 0.03), but not with other factors, in the ASD group. Conclusions: The current study showed that atypical Vestibular and Oral Sensory modulation may be a risk indicator for high activities during sleep among preschool children with ASD. Thus, whether the interventions for these sensory characteristics are effective in improving sleep quality, daytime activities, behaviors, and cognitive functions in this group of children must be considered.

Sleep, Sensory Integration/Processing, and Autism: A Scoping Review

“… Malow et al, 2006 ; Goldman et al, 2012 ; Morgan et al, 2020 ), the interplay between these constructs has not received the same degree of consideration. We report evidence indicating, at minimum, a co-existence of sensory integration/processing differences and sleep concerns in autistic children, and to some extent, autistic adults ( Nieminen-von Wendt et al, 2005 ; Klintwall et al, 2011 ; Reynolds et al, 2012 ; Silva and Schalock, 2012 ; Tzischinsky et al, 2018 ; Wang et al, 2019 ; Eyuboglu and Eyuboglu, 2020 ; Kosaka et al, 2021 ). In some instances the relationship was predictive ( Hohn et al, 2019 ; Mazurek et al, 2019 ).…”

“… Hohn et al (2019) suggested that visual sensory sensitivity is a driver for insomnia in autistic adults. In children, investigators report poor auditory filtering and taste/smell differences ( Hollway et al, 2013 ), tactile hypo-reactivity ( Wang et al, 2019 ; Jamioł-Milc et al, 2021 ), vestibular and oral hyper-reactivity ( Kosaka et al, 2021 ), vestibular hypo-reactivity ( Ornitz et al, 1973 ; Wang et al, 2019 ), and touch and oral hyper-reactivity ( Tzischinsky et al, 2018 ).…”

“…While literature reports consistency between parent report and objective measures of some domains of sleep ( Malow et al, 2006 ), other sleep concerns may be under-estimated (e.g., night wakings) or over-estimated (e.g., total sleep duration) ( Goodwin et al, 2007 ) by parents. The intervention study conducted by Gringras et al (2014) , and the characterization study by Kosaka et al (2021) coupled parent report tools with an objective measure of sleep such as actigraphy. To optimally measure sleep challenges many investigators recommended the use of actigraphy, polysomnography or activity trackers to enhance accuracy.…”

Integration of physical health and sensory processing assessment for children with autism spectrum disorder in schools

“…The vestibular system collaborates with organs and our central nervous system to provide sensory feedback on our head's position relative to gravity (Bialer & Miller, 2011, p. 23: Pelligrino, 2019, p. 100). Impairment of the vestibular system in children could impact motor skills, postural control, and even sleep (Kosaka et al, 2021; Lim et al, 2017; Perin et al, 2020). There are two main ways that vestibular function is assessed in children with neurodevelopmental disorders within research.…”

“…Research comparing children with ASD to their typically developing peers resulted in significant differences in sleep disturbances which could be predicted through behavioral and sensory assessment measures (Reynolds et al, 2011). Children with ASD were also more likely to have more sleep activity during sleep when they also had low thresholds for vestibular sensory stimuli, which can lead to worse sleep quality (Kosaka et al, 2021, p. 60).…”