Sleep patterns predictive of daytime challenging behavior in individuals with low‐functioning autism

Cohen, Simonne; Fulcher, Ben D.; Rajaratnam, Shanthakumar M W; Conduit, Russell; Sullivan, Jason P.; Hilaire, Melissa A St; Phillips, Andrew J. K.; Loddenkemper, Tobias; Kothare, Sanjeev V.; McConnell, Kelly; Braga-Kenyon, Paula; Ahearn, William H.; Shlesinger, Andrew; Potter, Jacqueline; Bird, Frank L.; Cornish, Kim; Lockley, Steven W.

doi:10.1002/aur.1899

Cited by 80 publications

(53 citation statements)

References 48 publications

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“…Alterations in specific sleep stages may also be associated with different ASD phenotypes; prolonged REM latency has been associated with regression (97). Other maladaptive behaviors, such as self-injury, tantrums and aggression, are associated with shorter sleep durations in ASD (15), and children with ASD with poorer sleep quality also have higher rates of internalizing and externalizing behavioral disorders and lower levels of adaptive functioning (98, 99).…”

Section: Meta-synthesis Of Theories Underlying Common Medical Comorbimentioning

confidence: 99%

Characterizing the Interplay Between Autism Spectrum Disorder and Comorbid Medical Conditions: An Integrative Review

et al. 2019

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Co-occurring medical disorders and associated physiological abnormalities in individuals with autism spectrum disorder (ASD) may provide insight into causal pathways or underlying biological mechanisms. Here, we review medical conditions that have been repeatedly highlighted as sharing the strongest associations with ASD—epilepsy, sleep, as well as gastrointestinal and immune functioning. We describe within each condition their prevalence, associations with behavior, and evidence for successful treatment. We additionally discuss research aiming to uncover potential aetiological mechanisms. We then consider the potential interaction between each group of conditions and ASD and, based on the available evidence, propose a model that integrates these medical comorbidities in relation to potential shared aetiological mechanisms. Future research should aim to systematically examine the interactions between these physiological systems, rather than considering these in isolation, using robust and sensitive biomarkers across an individual's development. A consideration of the overlap between medical conditions and ASD may aid in defining biological subtypes within ASD and in the development of specific targeted interventions.

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Section: Meta-synthesis Of Theories Underlying Common Medical Comorbimentioning

confidence: 99%

Characterizing the Interplay Between Autism Spectrum Disorder and Comorbid Medical Conditions: An Integrative Review

et al. 2019

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“…58 Sleep problems are not only linked to core symptoms of autism, but also with associated symptoms such as internalizing and externalizing behaviour problems and anxiety. 56 Nonetheless, these associations are not consistently confirmed in the literature, 59 leaving open the possibility that poorer sleep observed in children with ASD with a more severe symptomatology would be a mere reflection of brain immaturity, challenging a sleep-behaviour relationship. Indeed, brain maturation leads not only to behavioural changes and improvements in cognitive skills, but also shapes sleep features.…”

Section: Sleep-related Clinical Characteristics Associated With Autismmentioning

confidence: 99%

“…[77][78][79] Second, sleep quality seems to be temporally bound to subsequent daytime behaviour. Using an extensive longitudinal data set, Cohen et al 59 investigated whether prior sleep quantity and quality in children predicted subsequent daytime behaviour, and whether cumulative sleep loss over several nights increased the risk of behavioural problems the following day. Results confirmed a predictive relationship between sleep on the previous night and the presence of challenging behaviours the next day.…”

Section: Is There a Directionality In The Relationship Between Sleep mentioning

confidence: 99%

Sleep–behaviour relationship in children with autism spectrum disorder: methodological pitfalls and insights from cognition and sensory processing

Deliens

Peigneux

2019

Develop Med Child Neuro

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Sleep disturbances are frequent and varied in autism spectrum disorder (ASD). Growing evidence suggests that sleep problems in children with ASD are driven by their clinical characteristics and psychiatric comorbidities. Therefore, the wide range of reported sleep disturbances reflects the marked heterogeneity of clinical pictures in ASD. Whether sleep disturbances and their various forms may, in turn, account for at least part of the phenotypical variability of ASD is a crucial question discussed in this review. We first outline studies both validating and challenging a bidirectional theoretical framework for sleep disorders in children with ASD. We then propose to extend this model by including cognition and sensory processing as key factors in the vicious circle linking sleep disorders and autistic symptoms. What this paper adds There is a bidirectional interplay between autism symptoms and sleep disturbances. Sleep influence on daytime cognitive and sensory skills should be further investigated.

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“…Numerous studies have shown that a wide variety of persistent sleep difficulties experienced by ASD children exacerbate their core autistic symptoms (25) and are associated with many conditions that co-occur with ASD including increased anxiety, sensory over-responsivity (26), selfstimulatory behavior, and daytime challenging behavior (27), as well as medical comorbidities such as gastrointestinal problems (12) and epilepsy (28). Among children with ASD, poor sleepers exhibit more ritualistic, compulsive, irritable, and hyperactive behavior than good sleepers (29,30).…”

Section: Introductionmentioning

confidence: 99%

Sleep Problems Influence Emotional/Behavioral Symptoms and Repetitive Behavior in Preschool-Aged Children With Autism Spectrum Disorder in the Unique Social Context of China

et al. 2020

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Sleep disturbances are common in people with autism spectrum disorder (ASD), but research on this topic is still limited in China. In the current study, we evaluated the prevalence of sleep problems in preschool-aged children with ASD and to examine the correlations between sleep disturbances and emotional/behavioral symptoms and repetitive behavior in the unique social context of China. This study recruited 475 preschool-aged children aged 3-6 years old, including 252 children with ASD (mean age 5.13 ± 1.15, 80.6% male) and 223 age-matched typically developing (TD) children (mean age 5.12 ± 0.97, 74.9% male). The parents of all children completed a sociodemographic questionnaire and the Childhood Sleep Habits Questionnaire. The parents of 114 ASD children completed the Strengths and Difficulties Questionnaire (SDQ) and the Repetitive Behavioral Questionnaire-2 (RBQ-2). The prevalence of sleep problems in preschool-aged children with ASD in this study was 81.7%, which was higher than that in TD children (61.0%). The scores for bedtime resistance, sleep anxiety, sleep duration, parasomnias, and sleep onset delay in the ASD group were significantly higher than those in the TD group (t=−7.664, P=0.000; t=−10.477, P=0.000; t=−4.133, P=0.000; Z= −3.916, P=0.000; Z=−7.093, P=0.000; respectively). Sleep onset delay explained 17.3% of the variance (adjusted R 2 = 0.173) in the total SDQ score of children with ASD, and bedtime resistance explained a large proportion of total RBQ-2 score variance (adjusted R 2 = 0.206). The high rate of sleep disturbances in preschool-aged children with ASD emphasizes the importance of screening for sleep problems in this population. Attention should also be directed toward formulating good sleep hygiene practices for preschool-aged children in the particular social context and cultural setting of China.

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Sleep patterns predictive of daytime challenging behavior in individuals with low‐functioning autism

Cited by 80 publications

References 48 publications

Characterizing the Interplay Between Autism Spectrum Disorder and Comorbid Medical Conditions: An Integrative Review

Characterizing the Interplay Between Autism Spectrum Disorder and Comorbid Medical Conditions: An Integrative Review

Sleep–behaviour relationship in children with autism spectrum disorder: methodological pitfalls and insights from cognition and sensory processing

Sleep Problems Influence Emotional/Behavioral Symptoms and Repetitive Behavior in Preschool-Aged Children With Autism Spectrum Disorder in the Unique Social Context of China

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