Sleep Problems in Children with Autism Spectrum Disorder in Bangladesh: A Case–Control Study

Abstract

Background: Sleep problems in children with Autism Spectrum Disorder (ASD) are highly prevalent, but little information is available on this issue in low-to middle-income countries (LMIC) such as Bangladesh. Therefore, the present study investigated the prevalence and socio-demographic determinants of ASD sleep disturbances in a comparison with typically developing children (TDC). Methods: A cross-sectional interview study was carried out within a total of 446 Bangladeshi mothers, whose children's mean age was 8.1±2.9 years (151 ASD [8.5±2.7 years] and 295 TDC [7.9±2.9 years]); in addition to socio-demographics, the Child Sleep Habit Questionnaire (CSHQ) was used, and a cut-off score of 41 out of 93 points considered as reflecting sleep problems. Results: About 89.7% of the children reported having problems in sleep, with ASD reporting higher frequency vs TDC (94.00% vs 87.50%; χ 2 =4.678, p=0.031). The overall mean CSHQ score was 48.7±7.6 in total sample, whereas ASD children reported higher scores compared to TDCs (50.9±8.1 vs 47.5±7.0, p<0.001). Similarly, subscales of CSHQ such as sleep duration (4.23±1.56 vs 3.90±1.31, p=0.017), sleep anxiety (7.23±2.05 vs 6.45 ±1.92, p<0.001), night waking (3.82±1.07 vs 3.17±1.89, p<0.001), parasomnias (8.86±2.06 vs 7.85±2.27, p<0.001), and sleep disordered breathing (4.02±2.92 vs 3.43±2.07, p=0.014) were more problematic among ASD compared to TDC. Lastly, 28.5% of ASD reported taking sleep-related medications vs 0.3% for TDC (n=1). Conclusion: Bangladeshi ASD children are highly likely to manifest sleep disturbances, which warrant urgent implementation of parental educational and support programs to mitigate the impact of sleep problems in ASD families.

Elaboração de cartilhas educativas sobre sono de crianças com o Transtorno Espectro Autista

“…Dificuldades relacionadas à insônia são as razões frequentes pelas quais a família procura intervenção médica para crianças com TEA (Chen, 2021). A insônia atrapalha o sono da criança TEA, pois é uma desordem que pode dificultar o início do sono ou dificultar que a criança mantenha o sono, causando assim uma alteração do comportamento de maneira negativa (Sultana, 2021). Pode se relacionar nesta população ao estresse parental, má qualidade do sono da família e má higiene do sono (Malow, 2013).…”