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Sleep in children with autism spectrum disorders: How are measures of parent report and actigraphy related?

TitleSleep in children with autism spectrum disorders: How are measures of parent report and actigraphy related?
Publication TypeConference Abstract
Year of Publication2015
AuthorsVeatch, OJ, Reynolds, AM, Katz, TF, Weiss, SK, Loh, A, Wang, L, Malow, BA
Conference NameSLEEP
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Introduction: Sleep disturbance is common in children with autism, resulting in a great need for effective treatments. To evaluate treatments for sleep disturbance in this population, it is critical to understand the relationship between measures of sleep captured by parent report and objective measures.

Methods: Parent report using the Children's Sleep Habits Questionnaire (CSHQ) and actigraphy-measured data from 80 children with autism and sleep onset delay were evaluated. Responses on the CSHQ were evaluated focusing on whether or not the child had problems with sleep duration, night wakings, and/or bedtime resistance, in relation to sleep onset delay. Actigraphy measurements in children whose parent indicated the corresponding behavior was a problem on the CSHQ were compared to measurements in children who did not have a reported problem by performing Wilcoxon rank sum tests. Further, the correlation structure across CSHQ subscale item scores, questions of interest to insomnia, and the comparable actigraphy measurements was determined by calculating pairwise Spearman’s correlation coefficients (ρ).

Results: Reported problems with sleep onset delay were concurrent with sleep duration problems in 66% of children, night wakings in 72% of children, and bedtime resistance in 66% of children; 38% of children were reported to have problems with all insomnia domains. Actigraphy-measured sleep duration was correlated with estimates based on CSHQ-reported bed and waketimes. The relationship between parent report and actigraphy measures was stronger following intervention with parent education.

Conclusions: Parent report provides information regarding sleep duration that is related to sleep duration measured with actigraphy. This indicates that, in the absence of objectively-measured sleep duration data, parent-reported sleep durations derived from bedtimes and waketimes collected via the CSHQ provide estimates of total sleep time that are consistent with actigraphy measurements. This calculated variable from the CSHQ should be useful for future research studies of sleep duration in autism.