If you are a member of the network, please log in to access Network content and tools. If you do not have a username, contact your site principal investigator or site coordinator and request that they complete a membership request for you. If you have forgotten your password, you may CLICK HERE.


You are here

The relationship between sleep problems and daytime behavior in children of different ages with autism spectrum disorders.

TitleThe relationship between sleep problems and daytime behavior in children of different ages with autism spectrum disorders.
Publication TypeJournal Article
Year of Publication2012
AuthorsSikora, DM, Johnson, KP, Clemons, TE, Katz, TF
Date PublishedNov
KeywordsAIM, Child, Child Behavior Disorders/et [Etiology], Child Development Disorders, Female, Humans, IM, Male, Pervasive/co [Complications], Preschool, Severity of Illness Index, Sleep Disorders/co [Complications]

BACKGROUND: The purpose of the current study was to evaluate the relationships among sleep problems and daytime behaviors in a large, well-defined cohort of children with autism spectrum disorder (ASD). METHODS: Out of a registry population of 3452 children with ASDs, a subset of 1193 children aged 4 to 10 years of age from 14 centers across the country was used to evaluate the relationship between varying levels of sleep problems and daytime behavior. Measures included Children's Sleep Habits Questionnaire, Vineland Adaptive Behavior Scales, Survey Interview Form, Second Edition, and Child Behavior Checklist. Multiple analysis of covariance was used to assess the association between sleep and behavior. RESULTS: Results suggest that sleep problems, as identified by parent report by use of the Children's Sleep Habits Questionnaire, have a negative relationship with daytime behavior. More specifically, children with ASDs and sleep problems had more internalizing and externalizing behavior problems, as measured by the Child Behavior Checklist, and poorer adaptive skill development, as measured by the Vineland Adaptive Behavior Scales, than children with ASDs and no sleep problems. Children with moderate to severe sleep problems had greater behavior difficulties, but not necessarily poorer adaptive functioning, than children with mild to moderate sleep problems. Both preschool- and school-aged children demonstrated a negative relationship between behavior and sleep, whereas the relationship between sleep and adaptive functioning was much more variable. CONCLUSIONS: These results suggest that, although sleep has a negative relationship with internalizing and externalizing behavior, it may have a different relationship with the acquisition of adaptive skills.


Lead Author Darryn M. Sikora

Study Aims/Objectives
To better understand the relationship sleep problems and daytime behaviors of children with Autism Spectrum Disorder (ASD).

Methods - Sample, Procedure, Study Measures, Analysis
This study included 1193 children (1014 boys, 179 girls) aged 4 to 10 years. Parent questionnaires regarding sleep habits and child behaviors, as well as data from clinical evaluations were used.

Results – Main Finding(s)
Children who were good sleepers showed less problematic behaviors than those with sleep problems. Children who had more severe sleep problems also exhibit more problematic behaviors. Preschool aged children who are good sleeps showed less problems communicating with others than those with mild or moderate to severe sleep problems. The good sleepers who were school aged only showed significantly better communication skills than those with moderate to severe sleep problems. Children or both preschool and schooling age who were good sleepers showed increased ability in daily living skills and socializing when compared to children with moderate to severe sleeping problems.

Conclusion – Summary Statement
These results suggest that increased sleep problems are associated with more behavioral problems in children with ASD. These behavioral problems included those that were directed at the child him/herself (being anxious or depressive) and at other people (being aggressive, hyperactive or not following directions). However, the relationship between sleep problems and everyday living skills is not as robust.

PubMed ID23118258