Sleep disturbance is a significant problem in the general pediatric population, and it occurs even more frequently in children with Autism Spectrum Disorders (ASDs). Much time and energy has been spent examining the characteristics which predispose children in general to insomnia, and it is likely that similar factors influence sleep in young people with ASDs. Although the dynamics may be similar to those of children in the general population, unique characteristics associated with a diagnosis of ASD may have additive effects and increase the likelihood of developing sleep dysfunction.
The purpose of this research was to explore possible cognitive, behavioral, emotional, and physiological risk markers for sleep disturbance in children with ASDs. The investigation involved the analyses of two sets of preexisting data in a cross-sectional design. Study 1 consisted of data from the Autism Treatment Network Registry, and Study 2, involved data collected by the Research Units on Pediatric Psychopharmacology (RUPP) Autism Network. Approximately 40 to 45 variables were analyzed in each study using hierarchical regression modeling to establish the best linear combination of predictors for sleep disturbance and to control for the effects of psychotropic medication use. The results of Study 1 revealed that the combined effects of anxiety, autism symptom severity, sensory sensitivities, communication problems, GI problems, and externalizing behavior were the main associated factors for the development of insomnia. IQ positively predicted sleep disturbance and children with Asperger's Disorder were especially vulnerable. The amount of variance in sleep outcomes explained by the predictor variables was small to moderate (i.e., R2 ranged from .104 to .201).
The results of Study 2 showed that anxiety and compulsive or repetitive behaviors were the main predisposing factors for the development of disturbed sleep, and the amount of the variance in the sleep outcome explained by predictor variables was small-to-moderate (i.e., R2 = .206). Similar to Study 1 findings, level of intelligence positively predicted the sleep dysfunction. Variables that predicted sleep outcomes across both studies were elevated anxiety, medication use and elevated IQ. Elevated anxiety and medication use were consistent with the study hypotheses. IQ was not consistent as it was hypothesized that lower levels of intelligence would be associated with sleep dysfunction. Other variables that contributed to the variance in sleep outcomes in one study, but not the other remain inconclusive (i.e., age, communication deficits, impaired reciprocal social interactions, compulsive and repetitive behaviors, regressed autism, aggressive behavior, GI problems, race, sensory sensitivities, inattentiveness), while yet other variables were found to be inconsistent with the study hypotheses (i.e., parent education level, hyperactivity, oppositional defiance, respiratory problems, epilepsy). Predictor variables were evaluated for the appropriateness of fit in a bidirectional theoretical framework for sleep disturbance in children with ASDs.
Secondary analyses revealed relationships between sleep variables, parent stress and quality of life. Associations were also found between visual reception and fine motor skills development.
|Commitee:||Aman, Michael, Butter, Eric, Havercamp, Susan, Lecavalier, Luc|
|School:||The Ohio State University|
|School Location:||United States -- Ohio|
|Source:||DAI-B 78/11(E), Dissertation Abstracts International|
|Subjects:||Behavioral psychology, Psychology|
|Keywords:||Autism Spectrum Disorders, Correlates, Risk markers, Sleep disturbance|
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