Yale School of Medicine, Yale Child Study Center, Yale University, New Haven, Connecticut, USA.
Human Development & Family Studies, Purdue University, West Lafayette, Indiana, USA.
Autism Res. 2022 Jul;15(7):1249-1260. doi: 10.1002/aur.2758. Epub 2022 May 30.
Autistic individuals experience significantly higher rates of sleep problems compared to the general population, which negatively impacts various aspects of daytime functioning. The strength of associations across domains of functioning has not yet been summarized across studies. The present meta-analysis examined the strength of associations between sleep problems and various domains of daytime functioning in autistic individuals. Searches were conducted in EMBASE, PubMed, Web of Science, and Google Scholar through May 2020. Inclusion criteria were: an index of sleep disturbance in individuals diagnosed with autism spectrum disorder (ASD); data collected prior to any sleep-related intervention; statistical data indicating relations between sleep problems and outcomes relevant to behavior, cognition, and physical or mental health. Exclusion criteria were: statistics characterizing the relationship between sleep disturbance and outcome variables that partialled out covariates; studies examining correlations between different measures of sleep disturbance. Participants totaled 15,074 from 49 published articles and 51 samples, yielding 209 effect sizes. Sleep problems were significantly associated with more clinical symptomatology and worse daytime functioning. Subgroup analyses demonstrated that sleep problems were most strongly associated with internalizing and externalizing symptoms and executive functioning, followed by core autism symptoms, family factors, and adaptive functioning. Findings highlight the far-reaching consequences of sleep problems on daytime functioning for autistic individuals and support the continued prioritization of sleep as a target for intervention through integrated care models to improve wellbeing. LAY SUMMARY: Autistic individuals experience higher rates of sleep problems, such as difficulty falling asleep and staying asleep, compared to the general population. We quantitatively summarized the literature about how sleep problems are related to different aspects of daytime functioning to identify areas that may be most affected by sleep. Sleep problems were related to all areas assessed, with the strongest associations for mood and anxiety symptoms. We recommend prioritizing sleep health in autistic individuals to improve wellbeing and quality of life.
自闭症个体经历的睡眠问题发生率显著高于普通人群，这对日间功能的各个方面都产生了负面影响。目前，尚未对研究间各个功能领域的关联强度进行总结。本研究采用荟萃分析方法评估了自闭症个体的睡眠问题与日间功能各个领域之间的关联强度。研究人员在 2020 年 5 月前通过 EMBASE、PubMed、Web of Science 和 Google Scholar 进行了检索。纳入标准为：自闭症谱系障碍（ASD）个体的睡眠障碍指数；在任何与睡眠相关的干预之前收集的数据；表明睡眠问题与行为、认知以及身体或心理健康相关结果之间关系的统计数据。排除标准为：描述睡眠障碍与结果变量之间关系的统计数据，部分消除了协变量；研究睡眠障碍不同测量方法之间相关性的研究。共有 49 篇已发表文章和 51 个样本的 15074 名参与者，产生了 209 个效应量。睡眠问题与更多的临床症状和较差的日间功能显著相关。亚组分析表明，睡眠问题与内化和外化症状以及执行功能的关系最强，其次是核心自闭症症状、家庭因素和适应功能。研究结果强调了睡眠问题对自闭症个体日间功能的深远影响，并支持通过整合护理模式继续将睡眠作为干预目标，以改善幸福感。
