Miner Stacy, McVoy Molly, Damato Elizabeth
Kent State University.
Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center.
Res Sq. 2023 Mar 23:rs.3.rs-2674526. doi: 10.21203/rs.3.rs-2674526/v1.
Autism spectrum disorder (ASD) is one of the most puzzling disorders of childhood. Recent research of comorbidities that accompany ASD and are commonly attributed to the diagnosis, indicate that they may contribute to the severity of behavioral symptoms of the disorder.Disturbed sleep in all children can decrease cognition, decrease focus, increase performance problems, and alter mood and behavior. Children with ASD experience an increased sensitivity to disturbed sleep that may increase the severity of the disorder. Disturbed sleep patterns, such as increased sleep latency, nighttime waking and early arousal, have been identified in up to 80% of children with ASD. This study explored the relationship of disturbed sleep and the severity of the core ASD symptoms.
Actigraphy and an accompanying sleep diary captured disturbed sleep patterns in 24 children, ages 6-12, with ASD. Participants wore a GT3X actigraphy monitor for 7 nights to collect data on patterns of disturbed sleep. Parents completed a sleep diary and the Autism Spectrum Rating Scale (ASRS) questionnaire.A descriptive analysis was used to report the characteristics of nighttime sleep and sleep efficiency as well as sleep disturbances. Pearson's r determined the relationships between the number of sleep disturbances and the severity of ASD behavioral scores and diagnostic severity (determined by the ASRS).
Of the 24 study participants, almost 92% had one or more sleep disturbances. A positive correlation was present between the number of sleep disturbances and the severity of delays in social and communication symptoms. A moderate effect size was found between the number of sleep disturbances and unusual behaviors in ASD suggests a possible, unanticipated, inverse relationship.
Exploring the relationship of disturbed sleep to behavior and symptom severity in children with ASD can provide an understanding of how poor sleep influences ASD symptoms. This study identified distinct differences in ASD symptom severity between and within individual participants and found unique, and unexpected, symptom patterns. This finding supports the need, in research and treatment, to identify comorbidities and symptoms that contribute to individual behavioral profiles and phenotypes of the disorder.
自闭症谱系障碍（ASD）是儿童期最令人困惑的疾病之一。最近对伴随ASD且通常归因于该诊断的共病的研究表明，它们可能会加重该疾病行为症状的严重程度。所有儿童睡眠紊乱都会降低认知能力、注意力不集中、增加行为问题，并改变情绪和行为。患有ASD的儿童对睡眠紊乱更为敏感，这可能会加重疾病的严重程度。睡眠模式紊乱，如入睡潜伏期延长、夜间醒来和早醒，在高达80%的ASD儿童中都有发现。本研究探讨了睡眠紊乱与ASD核心症状严重程度之间的关系。
采用活动记录仪和配套的睡眠日记记录24名6至12岁ASD儿童的睡眠紊乱模式。参与者佩戴GT3X活动记录仪7晚，以收集睡眠紊乱模式的数据。家长完成睡眠日记和自闭症谱系评定量表（ASRS）问卷。采用描述性分析报告夜间睡眠特征、睡眠效率以及睡眠障碍情况。通过皮尔逊积矩相关系数（Pearson's r）确定睡眠障碍数量与ASD行为评分严重程度以及诊断严重程度（由ASRS确定）之间的关系。
在24名研究参与者中，近92%的人存在一种或多种睡眠障碍。睡眠障碍数量与社交和沟通症状延迟的严重程度之间存在正相关。在睡眠障碍数量与ASD异常行为之间发现了中等效应量，这表明可能存在一种意想不到的反向关系。
探索睡眠紊乱与ASD儿童行为及症状严重程度之间的关系，有助于理解睡眠不佳如何影响ASD症状。本研究发现了个体参与者之间以及个体内部ASD症状严重程度的明显差异，并发现了独特且意想不到的症状模式。这一发现支持在研究和治疗中识别导致该疾病个体行为特征和表型的共病及症状的必要性。
