Azrieli National Centre for Autism and Neurodevelopment Research, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
Department of Epidemiology, Biostatistics, and Community Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer-Sheva, 84105, Israel.
J Neurodev Disord. 2024 Jun 7;16(1):29. doi: 10.1186/s11689-024-09550-z.
Sleep disturbances are frequently reported in children with autism spectrum disorder (ASD) and are associated with the severity of co-occurring symptoms. This study's aim was to examine the extent of healthcare utilization and clinical outcomes associated with sleep disturbances in children with ASD.
A retrospective, cross-sectional study of 541 children with ASD from the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) whose parents completed the Children's Sleep Habits Questionnaire (CSHQ). Children with a total CSHQ score ≥ 48 were defined as having sleep disturbances. Sociodemographic characteristics, ASD diagnostic measures, chronic co-occurring conditions, medication usage, hospitalizations, visits to the emergency room (ER), and visits to specialists were compared in ASD children with and without sleep disturbances. Multivariate logistic regression models were then used to assess the independent association of sleep disturbances with clinical characteristics and healthcare utilization.
Of the 541 children with ASD, 257 (47.5%) had sleep disturbances. Children with sleep disturbances exhibited higher rates of multiple (≥ 3) co-occurring conditions (19.1% vs. 12.7%; p = 0.0414) and prescribed medications (45.5% vs. 32.7%; p = 0.0031) than other children. Finally, ASD children with sleep disturbances were 1.72 and 2.71 times more likely to visit the ER and be hospitalized than their counterparts (aOR = 1.72; 99%CI = 1.01-2.95; and aOR = 2.71; 99%CI = 1.10-6.67, respectively).
Our findings suggest that sleep disturbances are associated with greater healthcare utilization among children with ASD. Further studies could examine whether treating sleep disturbances in children with ASD yields additional clinical benefits beyond improvements in sleep.
自闭症谱系障碍（ASD）儿童常报告睡眠障碍，且这些障碍与共病症状的严重程度相关。本研究旨在探讨 ASD 儿童睡眠障碍与医疗保健利用和临床结局的关联程度。
这是一项回顾性、横断面研究，纳入了来自 Azrieli 国家自闭症和神经发育研究中心（ANCAN）的 541 名 ASD 儿童，其父母完成了儿童睡眠习惯问卷（CSHQ）。CSHQ 总分≥48 分的儿童被定义为存在睡眠障碍。比较 ASD 儿童中存在和不存在睡眠障碍者的人口统计学特征、ASD 诊断测量、慢性共病、药物使用、住院、急诊室（ER）就诊和专科就诊情况。然后，使用多变量逻辑回归模型评估睡眠障碍与临床特征和医疗保健利用的独立关联。
在 541 名 ASD 儿童中，257 名（47.5%）存在睡眠障碍。与其他儿童相比，存在睡眠障碍的儿童共病（≥3 种）的比例更高（19.1% vs. 12.7%；p=0.0414），使用的药物也更多（45.5% vs. 32.7%；p=0.0031）。最后，存在睡眠障碍的 ASD 儿童去 ER 和住院的可能性分别是其他儿童的 1.72 倍和 2.71 倍（aOR=1.72；99%CI=1.01-2.95；和 aOR=2.71；99%CI=1.10-6.67）。
我们的发现表明，睡眠障碍与 ASD 儿童的医疗保健利用增加相关。进一步的研究可以考察在 ASD 儿童中治疗睡眠障碍是否除了改善睡眠之外还能带来额外的临床获益。
