Richdale Amanda L, Morris Eric M J, Lawson Lauren P
Olga Tennison Autism Research Centre, La Trobe University, Melbourne, Australia.
Department of Psychology, Counselling and Therapy, La Trobe University, Melbourne, Australia.
Autism Res. 2025 Mar;18(3):468-475. doi: 10.1002/aur.3306. Epub 2025 Feb 3.
Despite substantial evidence linking insomnia with increased suicidality in non-autistic populations, its role in autism remains under-explored. Poor sleep, most commonly insomnia symptoms (hereafter insomnia), is a significant issue in autism, affecting up to 80% of autistic children and adults, compared with 30%-50% of children and about 45% of adults in the general population. Sleep, along with quality of life, anxiety, depression, and social well-being, is a top mental health research priority for autistic adults. These factors are all significantly associated with insomnia in both autistic and non-autistic individuals. Current findings highlight the association between depression, psychosocial factors, and suicidality in autistic individuals. Key factors in suicidality for autistic people include increased autistic traits, loneliness, lack of social support, and experiences such as camouflaging and burnout. What is under-explored is the role of sleep in suicidality and mental health in autism. Effective psychological interventions for insomnia in autistic individuals are lacking, and there is limited understanding of whether treating insomnia can reduce suicidality. Only two pilot studies have investigated insomnia treatments for autistic adults. In this commentary, we argue that, given the high rate of suicidality in autism and the potential role of insomnia, it is crucial to investigate whether insomnia contributes to suicidality in autistic people and if addressing sleep through prevention strategies, supports, and interventions improves outcomes. Collaboration with the autistic community is essential for addressing this knowledge gap and developing effective interventions.
尽管有大量证据表明在非自闭症人群中失眠与自杀倾向增加有关，但其在自闭症中的作用仍有待深入研究。睡眠不佳，最常见的是失眠症状（以下简称失眠），是自闭症中的一个重要问题，影响高达80%的自闭症儿童和成人，而普通人群中儿童的这一比例为30%-50%，成人约为45%。睡眠与生活质量、焦虑、抑郁和社会幸福感一样，是自闭症成年人心理健康研究的首要重点。这些因素在自闭症和非自闭症个体中均与失眠显著相关。目前的研究结果突出了自闭症个体中抑郁、心理社会因素与自杀倾向之间的关联。自闭症患者自杀倾向的关键因素包括自闭症特征增加、孤独、缺乏社会支持以及伪装和倦怠等经历。尚未充分探索的是睡眠在自闭症自杀倾向和心理健康中的作用。自闭症个体缺乏有效的失眠心理干预措施，对于治疗失眠是否能降低自杀倾向的了解也有限。仅有两项试点研究调查了针对自闭症成年人的失眠治疗方法。在这篇评论中，我们认为，鉴于自闭症患者的高自杀率以及失眠的潜在作用，研究失眠是否导致自闭症患者自杀倾向，以及通过预防策略、支持和干预来解决睡眠问题是否能改善结果至关重要。与自闭症群体合作对于填补这一知识空白和开发有效干预措施至关重要。
