Wenzell Megan L, Ievers-Landis Carolyn E, Kim Sehyun, DeSimio Samantha, Neudecker Mandy, Aaron Siobhan, Wierenga Kelly, Miao Meng, Williamson Ariel A
Frances Payne Bolton School of Nursing, Case Western Reserve University, 9501 Euclid Ave, Cleveland, OH, 44106, USA.
Reserve University School of Medicine, University Hospitals Rainbow Babies & Children's Hospital, 11100 Euclid Ave, Cleveland, OH, 44106-6038, USA.
J Autism Dev Disord. 2025 Apr 5. doi: 10.1007/s10803-025-06807-x.
Given the high prevalence of sleep problems in children with autism spectrum disorder (ASD), there is a critical need to examine how sleep problems may be exacerbated for children exposed to social and environmental adversity. Guided by the socio-ecological model, this review aimed to evaluate factors linked to sleep health disparities (SHDs) in children with ASD, determine possible gaps/limitations in existing literature, and identify possible solutions. A scoping review was selected to ascertain what is known about SHDs in ASD. Four databases identified articles from 2004 to 2023. Included articles were those conducted in children with ASD that focused on sleep and examined socio-ecological factors (i.e., individual, family, neighborhood and socio-cultural) possibly contributing to SHDs. 41 studies were extracted; 31 (75.6%) focused on individual factors, 27 (65.9%) focused on family factors, 11 (26.8%) focused on neighborhood and/or socio-cultural factors; 3 (7.3%) focused on factors across all three socio-ecological levels. Six studies included interventions that found improvements in child sleep, behavior, and quality of life. Representation of racial and ethnic minoritized groups was limited across studies. Most studies focused on individual child factors associated with sleep problems, with less research focused on family factors, and very few studies examining broader neighborhood and socio-cultural factors. Only about half of studies reported race and ethnicity data, with sparse representation of racial and ethnic minoritized children and families overall. These findings highlight the need for future research on modifiable socio-ecological factors to guide equitable sleep interventions for children with ASD.
鉴于自闭症谱系障碍（ASD）儿童中睡眠问题的高患病率，迫切需要研究对于面临社会和环境逆境的儿童而言，睡眠问题是如何可能会加剧的。在社会生态模型的指导下，本综述旨在评估与ASD儿童睡眠健康差异（SHD）相关的因素，确定现有文献中可能存在的差距/局限性，并找出可能的解决方案。本研究选择了一项范围综述，以确定关于ASD中SHD的已知情况。通过四个数据库检索了2004年至2023年的文章。纳入的文章是针对ASD儿童开展的，聚焦于睡眠，并研究了可能导致SHD的社会生态因素（即个体、家庭、邻里和社会文化因素）。共提取了41项研究；31项（75.6%）聚焦于个体因素，27项（65.9%）聚焦于家庭因素，11项（26.8%）聚焦于邻里和/或社会文化因素；3项（7.3%）聚焦于所有三个社会生态层面的因素。六项研究纳入了干预措施，发现儿童的睡眠、行为和生活质量有所改善。各研究中少数族裔群体的代表性有限。大多数研究聚焦于与睡眠问题相关的个体儿童因素，较少有研究关注家庭因素，极少有研究考察更广泛的邻里和社会文化因素。只有约一半的研究报告了种族和民族数据，总体上少数族裔儿童和家庭的代表性不足。这些发现凸显了未来需要对可改变的社会生态因素进行研究，以指导针对ASD儿童的公平睡眠干预措施。
