Chen Hongyu, Yang Ting, Chen Jie, Ding Yuan, Xiang Xueli, Wei Qiuhong, Mou Qiuhong, Yuan Binlin, Hu Binyue, Zhang Danyang, Ai Dan, Li Tingyu
Children's Nutrition Research Center, Children's Hospital of Chongqing Medical University, Chongqing Key Laboratory of Child Neurodevelopment and Cognitive Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Chongqing, China.
Growth, Development, and Mental Health of Children and Adolescence Center, Children's Hospital of Chongqing Medical University, Chongqing, China.
Front Psychiatry. 2025 May 16;16:1574814. doi: 10.3389/fpsyt.2025.1574814. eCollection 2025.
Social jet lag (SJL) is a form of circadian rhythm misalignment caused by the mismatch between social schedules and biological clocks, which is associated with cognition, behavior, and emotion in children. However, social jet lag among children with autism spectrum disorders (ASD) and its impacts are unknown.
This cross-sectional study recruited 2-7-year-old children with ASD from special education institutions and outpatient clinics. The Children's Sleep Habits Questionnaire (CSHQ) assessed children's sleep. SJL was calculated as |weekend sleep midpoint - weekday sleep midpoint|. Sleep adequacy was determined based on the National Sleep Foundation's recommendations. Core symptoms were evaluated using the Childhood Autism Rating Scale (CARS), Social Responsiveness Scale (SRS), and Autism Behavior Checklist (ABC). Developmental level was assessed using the Gesell Developmental Scale.
Our study found for the first time a correlation between SJL and core symptoms in 2-3-year-old children with ASD. This finding suggests that SJL may have a potentially negative impact on core symptoms in ASD. Therefore, it is crucial to emphasize the importance of regular routines for ASD, especially in younger children.
社会时差（SJL）是一种昼夜节律失调的形式，由社会日程安排与生物钟不匹配所致，这与儿童的认知、行为和情绪相关。然而，自闭症谱系障碍（ASD）儿童中的社会时差及其影响尚不清楚。
这项横断面研究从特殊教育机构和门诊招募了2至7岁的ASD儿童。儿童睡眠习惯问卷（CSHQ）用于评估儿童的睡眠情况。社会时差计算为|周末睡眠中点 - 工作日睡眠中点|。根据美国国家睡眠基金会的建议确定睡眠充足情况。使用儿童自闭症评定量表（CARS）、社会反应量表（SRS）和自闭症行为检查表（ABC）评估核心症状。使用盖塞尔发育量表评估发育水平。
1）ASD儿童睡眠问题的患病率为49.8%，CSHQ总分平均为48.04。周末和工作日的睡眠模式存在显著差异，表现为就寝时间更晚、起床时间延迟、总睡眠时间增加以及周末睡眠不足患病率降低。2）2至3岁组睡眠不足率最高（工作日为80.77%；周末为82.17%）。不同年龄组的睡眠时间无显著差异，中位睡眠时间为9.5至10小时。3）各年龄组的社会时差中位数分别为0.25小时（2至3岁）、0.5小时（3至4岁）、0.42小时（4至5岁）和0.5小时（≥5岁）。在2至3岁儿童中，社会时差与核心症状显著正相关。4）仅在≥3岁组中观察到社会时差与个人社交发育水平存在弱关联（r = 0.100，p = 0.042）。
我们的研究首次发现2至3岁ASD儿童的社会时差与核心症状之间存在相关性。这一发现表明社会时差可能对ASD的核心症状产生潜在负面影响。因此，强调ASD儿童规律作息的重要性至关重要，尤其是年幼的儿童。
