Sleep Problems in Children with Autism Spectrum

Disorder: Examining the Role of Anxiety and Sensory

Over-Responsivity
Micah Mazurek,
1University

1,2
PhD

& Gregory Petroski,

Methods

Delahaye et al., 2014).

The etiology of sleep problems in ASD is thought to be multifactorial,

including possible disruption in circadian rhythms and melatonin
regulation, medical problems, or medication effects (Malow & McGrew, 2008;
Johnson & Malow, 2008).

Hyperarousal is often associated with insomnia in the general population

(Riemann et al., 2010) and may also underlie sleep difficulties for children with
ASD, particularly given their increased risk for arousal-related symptoms.
Emerging evidence suggests that arousal-related symptoms, specifically
sensory over-responsivity and anxiety, may be related to the development
and maintenance of sleep problems in children with ASD.

Correlations by Age Group

Data were collected at AS ATN enrollment

Primary Measures:
Demographic Information
Child Behavior Checklist (CBCL) Anxiety Problems Scale
Short Sensory Profile (Sensory Over-Responsivity [SOR] created score)
Childrens Sleep Habits Questionnaire (CSHQ) subscales
Full Scale IQ score (various measures)

Data Analyses
Data Analysis Plan
Pearsons correlation coefficients
Bivariate relationships between anxiety, SOR & sleep problems
Path modeling techniques (fitting a single model)
CSHQ subscales as dependent variables
SOR and anxiety as independent variables
IQ, age and gender as covariates

Objectives

1
PhD

of Missouri, 2Thompson Center for Autism & Neurodevelopmental Disorders

Background
Sleep problems are common among children with autism spectrum
disorder (ASD) (Richdale & Schreck, 2009) and can have significant detrimental
effects on daytime functioning (Schreck, Mulick & Smith, 2004; Goldman et al., 2012;

Working collaboratively across North

America, to address the physical health of
children and adolescents with autism.

Anxiety
Ages 2-5

Ages 6-18

Ages 2-5

Ages 6-18

SOR

-.46***

-.39***

--

--

Bedtime Resistance

.31***

.24***

-.12**

-.18***

Sleep Onset Delay

.21***

.15***

-.17**

-.16***

Sleep Duration

.29***

.23***

-.25***

-.19***

Sleep Anxiety

.42***

.36***

-.23***

-.29***

Night Wakings

.29***

.14***

-.21***

-.09**

*p < .05, **p < .01, ***p < .001

Conclusions

Final Path Model: Ages 6-18

Final Path Model: Ages 2-5

SOR

To examine the bivariate and multivariate

relations among anxiety, sensory overresponsivity, and specific sleep problems in
children and adolescents with ASD

Children with ASD who have anxiety and SOR

are at increased risk for sleep problems.
These results support the idea that
hyperarousal may underlie sleep problems for
many children with ASD.
Future research is needed, including:

Participants

Chi-sq
DF
PR>Chi-sq
CFI
RMSEA
RMSEA LL
RMSEA UL

1347 children (2 17.6 years) with ASD enrolled

in the Autism Speaks Autism Treatment Network
(AS ATN) clinical registry database
Majority male (84.8%) and Caucasian (90.6%)

12.9
13
0.46
1.00
0.00
0.00
0.05

Chi-sq
DF
PR>Chi-sq
CFI
RMSEA
RMSEA LL
RMSEA UL

6.29
8
0.62
1.00
0.00
0.00
0.03

Physiological measures of arousal

Objective measures of sleep
Longitudinal designs
Treatment studies focusing on arousal

Continued research on this topic is essential to

inform understanding of etiology and targeted
treatments.

Note: Displayed paths are the statistically significant (p < 0.05) regression relationships. Covariance terms are suppressed for simplicity.

Collaborating with the ATN

Acknowledgements

To obtain access to the ATN Custom Forms or for information on collaborative

research activities, please go to: www.asatn.org

This project is/was supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)
under cooperative agreement UA3 MC11054 Autism Intervention Research Network on Physical Health. This information or content and conclusions are
those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S.
Government. This work was conducted through the Autism Speaks Autism Treatment Network serving as the Autism Intervention Research Network on
Physical Health.