Sleep Disturbances and Behavioural Phenotypes in Children With Autism Spectrum Disorder: A Comparative Study With Typically Developing Peers

OBJECTIVES: The primary objective of this study was to investigate the relationship between different types of sleep problems and specific behavioural difficulties in children and adolescents with autism spectrum disorder (ASD), compared with typically developing children (TDC). METHOD: We compared 40 children and adolescents with ASD and normal intellectual functioning with 50 TDC using the Sleep Disturbance Scale for Children (SDSC), the Conners' Parent Rating Scale-Revised Short (CPRS-RS) and the Repetitive Behaviour Scale-Revised (RBS-R). RESULTS: Participants with ASD had significantly higher scores on CPRS-RS inattention, hyperactivity and stereotyped, self-injurious, compulsive, routine, sameness and restricted behaviours, in addition to higher RBS-R scores. The ASD group also scored higher on the SDSC initiating and maintaining sleep subscale. Correlation analyses demonstrated significant associations between repetitive behaviours and multiple domains of sleep disturbances in the ASD group, whereas no significant correlations remained after Bonferroni correction in the TDC group. Regression analyses revealed that sleep breathing problems were associated with RBS-R Total (β = 0.590, p = 0.001); arousal/waking with compulsive behaviours (β = 0.394, p = 0.014); and sameness behaviours with both timing (β = 0.542, p = 0.012) and overall sleep problems (β = 0.516, p = 0.002) in the ASD group. CONCLUSIONS: In this study, sameness behaviours, compulsive behaviours and total RBS-R scores were significantly associated with several sleep problems in children and adolescents with ASD. These findings add to the literature demonstrating robust associations between specific types of sleep problems and particular behavioural difficulties in this population.