Associations of autism diagnosis, traits, and genetic liability with subsequent night-time sleep duration trajectories from infancy to adolescence

Abstract Background Autistic individuals experience higher rates of sleep problems throughout their lives, and there is considerable heterogeneity in manifestations of these issues that remains unexplained. Here, we examine associations over time of heterogenous sleep trajectories with autism diagnosis, and behavioural and genetic factors related to autism. Method We used data from the Avon Longitudinal Study of Parents and Children (N=13,886, autistic n=150). The primary outcome was parent and self-reported night-time sleep duration, measured on 10 occasions (between 0.5y and 15.5y). The independent variables were autism diagnosis, autism polygenic score (PGS) and four parent-reported autistic traits: repetitive behaviour, social communication, speech coherence, and sociability. Latent class growth analysis was conducted to identify heterogenous classes of sleep trajectories, and these trajectory classes were regressed onto the independent variables. Results Four night-time sleep duration trajectory subclasses were identified; shorter (n=512, 4.1%), longer (n=1654, 13.1%), intermediate-shorter (n=3630, 28.8%), and intermediate-longer (used as the reference class; n=6825, 54.1%). An autism diagnosis was associated with a shorter or intermediate-shorter sleep duration trajectory, compared to the reference class. Similarly, higher scores in domains of repetitive behaviour, speech coherence and social communication were associated with shorter sleep duration trajectories. The autism PGS and sociability were not associated with any sleep trajectories compared to the intermediate-longer sleep trajectory (reference group). Conclusion An autism diagnosis and specific autistic traits were associated with poorer long-term sleep outcomes across childhood and adolescence, highlighting the need for early, sustained sleep interventions, and the potential of trait-specific mechanisms for sleep problems. Highlights Four distinct night-time sleep duration trajectories were identified across development Autism diagnosis predicted shorter and intermediate-shorter sleep trajectories Specific (but not all) autistic traits were linked to shorter sleep trajectories Autism PGS did not predict sleep duration trajectories