Sleep characteristics in young children with autism spectrum disorder: a case control study

Objective This study aims to compare the differences in sleep characteristics between autistic children and typically developing children, with a focus on sleep timing, duration, and patterns. Methods This study included 246 children with autism from an autism cohort and 246 age-matched typically developing children selected as controls. Sleep-related data were collected using structured questionnaires and interviews, along with demographic, socioeconomic, and sleep-related variables. Sleep duration was expressed in hours, and sleep timing variables were converted into decimal hours for analysis. Multivariable linear and logistic regression analyses were performed to assess between-group differences after adjusting for relevant confounding factors. Results In the weekday sleep pattern, children with autism showed later sleep onset (adjusted β  = 0.55, 95% CI: 0.27–0.82) and later wake-up time (adjusted β  = 0.41, 95% CI: 0.25–0.58), along with shorter sleep duration (adjusted β  = −0.26, 95% CI: −0.47–−0.04). In the weekend sleep pattern, children with autism exhibited significantly later wake-up time (adjusted β  = 0.55, 95% CI: 0.32–0.79) and shorter sleep duration (adjusted β  = –0.29, 95%CI:–0.56–−0.03). Regarding circadian sleep timing characteristics, autism status was positively associated with sleep midpoint on both weekdays (adjusted β  = 0.54, 95% CI: 0.39–0.70) and weekends (adjusted β  = 0.75, 95% CI: 0.55–0.95) and was also significantly associated with a later corrected mid-sleep point on free days (MSFsc) (adjusted β  = 0.77, 95% CI: 0.57–0.97). Conclusion Children with autism exhibit notable sleep impairments, characterized by later sleep timing, shorter sleep duration, and more frequent nighttime awakenings. These findings suggest that sleep characteristics may be relevant for early identification and management in children with autism.