Patterns of sleep disturbances and associations with depressive symptoms in autistic young adults

Abstract

Autistic individuals are at an increased risk for both sleep disturbances and depression. While studies in the general population and in autistic adults have drawn general links between sleep disturbances and mental health, few studies have examined the extent to which specific sleep problems may be implicated in the extremely high rates of depression among autistic adults. This study aimed to describe the patterns of sleep disturbances in autistic young adults, and their associations with depressive symptoms while controlling for relevant demographic factors. A sample of 304 legally independent adults (age 18-35 years old) with a childhood diagnosis of autism spectrum disorder self-reported on their average sleep behaviors during the past week and depressive symptoms on the Beck Depressive Inventory-II. A significant proportion (86.01%) of autistic young adults experienced at least one of the primary sleep disturbances of interest, including short total sleep time (39.59%), poor sleep efficiency (60.07%), and delayed sleep phase (36.18%). Additionally, lower sleep efficiency and delayed sleep phase were both associated with higher depressive symptoms. The associations between sleep and depressive symptoms identified in our study suggest that sleep treatments may hold potential for ameliorating depressive symptoms in autistic adults who also experience sleep problems. Further research using daily sleep diaries and objective measures of sleep behaviors, as well as longitudinal studies, are needed to understand how changes in sleep may relate to changes in depressive symptoms in autistic adults.

Keywords: delayed phase; depression; sleep; sleep efficiency; young adults.

Figure 1.

Occurrence of sleep disturbances. TST: Disrupted total sleep time, SE: Disrupted sleep efficiency, CP: Delayed or advanced circadian phase. From the sample with all sleep variables available (N=293), 13.99% were determined to have none of the three primary sleep disturbances, 30.38% had one sleep disturbance (6.14% CP, 12.29% SE and 11.95% TST), 35.49% had two sleep disturbances (9.90% SE & CP, 7.85% TST & CP, and 17.75% TST & SE), and 20.14% had all three sleep disturbances.