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. 2023 Jul 21;15(1):21.
doi: 10.1186/s11689-023-09491-z.

Sleep disturbances are associated with irritability in ASD children with sensory sensitivities

Alona Molcho-Haimovich  1   2 , Liat Tikotzky  3 , Gal Meiri  4   5 , Michal Ilan  3   4   5 , Analya Michaelovski  4   6 , Hen Schtaierman  7 , Hava M Golan  4   8 , Yair Sadaka  9 , Idan Menashe  4   10 , Ilan Dinstein  3   4   11
Affiliations

Sleep disturbances are associated with irritability in ASD children with sensory sensitivities

Alona Molcho-Haimovich et al. J Neurodev Disord. .

Abstract

Background: Parent reports suggest that 44-84% of children with ASD exhibit sleep disturbances that are of clinical concern. Previous studies have reported that, in children with ASD, the severity of sleep disturbances is associated with the severity of either sensory problems or aberrant behaviors, but none have performed combined analyses with measures of both sensory and aberrant behaviors symptom domains from the same children.

Methods: We examined parent reports of 237 children with ASD, 1.4-8.7 years old, using the child sleep habits questionnaire (CSHQ), sensory profile (SP), and aberrant behaviors checklist (ABC).

Results: The analyses revealed that sleep disturbances were most strongly associated with SP sensory sensitivity and ABC irritability scores. Together these scores explained 35% of the variance in total CSHQ scores. Moreover, sensory sensitivity scores moderated the association between irritability and sleep disturbances, indicating that sleep disturbances were significantly associated with irritability only in children with moderate to severe sensory sensitivities.

Conclusion: We suggest that the three symptom domains may interact and exacerbate each other such that successful intervention in one symptom domain may have positive impact on the others. Further intervention studies testing this hypothesis are highly warranted.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Overview of the sleep disturbances, aberrant behaviors and sensory problems in the examined cohort. A Probability density function of CSHQ total sleep disturbance scores. Vertical dashed line: cutoff of 41 indicative of clinically significant sleep disturbances. B Percentage of children with Sensory Profile scores that were ≥ 2 standard deviations above the general population mean. Horizontal line: expected percentage of individuals in the general population with scores of 2 standard deviations or above assuming a normal distribution. C Box plot figures of the five ABC subscale scores: irritability, social withdrawal, stereotypical behavior, hyperactivity, and inappropriate speech. D Box plot figures of the four SP subscale scores: sensation seeking, sensation avoiding, sensory sensitivity, and low registration. Bold line: median of each distribution
Fig. 2
Fig. 2
Scatter plots demonstrating the correlations between CSHQ and SP scores for each of the four domains: Sensory Seeking. Sensory Avoiding, Sensory Sensitivity, and Low Registration. Each point represents a single child. Line: linear squares fit. Pearson’s correlation coefficients and corresponding p values are noted on each panel
Fig. 3
Fig. 3
Scatter plots demonstrating the correlations between CSHQ and ABC scores for each of the five subscales: A Irritability. B Social Withdrawal. C Stereotypical Behavior. D Hyperactivity. E Inappropriate Speech. Each point represents a single child. Line: linear squares fit. Pearson’s correlation coefficients and corresponding p values are noted on each panel
Fig. 4
Fig. 4
Simple slope analysis demonstrates the moderating effect of sensory sensitivity on the relationship between irritability and CSHQ total scores. Blue line: children with sensory sensitivity scores of 0, -1, or -2. Purple line: children with sensory scores of 1. Red line: children with sensory scores of 2
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