Child sleeping behaviors that influence sleep problems in parents of children with autism spectrum disorder: preliminary study

Objective: The main purpose of this study was to characterize the child’s aberrant and sleep behaviors that affect sleep quality and problems in parents of children with autism spectrum disorders (ASD). We hypothesized firstly, when ASD’s increased stereotypic and self-injurious behaviors exist, parents’ sleep problem severity increased. Second, child problem sleep habits, especially bedtime resistance,affect mothers more frequently because mothers participate more in sleeptime rituals of their child. Additionally, we compare sleep quality and disturbances between parents of children with ASD and typically developing (TD) children.

Methods: In this preliminary study, 30 families of children with ASD and 30 families of TD children completed Children’s Sleep Habits Questionnaire (CSHQ). Fathers and mothers of children completed Pittsburgh Sleep Quality Index (PSQI), individually. Additionally, parents of ASD children completed Aberrant Behavior Checklist (ABC). Families were included if they had a child aged 3 to 11years. For both groups, exclusion criteria was the presence of a family member with neurodevelopmental and mood disorder treatment history. Also, none of the ASD children have a mood disorder history.

Results: In the present investigation, diagnoses for children with ASDs were composed of Autism (n=22), Asperger Syndrome (n=3), and Pervasive Developmental Disorder not Otherwise Specified (PDD-NOS) (n=4). According to Pearson bivariate correlation analysis, stereotypic behavior has positive correlations with PSQI sleep disturbances score of the ASD child’s mother and father, father’s sleep latency and total score (p=0.05). Lethargy/Social Withdrawal behavior and irritability have positive correlations with father’s sleep disturbances score (p=0.05). The comparison of the father’s and mother’s sleep problems have only significant difference in subscale scores where sleep latency and daytime functioning in mothers are higher than we expected. In comparison with the community group, ASD mothers have a significantly higher PSQI total score and five subscales of PSQI. Fathers have only one significant difference, in subjective sleep quality scores.

Conclusion: Contrary to the hypothesis, there is no relationship between any aberrant behavior and parents’ sleep, except for fathers’ total PSQI score and stereotypic behaviors. Stereotypic behaviors also have a correlation with fathers’ sleep latency and disturbances and mothers’ sleep disturbances. As we expected, ASD parents have poorer subjective sleep quality compared to TD parents. While unexpected, fathers’ total score and subscales score were similar between the two groups. Fathers’ stressors (work schedule and smoking) may have a huge impact on this situation. Scores on CSHQ of ASD children show that mothers’ subjective sleep quality is mostly affected by bedtime resistance, sleep anxiety, and actual sleep time, respectively, whereas fathers are only affected by bedtime resistance. The results of the study confirm that when bedtime resistance behaviors are present in children with autism, they have a greater impact on parents’ sleep, mostly mothers, than when the same behaviors are present in typically developing children. Furthermore, we suggest that future studies should include measures about reasons for the special bedtime resistance and other contributing factors.