Written by:
An illustration of a person lying awake in bed.

Autism & sleep problems: Effects

Last updated on March 2, 2021 by Martin Silvertant

This is part 3 of a 4-part series on autism and sleep problems

Autism & sleep problems: Prevalence
Autism & sleep problems: Causes
Autism & sleep problems: Effects
Autism & sleep problems: Solutions


Research shows that sleep problems worsen autism symptoms across most core domains[1]The relationship between sleep and behavior in autism spectrum disorder (ASD): a review—particularly in the social domain[2]Sleep problems as possible predictors of intensified symptoms of autism—and were the highest predictor of challenging behaviors in autism.[3]Sleep, anxiety and challenging behaviour in children with intellectual disability and/or autism spectrum disorder


Correlations with dysfunctions

Autistic children experience more sleep-related anxiety, night waking, parasomnias, sleep-disordered breathing, and daytime sleepiness than neurotypicals.[4]Sleep and Executive Functioning Among High-IQ School-Aged Children with Autism

Certain sleep problems were found to correlate with certain dysfunctions:[5]Sleep and Executive Functioning Among High-IQ School-Aged Children with Autism

  • Sleep duration and resistance to falling asleep correlated with behavioral regulation and executive dysfunction.
  • The ability to fall asleep quickly correlated with working memory.
  • The ability to remain asleep through the night correlated with accuracy and efficiency of inhibiting conflicting information.

Sleep disorders

A study from 2015 that investigated the correlation between sleep disorders and the behavior of autistic people found correlations between sleep disorders and thinking- and behavioral problems:[6]Influence of sleep disorders on the behavior of individuals with autism spectrum disorder

  • Disorders of arousal (sleepwalking, sleep terrors, and confusional arousals) were correlated with thinking problems.
  • Disorders of excessive somnolence (i.e. desire to sleep) were correlated with thinking and behavioral problems.

The high frequency of sleep disorders was found to correlate with some of the behavioral traits that autistic people already exhibit (see below).[7]Influence of sleep disorders on the behavior of individuals with autism spectrum disorder


Behavioral traits

In terms of the effects of sleep problems on behavior, autistic people experience more social anxiety, depression, withdrawal, somatic complaints, attention issues, thought complaints, delinquency, aggression, internalizing (dealing with stressors in ways that don’t manifest externally), and externalizing (an unconscious defense mechanism where a person projects their own internal characteristics onto the outside world—in particular onto other people).[8]Influence of sleep disorders on the behavior of individuals with autism spectrum disorder

In the diagram below you can see how autistic people compare to neurotypicals on these behavioral problems.[9]Influence of sleep disorders on the behavior of individuals with autism spectrum disorder

Embrace ASD | Autism & sleep problems: Effects | diagram
Comparison of clinical (abnormal) or borderline values in the scores for behavioral problems between autistics and controls.

So it’s these areas that are likely predominantly affected by sleep problems. Speaking from personal experience, my aggression and volatility, as well as my anxiety certainly go up, whereas cognitive functions decrease.


Sleep & challenging behaviors

Studies exploring the relationship between sleep and challenging behaviors in autism found:[10]The relationship between sleep and behavior in autism spectrum disorder (ASD): a review


Embrace ASD | Autism & sleep problems: Effects | icon Sleep2

Next: Autism & sleep problems: Solutions

References

References
1, 10The relationship between sleep and behavior in autism spectrum disorder (ASD): a review
2, 11Sleep problems as possible predictors of intensified symptoms of autism
3, 18Sleep, anxiety and challenging behaviour in children with intellectual disability and/or autism spectrum disorder
4, 5Sleep and Executive Functioning Among High-IQ School-Aged Children with Autism
6, 7, 8, 9Influence of sleep disorders on the behavior of individuals with autism spectrum disorder
12Sleep disturbances and correlates of children with autism spectrum disorders
13Sleep disturbance and its relation to DSM-IV psychiatric symptoms in preschool-age children with pervasive developmental disorder and community controls
14Sleep problems, sleepiness and daytime behavior in preschool-age children
15, 16Variables related to sleep problems in children with autism
17Defining the sleep phenotype in children with autism
19The relation among sleep, routines, and externalizing behavior in children with an autism spectrum disorder
20Sleep is associated with problem behaviors in children and adolescents with Autism Spectrum Disorders
21The relationship between sleep problems and daytime behavior in children of different ages with autism spectrum disorders
22Sleep and daytime functioning: a short-term longitudinal study of three preschool-age comparison groups
23Children With Autism: Sleep Problems and Symptom Severity
24Sleep problems and their correlates and comorbid psychopathology of children with autism spectrum disorders
25Sleep disruption as a correlate to cognitive and adaptive behavior problems in autism spectrum disorders
26, 27Correlates and risk markers for sleep disturbance in participants of the Autism Treatment Network
28An investigation of comorbid psychological disorders, sleep problems, gastrointestinal symptoms and epilepsy in children and adolescents with Autism Spectrum Disorder
29Sleep in high-functioning children with autism: longitudinal developmental change and associations with behavior problems

Adaptive skills, Attention deficit hyperactivity disorder (ADHD), Autistic symptoms, Behavioral problems, Behavioral regulation, Behavioral traits, Depression, Disorders of arousal, Disorders of somnolence, Executive dysfunction, Externalization, Insomnia, Internalization, Kryptonite, Sleep disorders, Sleep problems, Social anxiety, Social challenges, Somatization, Stereotypic behavior, Withdrawal, Working memory


Martin Silvertant

Martin Silvertant

Co-founder of Embrace ASD, autism researcher, writer, ironically silver award-winning graphic designer, and type designer. I am also autistic, and I fight dodecahedragons during sleep onset.

Subscribe
Notify of
guest
7 Comments
Newest
Oldest
Inline Feedbacks
View all comments
7
0
Would love your thoughts, please comment.x
()
x