The impact of sleep quality, fatigue and social well-being on depressive symptomatology in autistic older adolescents and young adults.

This study followed 114 autistic young people for 2 years to understand how sleep, tiredness, and social connections affect depression. Poor sleep and feeling tired were linked to more depression symptoms. Having good social connections helped protect against depression. The research shows that helping autistic young people with sleep problems, fatigue, and social relationships could be important for preventing or treating depression.

This longitudinal study examined relationships between sleep quality, fatigue, social well-being, and depression in 114 autistic young adults (aged 15-25) over two years. Results showed that fatigue and social contribution significantly predicted depression at baseline, while social contribution remained the only significant predictor at follow-up. Sleep quality worsened over time, though depression and fatigue scores remained stable. Mediation analyses revealed that social well-being partially mediated the relationship between sleep quality and depression, with fatigue trending toward significance as a mediator.

The findings suggest that sleep quality, fatigue, and social well-being independently contribute to depression in young autistic adults.

Results support multi-modal interventions addressing sleep hygiene, fatigue management, and social skill development for depression in autistic young adults. Social contribution appears particularly important for long-term depression prevention, suggesting community engagement programs may be beneficial.

Sample size of 114 participants limits generalizability. Study design unclear from abstract. Potential for selection bias in online longitudinal study. Causal relationships cannot be established despite longitudinal design. Self-report measures may introduce bias.

Depression and poor sleep quality commonly co-occur with autism, and depression has been associated with loneliness and reduced social support. In non-autistic samples, poor sleep quality and daytime fatigue also contribute to depression. However, the contribution of sleep quality and fatigue to depressive symptoms, and how they interact with social factors to influence depression in autism remain unexplored. Our aim was to examine these relationships in 114 young autistic adults aged 15-25 years (57% male) from the SASLA online, longitudinal study (baseline and 2-year follow-up).

Hierarchical multiple regression models examined the association between social well-being (social integration and social contribution; T1), sleep quality (T1, T2), and fatigue (T1, T2) on depression (T1, T2). Two mediation models were conducted on T1 data predicting depression from sleep quality though fatigue and sleep quality through social well-being. Depression and fatigue scores did not change over 2 years, but sleep quality worsened. The T1 regression model was significant (R= 36%) with fatigue and social contribution individually predicting depression symptomatology.

The longitudinal regression model was also significant (adjusted R= 57%) with social contribution (T1) as the only significant predictor of depression (T2). Fatigue trended towards mediating the sleep quality-depression relationship, while social well-being was a significant partial mediator of this relationship. Results highlight that sleep quality, fatigue, and social well-being contribute to depression among young autistic adults. Interestingly, fatigue and social well-being were independently associated with depression.

Thus, addressing sleep quality and associated fatigue, and social well-being is important when treating depression in autistic individuals.