Cognitive behavioural therapy and related interventions for sleep disorders in children and adults with autism spectrum disorder: protocol for a systematic review and meta-analysis.

This study outlines a plan to review all research on whether talk therapy (CBT) can help autistic people sleep better. More than half of autistic children and adults have sleep problems like trouble falling asleep or waking up frequently during the night. These sleep issues make daily life harder and affect wellbeing. While some early studies suggest CBT might help, researchers want to look at all available studies together to get a clearer picture of whether this approach really works for improving sleep in autistic people.

This is a protocol for a systematic review and meta-analysis examining cognitive behavioural therapy (CBT) interventions for sleep disorders in autistic children and adults. Sleep problems affect more than half of autistic individuals, causing prolonged sleep onset and fragmented sleep that worsens functional impairments and quality of life. While preliminary studies suggest CBT may improve sleep quality in autism, no comprehensive systematic review has been conducted. The planned review will search multiple databases through May 2025, including randomised controlled trials and observational studies involving autistic individuals with moderate sleep problems.

The authors will assess intervention effects on various sleep measures and conduct meta-analysis to synthesise evidence on CBT efficacy for improving sleep quality in autism spectrum disorder.

Once completed, this systematic review may provide crucial evidence for clinicians treating sleep disorders in autistic individuals. The findings could inform evidence-based treatment guidelines and help determine whether CBT should be recommended as a first-line intervention for sleep problems in autism spectrum disorder, potentially improving both sleep quality and overall functional outcomes.

This is a protocol paper describing a planned systematic review, not actual research findings. The review has not yet been conducted, so no data on CBT effectiveness is presented. The protocol does not specify inclusion/exclusion criteria details or planned statistical analysis approaches beyond basic methodology.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterised by deficits in social communication and repetitive behaviours, often accompanied by sleep disturbances. These sleep problems, including prolonged sleep latency and fragmented sleep, affect more than half of autistic individuals, exacerbating functional impairments and diminishing quality of life. Cognitive behavioural therapy (CBT) has shown promise in addressing sleep disturbances in ASD, with preliminary studies indicating improvements in sleep quality. However, no systematic review has comprehensively summarised the effects of CBT on sleep in autistic individuals.

This systematic review and meta-analysis will synthesise evidence on the efficacy of CBT for improving sleep quality in individuals with ASD. We will search multiple databases (eg, PubMed, Web of Science) for studies published until May 2025. Inclusion criteria encompass randomised controlled trials, single-arm studies and observational studies involving children and adults with ASD and moderate sleep problems. Interventions targeting sleep quality using CBT techniques will be considered.

Data extraction will focus on study details, participant information, intervention specifics and sleep outcome measures (eg, total sleep time, sleep onset latency, etc). Risk of bias will be assessed using tools such as Cochrane Risk of Bias Tool V.2, Risk Of Bias In Non-randomised Studies-of Interventions and Review Manager 5.3. A meta-analysis will be conducted using Stata 18, with heterogeneity evaluated using the I² statistic and Cochran's Q test. Given that the dataset for this investigation is derived from publicly accessible databases, there is no direct interaction with patients; thus, ethical approval is not required.

CRD42025643701.