Associations between sleep problems, cortical morphometry, and structural brain network organization in preschool children with autism: a retrospective observational study.

Researchers studied brain scans of 183 preschool children with autism to see how sleep problems might affect brain development. They found that children with sleep troubles had different patterns of brain connections, especially in areas involved in processing senses and social information. However, the overall size of brain regions was similar between groups. The study suggests sleep problems might impact how the brain develops in young autistic children, but more research is needed to understand what this means.

This retrospective study examined brain structure and network organization in 183 preschool children with autism, comparing those with and without sleep problems using questionnaire data. While no significant differences were found in overall brain volumes, children with sleep problems showed disrupted local brain network connectivity, particularly reduced clustering coefficient and local efficiency, with altered small-world network properties. Exploratory analyses suggested some associations between specific brain regions and repetitive behaviors, though these did not survive statistical correction. The findings indicate that sleep problems in young autistic children may be associated with altered brain network organization, particularly affecting sensory and social-cognitive regions, though the clinical significance requires further investigation.

Sleep assessments should be considered in neurodevelopmental evaluations of young autistic children. The findings suggest sleep problems may affect brain network development, but clinical significance remains unclear. Interventions targeting sleep may potentially support healthy brain development, though this requires further research with longitudinal designs and objective sleep measurements.

This was a retrospective observational study using questionnaire-based sleep assessments rather than objective measures. Exploratory findings did not survive correction for multiple comparisons. The cross-sectional design cannot establish causality between sleep problems and brain differences. Longitudinal studies with objective sleep measures are needed.

Sleep problems are highly prevalent in autism spectrum disorder (ASD) and may contribute to behavioral challenges and atypical brain development. However, the neuroanatomical mechanisms linking sleep problems and ASD during early childhood remain underexplored. This retrospective observational study included 183 preschool children with ASD, grouped by sleep problem status using the Children's Sleep Habits Questionnaire (CSHQ). Structural MRI data were processed with FreeSurfer to obtain cortical volume measures across 68 regions.

Structural covariance networks were constructed to assess topological properties using graph theory. Group comparisons and exploratory correlation analyses were conducted to evaluate associations with behavioral measures. No significant group differences were found in total cortical or subcortical volumes. Exploratory analyses revealed uncorrected focal differences in the peri-calcarine cortex and right pars orbitalis, but these did not survive correction for multiple comparisons.

Network analyses showed significantly reduced local connectivity (clustering coefficient, local efficiency) and altered small-world topology (Gamma, Sigma) in children with sleep problems, with preserved global efficiency. Exploratory correlations suggested that regional volumes may be linked to repetitive behaviors and withdrawn symptoms, although these did not remain significant after correction. Preschool children with ASD and sleep problems show disrupted local brain network properties, particularly in sensory and social-cognitive regions. While some regional associations with behavior were observed, they should be interpreted cautiously due to their exploratory nature.

These findings support the importance of considering sleep in neurodevelopmental assessments and highlight the need for longitudinal studies with objective sleep measures. • Sleep problems are highly prevalent in children with autism spectrum disorder (ASD) and are linked to adverse behavioral outcomes. • Structural covariance networks (SCNs) reflect coordinated brain development and are altered in ASD. • This study explores associations between sleep problems and both cortical morphology and SCNs in preschoolers with ASD. • Exploratory analyses reveal regional volume trends and altered network topology in children with sleep problems, suggesting potential early neural correlates.