Clinical Correlates of Insomnia Symptoms in Young Children with Autism Spectrum Disorder.

This study looked at sleep problems in 103 young autistic children (ages 2-10). About one-third had significant sleep difficulties. Children with sleep problems were more likely to have challenging behaviors during meals, be hyperactive or non-compliant, take dietary supplements, and have families experiencing stress and reduced quality of life. The research helps identify which children might be at higher risk for sleep issues.

This cross-sectional study examined insomnia symptoms in 103 young children with autism spectrum disorder (mean age 5.8 years) from an outpatient clinic. Using the Pediatric Autism Insomnia Rating Scale (PAIRS), researchers found that 33% of children had clinically significant insomnia symptoms (scores ≥22). Key correlates included disruptive mealtime behaviors, hyperactivity/noncompliance, dietary supplement use, and impaired parent quality of life and family functioning. The study identified specific behavioral and family factors that predict insomnia severity in autistic children, with a predictive model achieving strong accuracy (ROC = 0.842).

The PAIRS demonstrated utility for characterizing insomnia symptoms in this population.

Clinicians should routinely screen for insomnia symptoms in young autistic children, particularly those with mealtime difficulties and hyperactive behaviors. Family functioning should be considered when addressing sleep problems. The PAIRS scale may be useful for clinical assessment of sleep issues in this population.

Cross-sectional design prevents causal inferences. Single clinic sample may limit generalizability. Study relies on parent-reported measures rather than objective sleep assessment. No comparison with typically developing children or community autism samples.

To examine clinical correlates of insomnia symptoms in children with autism spectrum disorder ascertained from a general outpatient autism clinic. This analysis included 103 children with autism spectrum disorder (mean age = 5.8 ± 2.2 years; range 2-10, 77.7% male). A multidisciplinary team assessed medical and psychosocial histories using parent ratings from the Pediatric Autism Insomnia Rating Scale (PAIRS), Aberrant Behavior Checklist (ABC), Brief Autism Mealtime Behavior Inventory, and the Parent Health-Related Quality of Life and Family Functioning and Family Functioning Surveys. Height and weight were collected.

Children in the current sample with scores on the PAIRS ≥ 22 were compared with those with a mean PAIRS score < 22. Univariable and multivariable logistic regression modeling was used to evaluate clinical correlates with insomnia symptoms ≥ 22. Best subset selection approach identified the most important predictors. The PAIRS mean was 18.39 ± 14.54 (range 0 to 58); 33% scored ≥ 22.

After adjusting for confounders, disruptive mealtime behaviors (P < .001), parent health-related quality of life and family functioning (P < .001 to .001), ABC subscales (P < .001 to .022), and dietary supplements (P = .019) were significantly associated with PAIRS ≥ 22. There were no group differences in height, weight, constipation, or demographics. Best subset modeling showed ABC hyperactivity/noncompliance, dietary supplements, and mealtime behaviors as the most significant predictors (receiver operating characteristic = 0.842, χ(df) = 32.84 (3), χDiff. = 4.80,P < .001). The PAIRS appears useful for characterizing the nature and severity of current insomnia symptoms in autistic children.