Study On The Factors Influencing Sleep Problems Of Children With Autism And Their Neurodevelopmental Correlation

Objective:Autism spectrum disorder（ASD）is a neurodevelopmental disorder.Sleep problems are common comorbidities in children with ASD.The purpose of this study is to explore the factors that influence sleep problems in children with ASD,as well as the correlation between sleep problems and neurodevelopment,providing a new entry point for the prevention and intervention of sleep problems in children with ASD.Method:1.A cross-sectional study design was used to select 181 children diagnosed with ASD who received medical treatment at the Women and Children’s Medical Center in Hainan Province from September 2020 to June 2022.The Children’s Sleep Habits Questionnaire（CSHQ）was collected,and based on the total score of CSHQ,the children were divided into the group without sleep problems（n₁=36）and the group with sleep problems（n₂=145）to evaluate the sleep problems of children with ASD.Demographic data were collected to analyze the factors affecting sleep problems in children with ASD.2.The Gesell Developmental Schedule was collected,and based on the average score of the Developmental Quotient（DQ）in the Gesell schedule,the children were divided into the group with normal development（n₁=55）and the group with developmental delay（n₂=126）to evaluate the neurodevelopmental status of children with ASD.Results:1.The use of electronic screens for more than 1 hour is an independent risk factor for sleep problems in children with ASD（P<0.05）,while parental education at the undergraduate level or above,supplementation of vitamin D and vitamin AD,and outdoor activities for more than 2 hours are protective factors（P<0.05）.2.The prevalence of sleep problems in children with ASD and co-occurring developmental delay is 69.6%,significantly higher than that in children with ASD and normal development（30.3%）（P<0.001）.The total score of CSHQ in children with ASD and co-occurring developmental delay is higher than that in children with ASD and normal development（P<0.05）.The scores for sleep duration,sleep anxiety,night waking,sleep breathing problems,and daytime sleepiness in children with ASD and co-occurring developmental delay are significantly higher than those in children with ASD and normal development（P<0.05）;the score for sleep onset latency in children with ASD and co-occurring developmental delay is significantly lower than that in children with ASD and normal development（P<0.05）.There is no statistically significant difference in bedtime habits and parasomnia between the two groups of children（P>0.05）.The sleep duration in children with ASD and co-occurring developmental delay is significantly lower than that in children with ASD and normal development（P<0.05）.3.The gross motor and social scores of children with ASD are negatively correlated with the total score of the CSHQ scale（P<0.05）.The adaptability,gross motor,and social scores of children with ASD are negatively correlated with four sleep factors:bedtime habits,sleep duration,sleep anxiety,and night waking（P<0.05）;the fine motor score is significantly negatively correlated with bedtime habits,sleep duration,and sleep breathing problem scores（P<0.05）;the language score is negatively correlated with the daytime sleepiness score（P<0.05）.Conclusion:1.Parental education level,nutrient supplementation,outdoor activity time,and electronic screen use time are factors influencing sleep problems in children with ASD.2.Sleep problems in children with ASD co-occurring with developmental delays are more severe than those in children with ASD without developmental delays.3.Sleep problems in children with ASD are related to their neurological development level.