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Molecular Autism
Published in: Molecular Autism 1/2018

Open Access 01-12-2018 | Research

The bidirectional association between sleep problems and autism spectrum disorder: a population-based cohort study

Authors: Maria E. Verhoeff, Laura M. E. Blanken, Desana Kocevska, Viara R. Mileva-Seitz, Vincent W. V. Jaddoe, Tonya White, Frank Verhulst, Maartje P. C. M. Luijk, Henning Tiemeier

Published in: Molecular Autism | Issue 1/2018

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Abstract

Background

Sleep difficulties are prevalent in children with autism spectrum disorder (ASD). The temporal nature of the association between sleep problems and ASD is unclear because longitudinal studies are lacking. Our aim is to clarify whether sleep problems precede and worsen autistic traits and ASD or occur as a consequence of the disorder.

Methods

Repeated sleep measures were available at 1.5, 3, 6, and 9 years of age in 5151 children participating in the Generation R Study, a large prospective birth cohort in the Netherlands. Autistic traits were determined with the Pervasive Developmental Problems score (PDP) of the Child Behavior Checklist (CBCL) at 1.5 and 3 years and the Social Responsiveness Scale (SRS) at 6 years. This cohort included 81 children diagnosed with ASD.

Results

Sleep problems in early childhood were prospectively associated with a higher SRS score, but not when correcting for baseline PDP score. By contrast, a higher SRS score and an ASD diagnosis were associated with more sleep problems at later ages, even when adjusting for baseline sleep problems. Likewise, a trajectory of increasing sleep problems was associated with ASD.

Conclusions

Sleep problems and ASD are not bidirectionally associated. Sleep problems do not precede and worsen autistic behavior but rather co-occur with autistic traits in early childhood. Over time, children with ASD have an increase in sleep problems, whereas typically developing children have a decrease in sleep problems. Our findings suggest that sleep problems are part of the construct ASD.
Appendix
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Metadata
Title
The bidirectional association between sleep problems and autism spectrum disorder: a population-based cohort study
Authors
Maria E. Verhoeff
Laura M. E. Blanken
Desana Kocevska
Viara R. Mileva-Seitz
Vincent W. V. Jaddoe
Tonya White
Frank Verhulst
Maartje P. C. M. Luijk
Henning Tiemeier
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Molecular Autism / Issue 1/2018
Electronic ISSN: 2040-2392
DOI
https://doi.org/10.1186/s13229-018-0194-8

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