The impact of sleep habits on emotional and behavioral problems, quality of life, caregiver depression, and burnout in children with autism spectrum disorder
Abstract
Background Sleep disturbances affect 40–80% of children with autism spectrum disorder (ASD), yet their concurrent associations with neurobehavioral functioning, health-related quality of life (HRQoL), and primary caregiver mental health remain insufficiently characterized within an integrated multivariate framework that includes typically developing controls. This limits clinicians’ ability to position sleep disturbance within the broader family burden associated with ASD. Methods This cross-sectional case-control study included 101 children aged 6–12 years with DSM-5-confirmed ASD and 81 typically developing controls, together with their primary caregiving mothers. Sleep was assessed using the Children’s Sleep Habits Questionnaire (CSHQ), child behavior using the Strengths and Difficulties Questionnaire (SDQ), HRQoL using the KINDL, and maternal psychiatric morbidity using the Beck Depression Inventory (BDI) and Maslach Burnout Inventory (MBI). Multiple linear regression and bootstrap mediation analyses were performed. Results Despite significantly longer total daily sleep duration, children with ASD had poorer scores across most CSHQ subscales, including bedtime resistance, night wakings, and parasomnias (p < 0.05), whereas daytime sleepiness was not significantly different (p = 0.075). Maternal depression and burnout were substantially higher in the ASD group (p < 0.001). In multivariable analysis, ASD diagnosis (B = −6.124, p = 0.001), SDQ total difficulties (B = −0.533,…
How strong is the evidence?
Evidence Hub reads this as a case-control, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 101 participants or records.
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