Feasibility and exploration of remote multimodal sleep measurement in autistic and nonautistic smartphone users

Sleep difficulties represent a health priority for autistic adults, yet scalable real-world sleep measurement tools remain limited. Remote measurement technologies (RMT), including wearable and smartphone data, offer low‑burden approaches but feasibility in autistic populations is unclear. We evaluated a 28-day protocol combining passive Fitbit sleep staging and smartphone sensor data, and active daily sleep quality ratings in autistic (n = 34) and nonautistic (n = 39) participants (14–35 years). Median data availability was over 70% across modalities. However, usable data (days with valid sleep period and quality rating) were lower (< 60%), particularly for autistic participants, whose tactile sensitivity associated with reduced usable Fitbit data. Autistic participants reported lower sleep quality; however, few differences in passively derived sleep features emerged. Several features (e.g., sleep efficiency, duration, REM proportion) were related to subjective sleep quality, as were passively-derived sleep profile clusters. This study provides foundational work for developing RMT suitable for sleep measurement in autistic populations.