Associations Between Social Responsiveness and Sleep disturbance are Modulated by Chronotype in Early Adolescence: Cross-Sectional and Prospective Findings from 10,108 Participants of the Adolescent Brain and Cognitive Development (ABCD) Study
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Study Objectives
Sleep disturbance is prevalent in people with neurodevelopmental disorders such as autism, but is not clear whether it occurs as an endophenotype or secondary to other behaviours. The ABCD Study is a population-based longitudinal study that monitors the health, demography and lifestyle of over 11,000 children in the US. In this study we leverage these data to investigate whether traits consistent with autism (social responsiveness) are associated with sleep disturbance independent of lifestyle and other behavioural measures.
Methods
Autistic traits were assessed using the Social Responsiveness Scale at age 11, and sleep disturbance and behavioural outcomes were assessed at ages 11 and 13 years using the Sleep Disturbance Scale, and the Child Behaviour Check List, respectively. Demographic, health and lifestyle-related variables were assessed by caregiver questionnaires. Regression models were applied to investigate associations between autistic traits and sleep outcomes.
Results
There was a significant cross-sectional association between sleep disturbance and SRS at age 11 years old that was independent of sex, ethnicity, socioeconomic position, physical activity, sedentary behaviour and anxiety/depression (β = 0.12, 95% CI (0.07, 0.17); p < 0.001), that persisted at age 13, and that was modulated by chronotype, with evening types showing a stronger association.
Conclusions
Social responsiveness assessed in early adolescence (age 11) were associated with sleep disturbance independent of multiple confounding factors and were prospectively associated with sleep disturbance at age 13 years. These findings contribute to the evidence that disruption of sleep and circadian timing may have a primary role in the mechanisms that mediate autistic traits.
Statement of significance
Sleep disturbance is prevalent in people with neurodevelopmental conditions including autism and is associated with the severity of social, behavioural, and sensory symptoms. Evidence from studies of high-risk infants and animal models suggest that sleep problems emerge early in development, and may reflect underlying neurobiological vulnerability rather than secondary effects of other aspects of neurodevelopmental conditions. This study provides population-level evidence that autistic traits are independently and longitudinally associated with sleep disturbance across early adolescence. This relationship was moderated by chronotype, was stronger in females, and clustered within families, implicating shared circadian or genetic mechanisms. Future research should focus on prospective and mechanistic studies to assess the aetiological significance of sleep disturbance in autism.
