Perinatal & Pediatric
Nationally-Representative Associations Between ASD Diagnosis and Irregular Sleep Patterns Chiashuan Chang* Chiashuan Chang Amanda E. Ng
Background: Irregular sleep patterns among children are a growing health concern, particularly among those diagnosed with autism spectrum disorder (ASD). While prior research has established that poor sleep is prevalent among children with ASD, limited studies have examined whether an ASD diagnosis itself predicts irregular sleep timing on a national scale. Furthermore, the role of sex differences in the ASD-sleep relationship remains unclear, with mixed findings reported. This study aimed to investigate (1) whether an ASD diagnosis is associated with irregular sleep timing among U.S. children aged 0–17, and (2) whether this association differs by sex. Method: This study analyzed parent-reported data on 11,611 children from the 2020 and 2022 National Health Interview Survey (NHIS) using complete case analysis (2.49% missing data). Descriptive analyses were conducted to summarize continuous and categorical variables. Bivariate analyses, including chi-square tests and Spearman’s correlations, assessed associations between study variables. Multinomial logistic regression was employed to examine the relationship between ASD diagnosis and irregular sleep timing (bedtime and wake-up time), adjusting for demographic factors (e.g., sex, parental education) and psychological factors (e.g., anxiety, depression). An interaction term (sex × ASD diagnosis) was included to evaluate potential sex differences. Results: After adjusting for covariates, children with ASD, relative to those who did not have ASD, were less likely to having a regular bedtime on some days compared to having a regular bedtime every day. In contrast, children with ASD, relative to those who were not, are more likely to never have regular wake-up times compared to having consistent wake-up times every day (OR: 2.13). However, no significant moderating effect of sex was observed.