Researchers explain why sleep problems aggravate autism symptoms


Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by a wide range of symptoms, including difficulty with social interactions, impairments in verbal and nonverbal communication, and repetitive behaviors or interests. It is a spectrum disorder, which means that the symptoms and their severity can vary from person to person. It is typically diagnosed in early childhood, and it affects more boys than girls. There is no known cure for ASD, but early intervention can help improve outcomes. Children with ASD often experience sleep disturbances, such as difficulty falling asleep, staying asleep, and waking up early. These sleep problems can be caused by a variety of factors, including anxiety, sensory issues, and difficulty with routines. Studies have shown that up to 80% of children with ASD have sleep problems, compared to 10-30% of typically developing children. Sleep disturbances in children with ASD can have a negative impact on their overall health and well-being, as well as their ability to function during the day.

In new research published in the peer-reviewed journal Autism Research, Prof. Guanghai Wang from Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, in collaboration with Dr. Guangshuai Wang and Prof. Jingying Chen from the Central China Normal University, conducted an innovative study to investigate the possible link between sleep disturbances and core symptoms of ASD in children, and to examine the possible mediating role of gaze patterns in this association. The authors recruited a total of 60 children with ASD and 60 typically developing children. The children’s sleep disturbances were assessed using the Children’s Sleep Habits Questionnaire (CSHQ) and the core symptoms of ASD were evaluated using the Social Communication Questionnaire (SCQ). The children’s gaze patterns during the facial emotion recognition task were also recorded by eye tracking.

The research team showed that children with ASD had significantly higher levels of sleep disturbances compared to typically developing children. Furthermore, their findings revealed that gaze patterns mediated the association between sleep disturbances and core symptoms of ASD. This means that the abnormal gaze patterns of children with ASD were found to be a potential underlying factor that can partially explain why sleep disturbances aggravate the ASD core symptoms in children. The study provided compelling evidence for the link between sleep disturbances and core symptoms of ASD in children, and suggests that gaze patterns may play a mediating role in this association. The findings highlight the need for further research to understand the underlying mechanisms of this link, and to develop interventions to improve sleep in children with ASD. The authors suggested that interventions that focus on improving sleep might be beneficial in enhancing social gaze in children with ASD, and ultimately promoting their social and communication skills. For behavioral sleep disturbances, especially for insomnia-related symptoms, interventions may include, but not limited to, good sleep hygiene and positive bedtime routine, cognitive and behavioral therapy, light therapy, and using melatonin. The work is important as it provides a deeper understanding of the underlying neurocognitive mechanisms for the association between sleep difficulties and core symptoms of children with ASD, and it highlights the potential for interventions that target sleep disturbances to improve intrinsic cognition ability, and extrinsic social and communication skills in this population. This research work provides a new insight into the relationship between sleep and core symptoms of ASD, and it opens the door to future studies in the field. As the corresponding author Prof. Guanghai Wang said “sleep disturbances are highly common in children with ASD, but have long been neglected by parents and professionals. We are hoping that the study can increase motivation to promote sleep health, and prevent and intervene sleep disturbances in children with ASD, and help the children achieve their optimal development. The study indicates sleep disturbances may be is not only related to the behavioral manifestations of autism core symptoms, but also influence the underlying neurocognitive functioning.”

In conclusion, the authors reported that sleep disturbances in children with ASD may be linked with gaze patterns, specifically with a lack of social gaze and increased focus on non-social features. This research has the potential to offer tremendous relief to children with ASD and their parents. The paper findings also highlight the importance of further investigations to understand better the underlying mechanisms of this important link and the potential for interventions that target sleep to improve ASD core symptoms.

About the author

Guangshuai Wang, PhD, is the associated professor at the National Engineering Research Center for ELearning, Central China Normal University ([email protected])

Guanghai Wang, PhD, is the Clinical Psychologist, Sleep Specialist, and Professor at the Department of Developmental and Behavioral Pediatrics, Pediatric Translational Medicine Institute, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University ([email protected]).


Wang G, Chen J, Zhang K, Tang S, Wang G. The mediating role of gaze patterns in the association of child sleep disturbances and core symptoms of autism spectrum disorder. Autism Research. 2022 May 6.

Go To Autism Research.