Becky DeWaay, Psy.D. Pediatric Psychology Fellow

Madigan Army Medical Center Department of Pediatrics

LEND Faculty Mentor: Beth Ellen Davis

Sleep Quality and Sleep Hygiene in Children with

Autism Spectrum Disorders

*The views expressed in this presentation are those of the author and do not reflect the official policy of the Department of the Army, the Department of Defense, or the U.S. Government.

Background: Sleep Quality

Background: Sleep Quality

Background: Sleep Quality

Background: Sleep Hygiene

Sleep Hygiene in Children with ASDs

Mindell, Meltzer, Carskadon, & Chervin (2009)

Sleep Onset Latency Mean min (SD)

Night wakings % None % 1+

Amount of Sleep Mean hours (SD)

Bedtime Routine Yes (n = 600)

17.1 (14.7)

86.7 13.3

9.5 (1.1)***

No (n = 27) 19.8 (16.0) 81.5 18.5 8.6 (1.5)***

Late Bedtime Before 9pm (n = 227)

14.8 (10.7)**

87.2 12.8

10.1 (0.8)***

After 9pm (n=400) 18.6 (16.5)** 86.0 14.0 9.1 (1.2)***

Parent Present at bedtime Never/rarely (n = 485)

17.7 (15.3)

89.9 10.1***

9.5 (1.2)

Few /every night (n=141) 15.6 (12.7) 74.5 25.5*** 9.4 (1.0)

Reading Yes (n = 157)

16.5 (14.4)

82.2 17.8

9.6 (1.2)*

No (n = 470) 17.4 (14.8) 87.9 12.2 9.4 (1.1)*

Television in Bedroom No (n = 357)

17.6 (15.6)

85.4 14.6

9.6 (1.1)***

Yes (n = 270) 16.6 (13.5) 87.8 12.2 9.3 (1.2)***

Caffeine None (n = 370)

17.5 (15.8)

87.6 12.4

9.6 (1.1)***

1+ per day (n = 257) 16.8 (13.0) 84.8 15.2 9.2 (1.2)***

*** p <.001 level, **p<.01 level, *p<.05 level

Mindell, Meltzer, Carskadon, & Chervin (2009)

Goal

To determine if significant differences exist between sleep hygiene factors and sleep quality amongst school-aged children with autism spectrum disorders as compared to a national sample.

Method

Sample Caregivers of children aged 6-10 and in 1st-5th

grades Caregivers: 22 mothers, 4 fathers, 1 guardian

Children 24 males, 3 females 16 autism, 7 asperger’s, 4 PDD-NOS

Results: Children with ASD had worse sleep quality Children with ASDs slept for less total time. ASD M = 8.53, SD = 2.04; National Sample M = 9.4, SD =

1.1 2-sample t(662) = 3.85, p < 0.001 Children with ASDs took longer to fall asleep. ASD M = 35.04, SD = 18.04; National Sample M = 17.2, SD

= 14.7 2-sample t(662) = 6.11, p < 0.001 Children with ASDs had more night wakings. 59.25% of the ASD sample, vs. 13.6% of the National

Sample χ2(1, N = 27) = 47.9, p < 0.001

Results: Children with ASDs were more likely to: Read as a part of their bedtime routine.

48.15% of the ASD sample, vs. 25% national norm χ2(1, N = 27) = 7.72, p < 0.01

Have a bedtime at or before 9pm. 77.78% of the ASD sample vs. 36.2% of the norm. χ2(1, N = 27) = 20.21, p < 0.001

Results:

Results: Children with ASDs were just as likely to: Not have a TV in their room.

51.85% of the ASD sample, vs. 43.1% of the national sample

χ2(1, N = 27) = 0.28, p = 0.60

Not use caffeine. 74.07% of the ASD sample, vs. 59% of the

national sample χ2(1, N = 27) = 2.54, p = 0.11

Results:

Results: All Children with ASDs had a consistent bedtime routine

100% of the ASD sample, vs. 95.5% of the national sample

Because of violating rules of goodness-of-fit for Chi Square tests, a Chi Square test could not be completed to compare the two samples in relation to bedtime routine.

Results:

Results: Children with ASDs were less likely to fall asleep independently.

37.04% of the ASD sample, vs. 77.4% of the

norm χ2(1, N = 27) = 25.15, p < 0.001

Results:

Discussion

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Acknowledgements

Thank you to: Lisa Meltzer, for helping me in study design. Marilisa Elrod, for assisting me with statistics. My Madigan supervisors: Ken Miles, David

DeWine, and Steve Parkison for supporting me in this research and in developing clinical skills.