Arch Dis Child doi:10.1136/archdischild-2013-304083
  • Original article

Sleep patterns in children with autistic spectrum disorders: a prospective cohort study

Open AccessPress Release
  1. Alan M Emond3
  1. 1Hospital for Sick Children, Toronto, Canada
  2. 2Guy's and St. Thomas’ NHS Foundation Trust, London, UK
  3. 3Centre for Child and Adolescent Health, University of Bristol, School of Social & Community Medicine, Bristol, UK
  4. 4Department of Psychology, Crosshouse Hospital, Kilmarnock, Ayrshire, UK
  1. Correspondence to Professor Alan Emond, Centre for Child and Adolescent Health, School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK; alan.emond{at}
  • Received 19 March 2013
  • Revised 16 July 2013
  • Accepted 31 July 2013
  • Published Online First 23 September 2013


Objective To investigate longitudinal sleep patterns in children with autistic spectrum disorders (ASDs).

Study design Prospective longitudinal study using Avon Longitudinal Study of Parents and Children, an English cohort born in 1991–1992. Parental reports of sleep duration were collected by questionnaires at 8 time points from 6 months to 11 years. Children with an ASD diagnosis at age 11 years (n=73) were identified from health and education records.

Results From aged 30 months to 11 years old, children with ASD slept for 17–43 min less each day than contemporary controls. No significant difference in total sleep duration was found in infancy, but from 30 months of age children with ASD slept less than their peers, a difference that remained significant after adjusting for sex, ethnicity, high parity and epilepsy. The reduction in total sleep was wholly due to changes in night rather than daytime sleep duration. Night-time sleep duration was shortened by later bedtimes and earlier waking times. Frequent waking (3 or more times a night) was also evident among the children with ASD from 30 months of age. Age-specific decreases of >1SD within individuals in sleep duration across adjacent time points was a predictor of ASD between 18 months and 30 months of age (p=0.04) and from 30 months to 42 months (p=0.02).

Conclusions Sleep duration in children with ASD is reduced from 30 months of age and persists until adolescence.

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