The relationship between autism spectrum and sleep–wake traits

Abstract Autistic children and adults often have sleep disturbances, which may affect their and their family's quality of life. Yet, the relationship between sleep–wake patterns and autism spectrum traits is understudied. Identifying such relationships could lead to future research elucidating common mechanistic underpinnings. Thus, we aimed to determine whether sleep–wake patterns, specifically related to sleep, physical activity, and the daily sleep–wake rhythm (i.e., circadian rhythm), are associated with autism spectrum‐related traits. Accelerometer‐derived sleep–wake parameters were estimated in individuals with autistic spectrum traits and their family members ( N = 267). We evaluated autism spectrum traits using the Social Responsiveness Scale (SRS) to assess the presence and severity of social impairment and the Behavior Rating Inventory of Executive Function (BRIEF) to assess executive function. The linear multivariate regression analysis (using SOLAR‐Eclipse) showed that in adults, increased core autism spectrum traits and executive dysfunction were associated with disruption of several sleep–wake parameters, particularly related to the daily sleep–wake rhythm, and that executive dysfunction was associated with disrupted sleep quality and level of physical activity. We highlight the interplay between daytime function and disrupted sleep–wake patterns, specifically related to the daily sleep–wake rhythm, that could guide future research into common mechanisms. Lay Summary Autistic children and adults often report sleep disturbances. To dissect the relationship between a range of autism spectrum traits and sleep–wake patterns, we assessed social interaction and executive function in participants who also wore actimetry watches on their wrists to assess their sleep–wake patterns. We found that increased impairments in social and executive function occurred with increased sleep–wake disturbances, particularly those related to the circadian rhythm, suggesting that these perturbations/disruptions in the sleep–wake cycle could be connected to autism spectrum traits.