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Open AccessArticle

Disturbances of Continuous Sleep and Circadian Rhythms Account for Behavioral Difficulties in Children with Autism Spectrum Disorder

1
Centre National de la Recherche Scientifique CNRS UPR 3212, Université de Strasbourg, Institut des Neurosciences Cellulaires et Intégratives, 8 allée du Général Rouvillois, 67000 Strasbourg, France
2
Department of Child and Adolescent Neurodevelopmental Psychiatry, Le Vinatier Hospital, 95 Boulevard Pinel, 69678 Bron CEDEX, France
3
Health Services and Performance Research (HESPER), Claude Bernard University Lyon 1, 43 Boulevard du 11 Novembre 1918, 69622 Villeurbane CEDEX, France
4
Department of Neurology and Clinical Neurophysiology, University Hospital Bretonneau, 2 Boulevard Tonnellé, 37044 Tours, France
5
Pediatric Sleep, Hôpital Femme-Mère-Enfant, Hospices civils of Lyon, 59 Boulevard Pinel, 69500 Bron, France
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Lyon Neuroscience Research Center U1028/UMR5292, Claude Bernard University Lyon 1, 43 Boulevard du 11 Novembre 1918, 69622 Villeurbane CEDEX, France
7
UMR 1253, iBrain, Université de Tours, Inserm, CHRU de Tours, Centre Universitaire de Pédopsychiatrie, 2 Boulevard Tonnellé, 37044 Tours, France
8
Sleep Disorders Center, International Research Center for ChronoSomnology, Strasbourg University Hospitals, 1 place de l’Hôpital, 67000 Strasbourg, France
9
Department of Child and Adolescent Psychiatry, Strasbourg University Hospitals & University of Strasbourg Medical School, 67000 Strasbourg, France
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(6), 1978; https://doi.org/10.3390/jcm9061978
Received: 27 May 2020 / Revised: 20 June 2020 / Accepted: 21 June 2020 / Published: 24 June 2020
(This article belongs to the Special Issue Sleep and Circadian Rhythms in Psychiatric Disorders)
Sleep disorders are among the most common comorbidities in children with Autism Spectrum Disorder (ASD), and subjectively defined sleep disturbances have been related to ASD symptom severity. However, no study has investigated the differential impact of objectively measured sleep and circadian rhythm disturbances on behavioral difficulties in this population. Fifty-two children with ASD aged 3–10 years underwent assessments of sleep and circadian rest–activity rhythms objectively with actigraphy and subjectively with the Children’s Sleep Habits Questionnaire. Behavioral difficulties were assessed using the ABC-C. Group comparison analyses were used to compare sleep and circadian rhythm parameters of children with higher and lower behavioral difficulties and dominance analysis to rank predictors and address multicollinearity. Children with high irritability had a shorter continuous sleep period compared to those with lower irritability (−60 min, p = 0.04), as well as those with high stereotypic behaviors compared to children with less stereotypies (−75 min, p = 0.006). Objective circadian and sleep disturbances accounted together for, respectively, 17%, 18% and 36% of the variance in social withdrawal, irritability and stereotypic behaviors. The identification of both sleep and circadian rhythm disturbances as explanatory factors for behavioral difficulties warrants their inclusion in the existing behavioral management strategies for children with ASD. View Full-Text
Keywords: autism; ASD; children; sleep; circadian rhythm; pediatrics autism; ASD; children; sleep; circadian rhythm; pediatrics
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MDPI and ACS Style

Yavuz-Kodat, E.; Reynaud, E.; Geoffray, M.-M.; Limousin, N.; Franco, P.; Bonnet-Brilhault, F.; Bourgin, P.; Schroder, C.M. Disturbances of Continuous Sleep and Circadian Rhythms Account for Behavioral Difficulties in Children with Autism Spectrum Disorder. J. Clin. Med. 2020, 9, 1978.

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