Clinical Correlates of Insomnia Symptoms in Young Children with Autism Spectrum Disorder.

Abstract

To examine clinical correlates of insomnia symptoms in children with autism spectrum disorder ascertained from a general outpatient autism clinic. This analysis included 103 children with autism spectrum disorder (mean age = 5.8 ± 2.2 years; range 2-10, 77.7% male). A multidisciplinary team assessed medical and psychosocial histories using parent ratings from the Pediatric Autism Insomnia Rating Scale (PAIRS), Aberrant Behavior Checklist (ABC), Brief Autism Mealtime Behavior Inventory, and the Parent Health-Related Quality of Life and Family Functioning and Family Functioning Surveys. Height and weight were collected. Children in the current sample with scores on the PAIRS ≥ 22 were compared with those with a mean PAIRS score < 22. Univariable and multivariable logistic regression modeling was used to evaluate clinical correlates with insomnia symptoms ≥ 22. Best subset selection approach identified the most important predictors. The PAIRS mean was 18.39 ± 14.54 (range 0 to 58); 33% scored ≥ 22. After adjusting for confounders, disruptive mealtime behaviors (P < .001), parent health-related quality of life and family functioning (P < .001 to .001), ABC subscales (P < .001 to .022), and dietary supplements (P = .019) were significantly associated with PAIRS ≥ 22. There were no group differences in height, weight, constipation, or demographics. Best subset modeling showed ABC hyperactivity/noncompliance, dietary supplements, and mealtime behaviors as the most significant predictors (receiver operating characteristic = 0.842, χ²(df) = 32.84 (3), χ²Diff. = 4.80,P < .001). The PAIRS appears useful for characterizing the nature and severity of current insomnia symptoms in autistic children.