The association of sleep problems in children with autism and parental quality of life

Background Many children with autism suffer from sleep problems that impact not only children’s daytime behavior and cognitive development but also their parents’ life and health. The current study explored how and to what extent sleep problems in children with autism spectrum disorder (ASD) impacted their parents’ quality of life (QOL).Methods This study adopted a case-control study design. A total of 440 ASD children aged 4 to 10 years and 344 age-matched typically developing (TD) children were included in the study. The Children’s Sleep Habits Questionnaire (CSHQ) was used to measure sleep problems in the enrolled children, and parental QOL was measured by the Short Form 36 Health Survey Questionnaire Version 2.0 (SF-36v2). Linear regression and pathway analysis were used to explore the impact of children’s sleep problems on parental QOL.Results The linear regression model showed that the CSHQ total scores were negatively associated with maternal mental health summary (MCS) scores (β=-2.831, p=0.005) in the TD group. In the ASD group, the CSHQ total scores were negatively associated with the parental physical health summary (PCS) scores (β=-3.030, p=0.003 for mothers, β=-3.651, p<0.001 for fathers) after adjusting for the child’s age, parental age, parental Zarit Caregiver Burden Interview (ZBI) score and Social Responsiveness Scale (SRS) score as covariates. The pathway analysis indicated that sleep problems in ASD children had both direct and indirect effects on maternal PCS.Conclusion The main results of the current study showed that sleep problems in children with or without ASD may affect parental QOL in different ways, and ASD children’s sleep problems affect parental physical health as a risk factor independent from the social impairments associated with ASD and the childcare burden of the parents.