Sleep Disturbances in Children and Adolescents with Autism Spectrum Disorder: A Scoping Review of Clinical Features, Impact and Interventions.

PURPOSE OF THE REVIEW: Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by social-communication deficits, restricted-repetitive behaviors, and sensory anomalies. Sleep disturbances are reported to significantly worsen behavioral, cognitive, and family functioning in ASD. This scoping review aims to map existing evidence on the clinical features, impact, and interventions for sleep disturbances in children with ASD.

COLLECTION AND ANALYSIS OF DATA: A comprehensive literature review was conducted in accordance with PRISM-ScR guidelines, and searches were performed in PubMed, Directory of Open Access Journals (DOAJ), Cochrane, Scopus, and Embase. Studies published from 2015 to August 31, 2025, were identified using combinations of the terms "Sleep disturbances," "ASD," "Prevalence," "Etiology," "Types," and "Intervention." Eligible studies included systematic reviews, meta-analyses, narrative reviews, randomized controlled trials, observational studies, and case series published in peer-reviewed English-language journals involving children and adolescents with ASD.

RESULTS

The reviewed literature indicates multifactorial causes for sleep disturbances in ASD, including medical/psychiatric comorbidities and behavioral factors like sensory sensitivities and bedtime resistance. Common sleep problems include insomnia, circadian rhythm disorders, parasomnias, sleep-disordered breathing, and sleep-related movement disorders (SRMDs). These disturbances exacerbate core ASD symptoms, impair adaptive functioning, contribute to aggression, and increase parental stress. Reported interventions include caregiver education, behavioral strategies, pharmacological approaches, and management of comorbid sleep-related conditions.

CONCLUSIONS

Sleep disturbances in children with ASD are highly prevalent, multifaceted, and clinically significant. Early identification and evidence-based, integrative interventions may improve sleep quality, behavioral outcomes, and overall family well-being. Future research should focus on longitudinal designs and objective sleep assessment methods to strengthen the evidence base.