Children with autism spectrum disorder (ASD) often face a range of challenges that affect daily life, including differences in sensory processing and sleep patterns.
A recent exploratory study published in Pediatric Health, Medicine and Therapeutics and conducted by Yuki Kondo, of the Nagano University of Health and Medicine in Japan and colleagues, examined how sleep-wake rhythms may relate to sensory processing in school-aged children with ASD, using objective sleep measurements collected over multiple days.
Sleep difficulties are widely reported among children with autism. Although about 20% to 25% of typically developing children experience sleep problems, research suggests that more than half of children with ASD have disrupted sleep.
“Children reaching school age experience significant changes in their living environment, such as school life, extracurricular activities, cram school attendance, friendships and digital media use, which may disrupt their sleep schedules and sleep quality,” the study authors wrote.
“Sleep problems during the school-age years have shown association with emotional, behavioral, and academic difficulties, such as depression, school refusal, and academic performance, potentially having broad effects on daily life and social adaptation,” they continued.
To better understand the possible connection between sleep and sensory processing, the researchers conducted a cross-sectional study involving children aged 6 to 9 years who had been diagnosed with autism. The participants were recruited from a pediatric outpatient clinic in Japan. The goal of the study was to determine whether specific sensory processing patterns were linked to measurable sleep characteristics.
The researchers used actigraphy, an objective method for monitoring sleep. Each child wore a small waist-mounted activity monitor for at least 2 weeks. The device tracked movement and posture continuously, allowing researchers to estimate sleep timing, total sleep duration, nighttime awakenings, and sleep efficiency. Compared with sleep questionnaires completed by parents, actigraphy provides more objective data about sleep-wake patterns in natural home environments.
To evaluate sensory processing characteristics, caregivers completed the Japanese version of the Sensory Profile, a standardized questionnaire that assesses how children respond to sensory information. The questionnaire examines different sensory domains including auditory, visual, tactile, vestibular, multisensory, and oral sensory processing, as well as broader patterns such as sensation sensitivity and sensation-seeking behavior.
Although 30 children were initially recruited, only 19 participants completed the study after exclusions related to participation and follow-up. The children were monitored for an average of 16.3 days, providing researchers with multiple nights of sleep data for analysis.
Overall, the study provided limited evidence of strong connections between sleep variables and most sensory processing measures. After applying statistical corrections for multiple comparisons, the researchers did not observe significant relationships between the main sensory processing patterns and the recorded sleep measures.
However, the researchers identified a significant positive correlation between oral sensory processing scores and the children’s average wake time. Although this does not necessarily indicate a cause-and-effect relationship, the association suggests that oral sensory processing traits may play a role in shaping sleep-wake rhythms in some children with autism.
The findings are considered exploratory because of the relatively small sample size. Nevertheless, the study contributes valuable insights by focusing specifically on school-aged children, a group that has been less frequently examined in previous research. Earlier studies often focused on preschool-aged children or relied primarily on parental reports rather than objective sleep measurements.
Understanding sleep patterns in children with ASD is particularly important during the school years, when changes in daily routines, social activities, and academic demands can influence sleep schedules. Sleep disturbances at this stage may also affect emotional regulation, behavior, and academic performance.
“The results of this study suggest that the association between sensory processing scores and sleep–wake patterns persists into the school-age period, despite changes in school life, daily rhythms, and increased independence,” the researchers wrote. “This finding indicates the potential clinical significance extending beyond early childhood.”