Neurobehavioral Associations with NREM and REM Sleep Architecture in Children with Autism Spectrum Disorder

Overview

Journal Children (Basel)

Specialty Health Services

Date 2022 Sep 23

PMID 36138632

Authors

Jennifer Nguyen

Bo Zhang

Ellen Hanson

Dimitrios Mylonas

Kiran Maski

Affiliations

Soon will be listed here.

Abstract

Objective: Insomnia and daytime behavioral problems are common issues in pediatric autism spectrum disorder (ASD), yet specific underlying relationships with NonRapid Eye Movement sleep (NREM) and Rapid Eye Movement (REM) sleep architecture are understudied. We hypothesize that REM sleep alterations (REM%, REM EEG power) are associated with more internalizing behaviors and NREM sleep deficits (N3%; slow wave activity (SWA) 0.5-3 Hz EEG power) are associated with increased externalizing behaviors in children with ASD vs. typical developing controls (TD).

Methods: In an age- and gender-matched pediatric cohort of = 23 ASD and = 20 TD participants, we collected macro/micro sleep architecture with overnight home polysomnogram and daytime behavior scores with Child Behavior Checklist (CBCL) scores.

Results: Controlling for non-verbal IQ and medication use, ASD and TD children have similar REM and NREM sleep architecture. Only ASD children show positive relationships between REM%, REM theta power and REM beta power with internalizing scores. Only TD participants showed an inverse relationship between NREM SWA and externalizing scores.

Conclusion: REM sleep measures reflect concerning internalizing behaviours in ASD and could serve as a biomarker for mood disorders in this population. While improving deep sleep may help externalizing behaviours in TD, we do not find evidence of this relationship in ASD.

Citing Articles

Effects of Extremely Low-Frequency Electromagnetic Field Treatment on ASD Symptoms in Children: A Pilot Study.

Pietramala K, Greco A, Garoli A, Roblin D Brain Sci. 2025; 14(12.

PMID: 39766492 PMC: 11675033. DOI: 10.3390/brainsci14121293.

Sleep architecture is associated with core symptom severity in autism spectrum disorder.

Kawai M, Buck C, Chick C, Anker L, Talbot L, Schneider L Sleep. 2022; 46(3).

PMID: 36385326 PMC: 9995925. DOI: 10.1093/sleep/zsac273.

M1M2: Deep-Learning-Based Real-Time Emotion Recognition from Neural Activity.

Akter S, Prodhan R, Pias T, Eisenberg D, Fernandez J Sensors (Basel). 2022; 22(21).

PMID: 36366164 PMC: 9654596. DOI: 10.3390/s22218467.

References

Sitaram N, Nurnberger Jr J, Gershon E, Gillin J . Cholinergic regulation of mood and REM sleep: potential model and marker of vulnerability to affective disorder. Am J Psychiatry. 1982; 139(5):571-6. DOI: 10.1176/ajp.139.5.571. View

Sikora D, Johnson K, Clemons T, Katz T . The relationship between sleep problems and daytime behavior in children of different ages with autism spectrum disorders. Pediatrics. 2012; 130 Suppl 2:S83-90. DOI: 10.1542/peds.2012-0900F. View

Greden J . Biological markers of melancholia and reclassification of depressive disorders. Encephale. 1982; 8(2):193-202. View

Ansseau M, von Frenckell R, FRANCK G, Reynolds 3rd C, Kupfer D . [Sleep and depression: toward a standardization of the use of the latency of paradoxical sleep as a biological marker of major depression]. Rev Electroencephalogr Neurophysiol Clin. 1987; 17(4):411-24. DOI: 10.1016/s0370-4475(87)80087-4. View

Kupfer D . Application of EEG sleep for the differential diagnosis and treatment of affective disorders. Pharmakopsychiatr Neuropsychopharmakol. 1978; 11(1):17-26. DOI: 10.1055/s-0028-1094559. View

Hill A, Zuckerman K, Hagen A, Kriz D, Duvall S, van Santen J . Aggressive Behavior Problems in Children with Autism Spectrum Disorders: Prevalence and Correlates in a Large Clinical Sample. Res Autism Spectr Disord. 2014; 8(9):1121-1133. PMC: 4160737. DOI: 10.1016/j.rasd.2014.05.006. View

Kanne S, Gerber A, Quirmbach L, Sparrow S, Cicchetti D, Saulnier C . The role of adaptive behavior in autism spectrum disorders: implications for functional outcome. J Autism Dev Disord. 2010; 41(8):1007-18. DOI: 10.1007/s10803-010-1126-4. View

Gunes S, Ekinci O, Feyzioglu A, Ekinci N, Kalinli M . Sleep problems in children with autism spectrum disorder: clinical correlates and the impact of attention deficit hyperactivity disorder. Neuropsychiatr Dis Treat. 2019; 15:763-771. PMC: 6452798. DOI: 10.2147/NDT.S195738. View

Achenbach T, Edelbrock C . Behavioral problems and competencies reported by parents of normal and disturbed children aged four through sixteen. Monogr Soc Res Child Dev. 1981; 46(1):1-82. View

10.

Bruni O, Lo Reto F, Miano S, OTTAVIANO S . Daytime behavioral correlates of awakenings and bedtime resistance in preschool children. Suppl Clin Neurophysiol. 2003; 53:358-61. DOI: 10.1016/s1567-424x(09)70181-3. View

11.

Goldstein A, Walker M . The role of sleep in emotional brain function. Annu Rev Clin Psychol. 2014; 10:679-708. PMC: 4286245. DOI: 10.1146/annurev-clinpsy-032813-153716. View

12.

Beattie L, Kyle S, Espie C, Biello S . Social interactions, emotion and sleep: A systematic review and research agenda. Sleep Med Rev. 2015; 24:83-100. DOI: 10.1016/j.smrv.2014.12.005. View

13.

Castelnovo A, Lividini A, Bernardi G, Pezzoli V, Foderaro G, Ramelli G . Sleep Power Topography in Children with Attention Deficit Hyperactivity Disorder (ADHD). Children (Basel). 2022; 9(2). PMC: 8870029. DOI: 10.3390/children9020197. View

14.

Scarpelli S, Gorgoni M, DAtri A, Reda F, De Gennaro L . Advances in Understanding the Relationship between Sleep and Attention Deficit-Hyperactivity Disorder (ADHD). J Clin Med. 2019; 8(10). PMC: 6832299. DOI: 10.3390/jcm8101737. View

15.

Rochette A, Soulieres I, Berthiaume C, Godbout R . NREM sleep EEG activity and procedural memory: A comparison between young neurotypical and autistic adults without sleep complaints. Autism Res. 2018; 11(4):613-623. DOI: 10.1002/aur.1933. View

16.

Bougeard C, Picarel-Blanchot F, Schmid R, Campbell R, Buitelaar J . Prevalence of Autism Spectrum Disorder and Co-morbidities in Children and Adolescents: A Systematic Literature Review. Front Psychiatry. 2021; 12:744709. PMC: 8579007. DOI: 10.3389/fpsyt.2021.744709. View

17.

Mazurek M, Sohl K . Sleep and Behavioral Problems in Children with Autism Spectrum Disorder. J Autism Dev Disord. 2016; 46(6):1906-1915. DOI: 10.1007/s10803-016-2723-7. View

18.

Lord C, Risi S, Lambrecht L, Cook Jr E, Leventhal B, DiLavore P . The autism diagnostic observation schedule-generic: a standard measure of social and communication deficits associated with the spectrum of autism. J Autism Dev Disord. 2000; 30(3):205-23. View

19.

Lauer C, Modell S, Schreiber W, Krieg J, Holsboer F . Prediction of the development of a first major depressive episode with a rapid eye movement sleep induction test using the cholinergic agonist RS 86. J Clin Psychopharmacol. 2004; 24(3):356-7. DOI: 10.1097/01.jcp.0000125744.22031.3a. View

20.

Owens J, Spirito A, McGuinn M . The Children's Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep. 2001; 23(8):1043-51. View