The Connection Between Sleep Problems and Emotional and Behavioural Difficulties in Autistic Children: A Network Analysis

The interactions between sleep problems, autism symptoms and emotional and behavioural difficulties were explored using network analysis in 240 autistic children (mean age: 8.8 years, range 5-13 years) with moderate to severe sleep problems. Findings revealed a highly connected and interpretable network, with three separate clusters identified of the modelled variables. Depression, anxiety and behavioural difficulties were the most central variables of the network. Depression, anxiety and restricted repetitive and stereotyped patterns behaviours (RRBs) were the strongest bridging variables in the network model, transmitting activation both within and between other symptom clusters. The results highlight that depression and anxiety were highly connected symptoms within the network, suggesting support in these areas could be helpful, as well as future research. center dot Studies have found that autistic children experience a high rate of sleep problems, which worsen autism symptoms and increase emotional and behavioural difficulties.center dot Network analysis offers an advanced statistical approach to explore complex interactional patterns of co-occurring symptoms and identify possible intervention targets, ultimately improving supports for autistic children and their families.center dot The network model produced, was highly connected and interpretable, with three distinct symptom clusters identified.center dot The variables of depression, anxiety and behavioural difficulties were the most central variables of the network model.center dot The variables of depression, anxiety and RRBs emerged as the strongest bridging variables within the network model and could be the focus of supports for children and their families.