Sleep and daytime functioning in autistic teenagers A psychological network approach

Background: Although sleep problems in autistic teenagers are associated with impaired daytime functioning, it remains unclear how sleep and daytime functioning are related. 

Method: We used a network approach to disentangle patterns between sleep, sleep hygiene, and daytime functioning. Over a three-week period, 31 autistic teenagers answered daily questions about sleep and daytime functioning. Sleep tracker data were collected from 14 of the teenagers. We preregistered the analysis plan for this study at AsPredicted (#34594; https://aspredicted.org/blind.php?x = 3c4t65). 

Results: Perceived sleep quality seemed to be the most important sleep variable in relation to daytime functioning (self/parent/teacher reports). We also found that sleep onset latency, total sleep time, and wake time after sleep onset were related to daytime functioning, but mostly indirectly through perceived sleep quality. 

Conclusion: These findings are important for developing sleep interventions because perceived sleep quality would be a logical target for increasing the likelihood of actually improving daytime functioning.