The relationship between sleep problems and challenging behavior among children and adolescents with autism spectrum disorder

• Research indicates ASD and sleep problems frequently co-occur.
• Differences found in challenging behavior (CB) ratings across sleep problem groups.
• As severity of sleep problems increase, total and externalizing CB ratings increase.
• Only presence, not degree, of sleep problems related to increased internalizing CB.

Prior research has indicated fairly consistently that sleep problems appear to worsen ASD core symptomatology. As such, the present study was conducted to examine whether or not sleep problems also exacerbate behavior problems commonly exhibited by children and adolescents with ASD in terms of total, internalizing, and externalizing challenging behavior. Results indicated that presence of sleep problems increased the ratings of challenging behavior across types, as hypothesized. Unexpectedly, degree of sleep problem (i.e., mild versus severe) only affected total and externalizing challenging behavior, whereas ratings of internalizing challenging behavior were not significantly different between mild and severe sleep problem groups. Clinical applications of findings, as well as future directions for additional research on the topic of sleep among individuals with ASD, are discussed.