The relationship between autism symptom severity and sleep problems: Should bidirectionality be considered?

Prior research assessing the relationship between autism spectrum disorder (ASD) symptom severity and sleep problems has considered the association in a unidirectional manner; researchers have primarily focused on how sleep difficulties affect ASD symptom presentation. Specifically, extant research literature on this topic indicates that sleep problems exacerbate ASD symptom severity. The present study provides an investigation of this topic in a bidirectional manner. Primary results corroborated the compounding effect of sleep problems on ASD symptom severity. Furthermore, the results of a multinomial linear regression provided preliminary evidence that increased ASD symptom severity may predict an increased likelihood of the presence of sleep problems. As such, the authors conclude that the relationship between ASD symptom severity and sleep problems should be considered bidirectionally in future research. Implications for a relationship in each direction are discussed.