Sleep problems are more frequent and associated with problematic behaviors in preschoolers with autism spectrum disorder

•Sleep problems in Japanese ASD preschoolers measured with questionnaires.•ASD preschoolers had a higher prevalence of sleep problems than those in the community.•Children with ASD showed a higher prevalence of obstructive sleep apnea.•Sleep and behavioral problems were correlated in children with ASD.

BackgroundChildren with autism spectrum disorder (ASD) often suffer from sleep problems that in turn correlate with behavioral problems. However, in Japan, there have been few studies of sleep problems in children with ASD.AimsThis study compared sleep problems in preschoolers from the community and preschoolers with ASD in Japan, and examined whether sleep problems were related to problematic behaviors in ASD preschoolers.Methods and proceduresSleep problems were assessed in 965 community and 193 ASD preschoolers using the Japanese Sleep Questionnaire for Preschoolers, which was developed to assess sleep problems in Japanese preschoolers. Behavioral problems were assessed in 107 ASD preschoolers using the Child Behavior Checklist.Outcomes and resultsCompared with community preschoolers, ASD preschoolers experienced significantly more sleep problems, including obstructive sleep apnea and parasomnias. ASD preschoolers with sleep problems exhibited more behavioral problems than those without sleep problems. The severity of sleep problems, especially insomnia, was significantly correlated with behavioral problems in ASD preschoolers.Conclusions and implicationsThe present study suggests that sleep problems, especially obstructive sleep apnea, are more common in ASD preschoolers than in community preschoolers. The study also shows that sleep problems, especially insomnia, are related to problematic behavior in ASD preschoolers.