1002 Endorsement Of Sleep Problems Indexes Autism Severity In Children And Adolescents: Evidence From A Large Community Sample

Introduction

Individuals with autism spectrum disorder (ASD) often experience sleep problems. A reliance on case-control studies rather than dimensional samples limit our ability to understand how sleep problems distinguish diagnosis and severity of ASD. To address this need, we present preliminary findings from a large community sample of individuals with heterogeneous autism phenotypes.

Methods

All participants (≤ 21 years) were selected from the Rhode Island Consortium for Autism Research and Treatment (RI-CART) (final n= 977; 233F; 11.27±4.13 years), a public-private-academic registry of families in Rhode Island affected by ASD-like symptoms. Participants completed the Autism Diagnostic Observation Schedule, 2nd Edition to confirm the presence of diagnosable ASD. Each caretaker also completed dimensional measures of functional impairment: Social Responsiveness Scale, 2nd edition and the Vineland Adaptive Behavior Scale (2nd/3rd editions). Caretakers were asked whether the participant suffered current/past sleep problems: yes/no. All analyses are adjusted for age, sex, race, ethnicity, caregiver education, and scale-version (e.g., 2nd/3rd ed., where applicable).

Results

Endorsement of sleep problems distinguished ASD diagnosis: a confirmed diagnosis of ASD was associated with greater prevalence of sleep problems compared to ASD diagnosis (OR: 1.58; 95% CI: 1.05,2.38; p = .028). Across the sample, endorsement of sleep problems was associated with impairments in adaptive behavior (b = -4.73; 95% CI: -7.47,-2.00045; p = .001) and social responsiveness (b = 6.72; 95% CI: 3.27,10.16; p < .001).

Conclusion

These data from a heterogenous community sample provide evidence for a link of sleep to the phenomenology of ASD. While the search for better diagnostic indicators of ASD continues, we recommend that clinicians consider a brief assessment of sleep behaviors of patients with such neurodevelopmental conditions as autism.

Support

Simons Foundation Autism Research Initiative, Hassenfeld Child Health Innovation Institute at Brown University. K01MH109854 (JMS), NIGMS Advance CTR (JMS). KNAW Ter Meulen Grant (MEKV).

0312 Performance on a Cognitive Interference Task in Children After One-Night of Sleep Restriction

Introduction

Short sleep contributes to attention failure in conditions such as ADHD. Whether sleep loss affects attentional processes as a task varies in cognitive interference is unclear. We used a multi-source interference task (MSIT) in a sleep restriction paradigm in children with a range of ADHD symptoms to examine how short sleep disrupts attention in these youth.

Methods

Thirteen children (7F, 11.7±1.28 years) with a range of ADHD symptom severity completed a repeated-measures experiment on two consecutive nights in the laboratory: baseline (BSLN; 9.5h time-in-bed) and sleep restriction (SR; 4h time-in-bed). Each morning they took part in an fMRI session including the MSIT, in which participants respond to a series of 3-digit numbers by indicating which digit is different on no-interference (e.g., 003; correct=3) or interference (e.g., 311, correct=3) trials. Performance measures were inverse reaction time (1/RT) and accuracy. A two-way within-subject ANOVA assessed performance across interference and sleep conditions respectively.

Results

1/RT showed main-effects of sleep loss (BSLN vs. SR; F(1,148)=4.01;p<0.05;η 2=0.026) and trial type (no-interference vs. interference; F(1,148)=24.7;p<0.001;η 2=0.143). Responses were slower for interference (BSLN RT: 799.3ms, SR RT: 895.8ms) than no-interference (BSLN RT: 653.2ms, SR RT: 697.4ms) trials. No interaction between interference and sleep loss was found (F(1,148)=0.11;p>0.05;η 2=0.001). Likewise, accuracy was lower (F(1,148) = 31.1, p<.001;η 2=0.174) in interference trials (73.5%) than in no-interference trials (92.2%), however with no effect of sleep loss, nor an interaction of interference and sleep loss (all p’s > .05).

Conclusion

These data provide evidence that partial sleep loss disrupts attention processes in children, yet these differences do not appear to depend on cognitive interference in our sample. Future analyses will examine whether ADHD symptoms distinguish individual differences, as well as analyze fMRI data to probe neural processes underlying attention control.

Support

K01MH09854 (to JMS); Brown University UTRA (to GDQC).

You'll feel better in the morning: slow wave activity and overnight mood regulation in interepisode bipolar disorder

BACKGROUND

Sleep disturbances are prominent correlates of acute mood episodes and inadequate recovery in bipolar disorder (BD), yet the mechanistic relationship between sleep physiology and mood remains poorly understood. Using a series of pre-sleep mood inductions and overnight sleep recording, this study examined the relationship between overnight mood regulation and a marker of sleep intensity (non-rapid eye movement sleep slow wave activity; NREM SWA) during the interepisode phase of BD.

METHODS

Adults with interepisode BD type 1 (BD; n = 20) and healthy adult controls (CTL; n = 23) slept in the laboratory for a screening night, a neutral mood induction night (baseline), a happy mood induction night, and a sad mood induction night. NREM SWA (0.75-4.75 Hz) was derived from overnight sleep EEG recordings. Overnight mood regulation was evaluated using an affect grid pleasantness rating post-mood induction (pre-sleep) and the next morning.

RESULTS

Overnight mood regulation did not differ between groups following the sad or happy inductions. SWA did not significantly change for either group on the sad induction night compared with baseline. In BD only, SWA on the sad night was related to impaired overnight negative mood regulation. On the happy induction night, SWA increased relative to baseline in both groups, though SWA was not related to overnight mood regulation for either group.

CONCLUSIONS

These findings indicate that SWA disruption may play a role in sustaining negative mood state from the previous night in interepisode BD. However, positive mood state could enhance SWA in bipolar patients and healthy adults.