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Relationships between autistic traits, insufficient sleep, and real-world executive functions in children: a mediation analysis of a national epidemiological survey

Published online by Cambridge University Press:  26 November 2019

Tsung-Han Tsai ,
Yi-Lung Chen Open the ORCID record for Yi-Lung Chen [Opens in a new window]  and
Susan Shur-Fen Gau Open the ORCID record for Susan Shur-Fen Gau [Opens in a new window]
Tsung-Han Tsai
Affiliation:
School of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
Yi-Lung Chen
Affiliation:
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
Susan Shur-Fen Gau*
Affiliation:
Department of Psychiatry, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
*
Author for correspondence: Susan Shur-Fen Gau, E-mail: gaushufe@ntu.edu.tw
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Abstract

Background

Although the literature documents low executive functions and sleep deficits in individuals with autism spectrum disorder or subclinical autistic traits, no study has simultaneously examined their relationships in the general child population. This study aimed to examine whether autistic traits impacted real-world executive functions through insufficient sleep in a nationally representative sample of children.

Methods

This was a national survey of 6832 primary and secondary school students, aged 8–14 years old, with equal sex distribution (3479 boys, 50.8%). Parents reported their child's nocturnal sleep duration and the need for sleep to maintain their daytime function and the Social Responsiveness Scale and the Behavior Rating Inventory of Executive Function (BRIEF) for their children's autistic traits and real-world executive functions, respectively.

Results

We found that autistic traits exerted indirect effects on real-world executive functions through sleep deficits, independent of sex, and age. Moreover, such an indirect effect was observed only from restricted and repetitive behaviors to executive functions through sleep deficits, but not in the other components of autistic traits (i.e. social communication and interaction).

Conclusions

Our novel findings underscore the importance of sleep and autistic traits in executive functions and suggest potential mechanisms that may underlie the observed correlational structure among autistic behaviors, sleep deficits, and low executive function performance.

Keywords

Autism spectrum disorderautistic traitsexecutive functioninsufficient sleepmediation
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 4 , March 2021 , pp. 579 - 586
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Copyright
Copyright © Cambridge University Press 2019

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Footnotes

*

Tsung-Han Tsai and Yi-Lung Chen contributed equally to this work as the joint first authors.

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