Table 1 ICSD-3 Classification of sleep disorders in children with ASD including descriptions and evidence

Insomnia

Persistent difficulty with sleep initiation, maintenance, duration, consolidation, or quality. Includes bedtime resistance, frequent night awakenings, and/or an inability to sleep independently

Wiggs et al.[24]

Actigraphy and SQ

Increased sleep latency, night awakenings, and poor sleep efficiency

Malow et al.[25]

PSG and CSHQ

Poorer sleep efficiency, longer sleep latency, and frequent night awakenings (up to 2–3 h)

Goodlin-Jones et al.[26]

Actigraphy and SD

Less total sleep time (TST) compared to TYP children or those with a DD

Krakowiak et al.[27]

SQ

Higher sleep-onset factor scores and night awakenings compared to typical children

Souders et al.[28]

CSHQ, SD, and actigraphy

Behavioral insomnia evident in 66% of children with ASD compared to 45.9% in controls

Anders et al.[29]

Actigraphy and SD

ASD children aged 2–5 years slept less per 24-h period on average compared to controls

Giannotti et al. [30]

PSG and CSHQ

Children with regressive ASD (n = 18) had greater bedtime resistance, sleep-onset latency, and less TST than controls

Sivertsen et al.[31]

Parent report

Prevalence of chronic insomnia was ten times higher in children with ASD symptoms compared to controls

Baker et al.[32]

Actigraphy and SD

Adolescents with ASD were three times more likely to have symptoms of insomnia than their TYP peers

Parasomnias

Undesirable physical experiences which occur within sleep or during arousal from sleep. Includes nightmares, wake screaming, complex movements, dreams, and automatic nervous system activity

Hering et al.[33]

Actigraphy and SQ

54% of children with ASD had multiple and early night arousals

Doo et al.[34]

SQ, CSHQ, and actigraphy

All reported evidence of higher rates of parasomnias in children with ASD compared to comparison groups

Schreck et al.[35]

Liu et al.[20]

Goldman et al. [36]

CSHQ

Younger children with ASD had more parasomnias than older children

Circadian rhythm sleep-wake disorders

Alterations of the circadian time-keeping system, its entrainment mechanisms, or misalignment of the endogenous circadian rhythm and the external environment. Manifests in difficulty initiating and maintaining sleep

Giannotti et al.[37]

PSG and CSHQ

More than 10% of children with ASD were found to have sleep problems that varied by season due to fluctuations in light/dark cycles

Tordjman et al.[38]

Measures of melatonin

Elevated daytime and lower nocturnal melatonin in individuals with ASD compared with controls

Hayashi [39]

SD, CSHQ, and PEQ

“Free-running” sleep (not entrained to 24-h), sleep-onset delay, and early morning awakening in children with ASD

Segawa [40]