0801 The Relationship of Objectively Measured Sleep to Puberty in School-Age Children with Familial Autism

Abstract Introduction The onset of puberty brings changes in sleep patterns in neurotypical school-aged children, shifting circadian timing and decreasing total sleep time. Sleep problems affect over 80% of school-aged autistic children. The predominant autism sleep phenotype involves longer sleep onset latency, night wakings, and early morning waking—defining features of insomnia. Research on the relationship of puberty to sleep problems, sleep duration, and sleep onset timing in autistic children is limited. Methods 232 school-aged children (age 6-13 years; Male n=142, Female n=90) participated in a sleep study through the longitudinal, multisite Infant Brain Imaging Study (IBIS) network. Participants were ascertained at 6-months-old for having an older autistic sibling (high-likelihood; HL) or no family history of autism (lower-likelihood; LL). The HL group included 47 diagnosed with autism (HL+), 104 without autism (HL-), and an LL comparison group of 81. The participants with actigraphy were categorized as Pre-puberty (n=89) or In-puberty (n=38) based on Tanner Staging. Measures include sleep problems (Children's Sleep Habits Questionnaire, CSHQ), sleep duration and sleep onset time (via 10 days actigraphy and sleep diary). Results Sleep problems were significantly increased in the HL+ group compared to HL- and LL groups (CSHQ; p< 0.01; χ2=23.736). Sleep onset times were later for the In-Puberty versus Pre-Puberty HL- group by 52.2 minutes (Kruskal-Wallis; p=0.01), and later, but not statistically significant, for the HL+ group by 43.2 minutes and LL group by 6.6 minutes. Sleep duration was lower, but not statistically significant, for the In-Puberty versus Pre-Puberty HL+ group by 36.6 minutes and HL- group by 37.2 minutes, and higher for the LL group by 3 minutes (ns). Conclusion Overall, parent-reported sleep problems were increased in school-age HL autistic children compared with HL- and LL children. Objective measures revealed In-Puberty HL+ and HL- had notably later sleep onset times and decreased sleep duration compared with Pre-Puberty. However, only HL- sleep onset time was significantly later. This pattern suggests sleep characteristics could be associated with familial autism and puberty. Future studies with a larger sample are needed to further evaluate the effect of puberty on sleep in autism. Support (if any) R01 HD101578