692 Longitudinal Stability of Sleep and Health Correlates in Adults with Autism Spectrum Disorder

Abstract

Abstract Introduction Individuals with Autism Spectrum Disorder (ASD) experience sleep disturbances to a greater degree than the general population. The majority of research investigating sleep disturbances in ASD has focused on children and adolescents. The aim of the current study was to determine the stability and health correlates of self-reported sleep disturbances in adults with ASD. Methods Participants included 55 adults with ASD recruited from state-funded Pennsylvania programs (31.2±7.6 years old, 80% male, 10.9% minority). Patient-Reported Outcomes Measurement Information System (PROMIS) measures assessing Sleep Disturbances, Sleep-Related Impairment, Fatigue, Anxiety, Depression, Anger, and Physical Health, were completed at baseline and every 90 ± 14 days over a 2-year period. Intraclass correlation coefficients (ICC) were calculated for each sleep outcome, and interpreted as 0.00–0.20=“poor stability,” 0.21–0.40=“slight stability,” 0.41–0.60=“moderate stability,” 0.61–0.80=“substantial stability,” and 0.81–1.00=“almost perfect stability” across the first three time-points. Linear mixed models examined the independent association of sleep disturbances, sleep-related impairment, and fatigue on anxiety, depression, anger, and physical health over the two-year period. Results Sleep-related impairment (ICC=0.73) and fatigue (ICC=0.64) were substantially stable, while sleep disturbances were moderately stable (ICC=0.58). All three sleep-related outcomes were independently associated with anxiety (sleep-related impairment p=0.012; sleep disturbance p<0.001; fatigue p=<0.001) and anger (sleep-related impairment p=<0.001; sleep disturbance p=0.001; fatigue p<0.001) across the two-year period. Sleep disturbance (p=<0.001) and fatigue (p<0.001), but not sleep-related impairment (p=0.267), were associated with depression across the two-year period. In contrast, none of the sleep-related outcomes (sleep-related impairment p=0.285; sleep disturbance p=0.250; fatigue p=0.709) were associated with physical health over time. Conclusion Measures of sleep-related impairment, fatigue, and sleep disturbance remained stable over time, suggesting that they can provide clinicians and researchers with a brief, accurate, and reliable way to assess patient-reported sleep outcomes in adults with ASD. Furthermore, given the stability of these sleep measures and their independent association with elevated mental health outcomes, there is a need for evidence-based treatments targeting sleep difficulties and associated symptomology in adults with ASD, a particularly underserved population. Support (if any) Pennsylvania State Bureau of Autism Services through the Autism Services, Education, Resources, and Training (ASERT) grant