Abstract
BackgroundVitamin A deficiency (VAD) and sleep disturbances have been reported in children with autism spectrum disorder (ASD). The influence of vitamin A (VA) levels on sleep regulation and sleep disturbances in ASD has garnered concern. The present study aimed to characterize the association of VA levels with sleep disturbances in children with ASD.MethodsThis cross-sectional study compared children with ASD (n = 856) to typically developing children (TDC; n = 316). We used the Children’s Sleep Habits Questionnaire to assess sleep disturbances, Childhood Autism Rating Scale to evaluate the severity of autism symptoms, and Autism Behavior Checklist and Social Responsiveness Scale to assess autism behaviors. Serum VA levels were estimated using high-performance liquid chromatography. Multivariable linear regression and two-way analysis of variance were performed to investigate if VAD was related to sleep disturbances in children with ASD.ResultsChildren with ASD had lower serum VA levels and a higher prevalence of sleep disturbances than TDC did. The incidence of VAD in ASD children with sleep disturbances was higher, and the symptoms more severe than those without sleep disturbances and TDC. Interestingly, the interaction between VAD and sleep disturbances was associated with the severity of autism symptoms.ConclusionVAD and sleep disturbances are associated with the core symptoms of ASD in children. Regular monitoring of sleep and VA levels may be beneficial for children with ASD.Trial registrationChinese Clinical Trial Registry, registration number: ChiCTR-ROC-14005442, registration date: December 9th 2014.
Highlights
Vitamin A deficiency (VAD) and sleep disturbances have been reported in children with autism spectrum disorder (ASD)
The mean serum vitamin A (VA) level was significantly lower in the ASD group than the typically developing children (TDC) group
The children with ASD had a significantly higher prevalence of sleep disturbances than TDC based on the defined cutoff score of 41 on the Childhood Sleep Habit Questionnaire (CSHQ) (ASD: 79% [682/856 children], TDC: 49% [157/316 children], P < 0.001)
Summary
Vitamin A deficiency (VAD) and sleep disturbances have been reported in children with autism spectrum disorder (ASD). The present study aimed to characterize the association of VA levels with sleep disturbances in children with ASD. Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by core symptoms including deficits in social communication and interaction, speech and language disorders, as well as restricted, repetitive, and stereotyped behaviors [1]. With a reported prevalence of 50–80% in children with ASD [4,5,6] compared with 25–50% in typically developing children (TDC), have attracted substantial attention recently [7, 8]. While the underlying mechanisms are not clear, multiple neurodevelopmental, medical, psychosocial, and environmental factors have been hypothesized to cause increased sleep disturbances in children with ASD. Abnormalities in melatonin levels and their secretion patterns and in Clock or Clock-related genes and their synaptic pathways have been suggested as possible intrinsic contributors [6, 16,17,18]
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