Sleep disturbances are associated with greater healthcare utilization in children with autism spectrum disorder

Shirley Solomon, Leena Elbedour, Gal Meiri, Analya Michaelovski, Yair Sadaka, Michal Ilan, Michal Faroy, Ilan Dinstein, Idan Menashe

Research output: Contribution to journalArticlepeer-review


Background: Sleep disturbances are frequently reported in children with autism spectrum disorder (ASD) and are associated with the severity of co-occurring symptoms. This study’s aim was to examine the extent of healthcare utilization and clinical outcomes associated with sleep disturbances in children with ASD. Study design: A retrospective, cross-sectional study of 541 children with ASD from the Azrieli National Center for Autism and Neurodevelopment Research (ANCAN) whose parents completed the Children’s Sleep Habits Questionnaire (CSHQ). Children with a total CSHQ score ≥ 48 were defined as having sleep disturbances. Sociodemographic characteristics, ASD diagnostic measures, chronic co-occurring conditions, medication usage, hospitalizations, visits to the emergency room (ER), and visits to specialists were compared in ASD children with and without sleep disturbances. Multivariate logistic regression models were then used to assess the independent association of sleep disturbances with clinical characteristics and healthcare utilization. Results: Of the 541 children with ASD, 257 (47.5%) had sleep disturbances. Children with sleep disturbances exhibited higher rates of multiple (≥ 3) co-occurring conditions (19.1% vs. 12.7%; p = 0.0414) and prescribed medications (45.5% vs. 32.7%; p = 0.0031) than other children. Finally, ASD children with sleep disturbances were 1.72 and 2.71 times more likely to visit the ER and be hospitalized than their counterparts (aOR = 1.72; 99%CI = 1.01–2.95; and aOR = 2.71; 99%CI = 1.10–6.67, respectively). Conclusions: Our findings suggest that sleep disturbances are associated with greater healthcare utilization among children with ASD. Further studies could examine whether treating sleep disturbances in children with ASD yields additional clinical benefits beyond improvements in sleep.

Original languageEnglish
Article number29
JournalJournal of Neurodevelopmental Disorders
Issue number1
StatePublished - 1 Dec 2024


  • Autism
  • Autism spectrum disorder (ASD)
  • Co-occurring conditions
  • Healthcare utilization
  • Medication use
  • Melatonin
  • Sleep
  • Sleep disturbances

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine
  • Clinical Neurology
  • Cognitive Neuroscience


Dive into the research topics of 'Sleep disturbances are associated with greater healthcare utilization in children with autism spectrum disorder'. Together they form a unique fingerprint.

Cite this