A longitudinal study of the relationships between sleep problems in autistic children and maternal mental health

Abstract

Autistic children experience a high rate of sleep problems, which have been associated with maternal mental health difficulties. However, the directionality of these relationships has received little attention. The extent to which children’s sleep problems influence maternal mental health difficulties and vice versa remains unclear. The aim of this study was to examine the bidirectional relationships between the sleep problems of autistic children and maternal mental health difficulties over 12 years. Six biennial waves of longitudinal data from when children were 4 to 5 years old were drawn from the Longitudinal Study of Australian Children. The sample comprised 397 child–mother dyads. Maternal mental health was assessed with the Kessler-6, while sleep problems were assessed through a series of questions relating to common sleep problems in children. The results demonstrated significant bidirectional effects between maternal mental health and child sleep problems at key developmental transition time points. Specifically, when children transitioned from preschool to primary school and again when the children transitioned from primary school to high school. These findings highlight the need for increased support for both the child and mother at these critical time points to reduce the negative impact of maternal psychological distress on child sleep problems and vice versa. Lay abstract Autistic children experience increased the rates of sleep problems. These sleep problems have been associated with mother’s mental health symptoms. However, the direction of these relationships is not well understood. This study investigated the relationships between autistic children’s sleep problems and mothers’ mental health over a 12-year period using data collected as part of the Longitudinal Study of Australian Children. Data from 397 autistic children and their mothers were included in this study. Mothers completed a questionnaire about their own mental health and common childhood sleep problems at four time points from 4–5 years to 14–15 years. The results showed important relationships between mothers’ mental health symptoms and child sleep problems at two time points. Specifically, (1) mothers’ mental health symptoms when the child was aged 4 to 5 years predicted child sleep problems at age 6 to 7 years; and (2) child sleep problems at age 12–13 years predicted mothers’ mental health symptoms when the child was aged 14 to 15 years. Interestingly, these significant relationships also coincide with key developmental transition time points, when the child is transitioning in and out of primary school. These findings highlight the need for increased support for both the child and mother at these times to optimise outcomes for both.