Research from Türkiye highlights significant sleep difficulties, behavioural issues, and emotional exhaustion in children with ASD and their mothers, urging a family-centred approach to care.
Children with autism spectrum disorder are far more likely to struggle with sleep than their typically developing peers, but a new case-control study suggests the issue goes well beyond broken nights. Researchers at a tertiary psychiatric clinic in southern Türkiye found that children with ASD had more bedtime resistance, night waking and parasomnias, alongside worse behavioural scores, lower health-related quality of life and markedly higher levels of depression and burnout in their mothers.
The study followed 101 children aged six to 12 with DSM-5-confirmed ASD and 81 controls, all assessed through maternal questionnaires during a single outpatient visit between March 2024 and March 2025. Although the children with ASD were reported to sleep for longer each day, their sleep quality was poorer across most measures. Daytime sleepiness did not differ significantly, suggesting that duration alone is a misleading marker of rest in this group. The authors also reported substantial clinical complexity in the ASD cohort, including high rates of intellectual disability, speech impairment, psychiatric comorbidity and medication use.
On standard scales, children with ASD scored worse for emotional symptoms, conduct problems, hyperactivity, peer difficulties and prosocial behaviour, while their quality-of-life scores were lower across emotional wellbeing, self-esteem, family life, friendships and school functioning. Mothers in the ASD group had significantly higher emotional exhaustion and depressive symptoms than mothers of controls. In statistical models, autism diagnosis, behavioural difficulties, sleep disturbance and maternal burnout all independently predicted lower child quality of life. Sleep quality also appeared to explain part of the link between poorer child behaviour, maternal distress and reduced wellbeing.
The authors say the findings support a more family-centred approach to ASD care, in which sleep is treated as a core clinical concern rather than an isolated symptom. They caution that the study’s cross-sectional design cannot prove cause and effect, and that parent-reported data and the lack of detailed medication records limit how far the results can be generalised. Even so, the pattern points to a wider burden shared by children and caregivers alike, and suggests that routine assessment of sleep and maternal mental health could improve management.
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