Insomnia severity and its association with gaming behavior and perceived health in autistic adults

Insomnia is a prevalent and growing health concern among autistic adults, profoundly impacting their well-being. Empirical studies suggest that autistic adults tend to spend extensive time playing online or video games, which may contribute to sleep disturbances and low health perceptions in this population. This study aimed to explore the associations between insomnia, gaming behavior, and perceived physical and mental health among autistic adults, including those with co-occurring mild intellectual disabilities (ID). A total of 117 autistic adults (Mage33.7 ± 9.2; 63.2% female) participated in this cross-sectional study. Standardized self-report instruments were utilized to assess demographics, insomnia severity, gaming behavior, and perceived physical and mental health. Descriptive statistics, independent t-tests, Spearman’s rank correlations, and stepwise multiple regression analyses were performed to answer the research questions. Of the 117 autistic adult participants, 32.5% reported moderate-to-severe insomnia, and 14.5% were identified as potentially meeting the criteria for gaming disorder. Significantly higher gaming time was reported in autistic adults with co-occurring mild ID (M = 672.6 ± 941.6 min/week) compared to those without mild ID (M = 334.8 ± 354.3 min/week, t(115) = 2.432, p < .001), and in males (M = 615.9 ± 830.3 min/week) compared to females (M = 404.3 ± 592.1 min/week, t(115) = 1.469, p = .038). Perceived mental health was negatively correlated with both gaming disorder risk (ρ = -0.221, p < .05) and insomnia severity (ρ = -0.341, p < .01), indicating modest yet noteworthy associations. Perceived mental health was the strongest predictor of insomnia severity (β = -0.273, t(113) = -3.186, p = .002.), while a more recent autism diagnosis and gaming disorder risk were also significant predictors in the regression model, which explained 22.2% of the variance in insomnia scores (F(3, 113) = 10.76, p < .001). The findings of this study indicate that insomnia may co-occur with lower perceived mental health and problematic gaming behaviors among autistic adults, and these patterns appear pronounced in autistic males with co-occurring mild ID.