Methodological Approaches to Sleep Measures in Children with Autism Spectrum Disorder – A Systematic Review

Given the prevalence and significance of sleep difficulties in children with autism spectrum disorder (ASD), several interventional studies using diverse sleep measurement tools have recently emerged. This systematic review assesses the methodology quality of frequently used sleep measurement tools in interventional RCT studies involving children with ASD, and it recommends a methodological approach to evaluating sleep outcomes. This review process followed PRISMA guidelines. All 39 identified interventional RCTs involved children with ASD (<18 years old), of which they were of low (n = 2, 5%), moderate (n = 13, 33%), and high (n = 24, 62%) quality. The Children's Sleep Habits Questionnaire (CSHQ, n = 22), actigraphy (ACT, n = 12), and the Sleep and Nap Diaries (SNDs, n = 11) were the most frequently used sleep measurement tools. Most studies (n=28, 72%) chose single and or subjective sleep measurement tools, and their methodologies generally had moderate to high compliance with reporting criteria: none employed polysomnography (PSG). This review revealed that the quality of interventional RCT studies within the population was generally optimal; however, using single and subjective sleep measurement tools was a notable limitation. Future research that combines PSG, ACT, sleep questionnaires such as CSHQ, and SNDs is recommended as a robust methodological approach to evaluating sleep outcomes in children with ASD during interventional RCT studies.