Poor Infant Sleep May Signal Higher Autism Risk, Study Finds

The prospective study, conducted in Victoria’s Barwon region, involved over 1,000 mother-infant pairs recruited between 2010 and 2013. Zaynab Mohamed, The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia, and colleagues analyzed infant sleep behaviors at ages 6 and 12 months of age. They followed up on autism-related traits and diagnoses through early childhood and into preadolescence.

Using the Brief Infant Sleep Questionnaire, parents reported their child's sleep duration and latency—the time it takes for a child to fall asleep. These sleep metrics were compared with behavioral assessments at ages 2 and 4, and formal autism diagnoses made by 11.5 years based on DSM-5 criteria.

The study led to the following findings:

• A 10% increase in infant night-time sleep duration (approximately one hour) was associated with a 4.5% reduction in autism-related traits at ages 2 and 4.
• The same increase in sleep duration was linked to a 22% lower likelihood of an autism diagnosis by age 11.5.
• A 25% increase in sleep latency at 12 months (around five additional minutes to fall asleep) was associated with a 1.5% rise in autism-related traits.
• This increased sleep latency also corresponded to a 7.7% higher chance of being diagnosed with autism.
• Among children later diagnosed with autism, 42% had used melatonin in the month before assessment, indicating ongoing sleep difficulties.

The study authors emphasized that while these associations are compelling, they do not confirm a direct cause-and-effect relationship. It remains unclear whether sleep disturbances are a symptom of underlying neurodevelopmental differences or whether they play a contributory role in the onset of autism. Nonetheless, these results highlight the value of monitoring sleep during infancy as a potential early signal of developmental concerns.

According to the researchers, early identification and intervention could help families access support sooner. They suggest pediatricians and caregivers consider sleep behaviors—particularly reduced night sleep and prolonged sleep latency—as part of routine developmental screening.

The population-based research adds to the growing evidence suggesting that early-life sleep patterns are intricately linked to later neurodevelopmental outcomes. Future studies may further explore the shared biological pathways that influence sleep regulation and autism spectrum traits.

Reference:

Mohamed Z, Ponsonby A, Wakhlu A, et alInfant sleep characteristics in children with autism spectrum disorder: a population-derived Australian birth cohort studyArchives of Disease in Childhood Published Online First: 11 May 2025. doi: 10.1136/archdischild-2024-328393