Evidence map›Paper›PMID 36385326›Full record

ArticleSleep2023

Sleep architecture is associated with core symptom severity in autism spectrum disorder.

Makoto Kawai, Casey Buck, Christina F Chick, Lauren Anker, Lisa Talbot, Logan Schneider, Omer Linkovski, Isabelle Cotto, Kai Parker-Fong, Jennifer Phillips and 3 more

Open access · greenAbstract read
In one paragraph

Article in Sleep, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed
2.2field-weighted citation impact, top 12% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

19 citing papers in PubMed, 27 citations in OpenAlex.

  1. Article
  2. Article
  3. Review
  4. Observational
  5. Article
  6. Sleep and activity patterns in autism.Autism : the international journal of research and practice · 2026
    Article
  7. Article
  8. Article
  9. Article
  10. Theta Activity at Sleep Onset in Children with Autism Spectrum Disorder.Journal of autism and developmental disorders · 2025
    Article
  11. Article
  12. Article
  13. Article
  14. Review
  15. Autism Across the Lifespan.Focus (American Psychiatric Publishing) · 2024
    Article
  16. Article
  17. Review
  18. Article
  19. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 2 institutions in 1 country.

Makoto KawaiDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Casey BuckDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Christina F ChickDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Lauren AnkerDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Lisa TalbotDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Logan SchneiderDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.ORCID 0000-0001-8729-5224
Omer LinkovskiDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Isabelle CottoDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Kai Parker-FongDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Jennifer PhillipsDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.ORCID 0000-0002-6360-2346
Antonio Y HardanDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Joachim HallmayerDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Ruth O'HaraDepartment of Psychiatry and Behavioral Sciences, Stanford University, School of Medicine, Stanford, CA, USA.
Stanford University · USVA Palo Alto Health Care System · US

Funding

Stanford Center for Clinical & Translational Education and Research (Spectrum)UL1TR003142 · NCATS · STANFORD UNIVERSITY · PI O'HARA, RUTH M · 2019 to 2023
$45.0M
Cortical Hemodynamism and Oxygenation During Sleep and Cognition: Window to Cognitive Impairment and Neurodegeneration in AgingK23AG053465 · NIA · STANFORD UNIVERSITY · PI KAWAI, MAKOTO · 2017 to 2022
$1.1M
NCATS NIH HHS UL1 TR003142NIA NIH HHS K23 AG053465
6 · The paper itself

Abstract

STUDY

objectivesWhile caregiver-reported sleep disturbances are common in children and adolescents with autism spectrum disorder (['), few studies have measured objective sleep in ASD compared to controls, and their findings are mixed. We investigated (1) differences in sleep architecture, specifically slow-wave sleep (SWS) and rapid eye movement (REM) sleep, between ASD and typically developing controls (TD); and (2) if any observed differences in sleep were associated with core ASD symptoms.

methodsWe used ambulatory polysomnography (PSG) in 53 participants with ASD (ages 4-18) and 66 age-matched TD in their home sleeping environment. The primary outcome measures were SWS and REM sleep. Core behavioral ASD symptoms were assessed using the Autism Diagnostic Interview-Revised (ADI-R). Spectral power bands during sleep, and additional behavioral measures, were examined in exploratory analyses.

resultsCompared to TD, participants with ASD exhibited a higher SWS ratio and lower REM sleep ratio. Within the ASD group, higher SWS was associated with more severe symptoms on the Restricted, Repetitive, and Stereotyped Behaviors subscale of the ADI-R. No association was observed between REM sleep ratio and any ASD symptom.

conclusionsIncreased SWS and reduced REM sleep ratio differentiated ASD from TD. However, only increased SWS was associated with more severe core ASD symptoms. Increased SWS may reflect neuronal immaturity specific to ASD in this age group. These findings may inform the underlying mechanisms of clinical symptoms observed in children and adolescents with ASD.

Indexed as

Autism Spectrum DisorderSleep, Slow-WaveAdolescentChildChild, PreschoolHumansPolysomnographySleepSleep, REMautism spectrum disorderrepetitive behaviorsslow wave activityslow wave sleep

Identifiers

PMID36385326
PMCPMC9995925
OpenAlexW4309243789

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.