Eating behaviors and sleep problems in children with autism spectrum disorder and their correlation factors
Objective To investigate the distribution of sleep and eating behavior problems in children with autism spectrum disorder(ASD),and to analyze their correlations with clinical characteristics,in order to provide basis for fwture mechanism research and clinical intervention.Methods A total of 211 ASD children aged 2-7 were enrolled into this study from outpatient department from January to June 2023,and 91 typically developed children matched with age and sex were enrolled into control group.Autism Behavior Checklist(ABC),Children's Sleep Habits Questionnaire(CSHQ)and a self-made questionnaire were used to assess children's autistic behavior,sleep problems and eating behaviors.Chi-square test,t test,non-parametric test and multinomial Logistic regression analysis were performed to analyze the relationship between sleep problems and eating behaviors in children with ASD.Results The prevalence rates of sleep problems and food selectivity were significantly higher in children with ASD than those in control group(x2=6.876、17.299,P＜0.05).The total score of CSHQ of ASD children(48.55±6.07)was significantly higher than that of control group(45.24± 5.33)(t=4.494,P＜0.05).ASD children were more likely to report bedtime resistance,sleep onset delay,sleep duration,night waking,parasomnias and sleep disordered breathing than control group(P＜0.05).The total score of CSHQ was significantly higher in ASD children with aberrant eating behaviors,and the difference was statistically significant in food selectivity(type selectivity,texture selectivity and pica)(Z=2.803,P＜0.05).Multinomial Logistic regression indicated that the occurrence of sleep onset delay was positively affected by body and object use(OR=1.063),and negatively affected without food texture selectivity(OR=0.524)and pica(OR=0.343).Conclusions ASD children have a higher risk of sleep problems and aberrant eating behaviors than the typically developed children.Moreover,ASD children with aberrant eating behaviors have more severe sleep problems.The influencing factors of sleep onset delay include body and object use,food texture selectivity and pica.
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