Physiological and Family-Level Correlates of Autistic Adolescents' Sleep Quality.

The analysis used 107 of the 119 families in the larger study; some families were excluded for missing physiological data or invalid survey responses. The study was cross-sectional, so it cannot show that family environment causes poor sleep or that poor sleep affects family environment. Only adolescents with an IQ score of at least 70 and verbal fluency were included, so findings may not apply to autistic adolescents with intellectual disability or limited speech. Autism diagnosis was based on community diagnosis rather than a formal clinical diagnosis in this study. Both family environment and sleep quality were self-reported by adolescents, which may create shared reporter bias. Medication use was examined, but side effects such as sleepiness caused by medication were not captured. The null interaction findings may reflect limited power to detect two- and three-way interactions. The sample was mostly male (79.2%), White/European American (69.2%), and many families reported high income (27.6% above $150,000), so generalisability is limited.

The authors declared no conflict of interest.

Do not conclude that family environment causes poor sleep or that changing family relationships will improve sleep. The study is cross-sectional and both family environment and sleep were reported by the same adolescents. Do not use RSA as a clinical marker for sleep problems here, because RSA was not associated with sleep quality.