Children's sleep problems and maternal mental health in mothers of children with and without autism

There has been a recent and marked increase in the rates of autistic spectrum disorders (ASD). Children diagnosed with an ASD have qualitative impairments in social interactions and communication and they engage in repetitive, stereotyped behaviors. Significant sleep difficulties are frequently associated with ASDs, particularly in terms of the ability to fall asleep, stay asleep, and sleep for an adequate length of time. One potential consequence of children's sleep problems is that parental well being may suffer. This relationship would account for the high rates of sleep disorders in children with an ASD and the concomitantly high rates of psychopathology in the parents of children with ASDs. The research presented here tested a model of the relationship between children's sleep problems and parental mental health, whereby the influence of children's sleep is transmitted via its impact on maternal sleep and maternal stress. It is suggested that children's sleep problems impair parents' sleep, which subsequently impairs parental mental health. A second possibility is that children's sleep problems contribute to maternal stress, which, in turn, increases mothers' mental health problems. It was also proposed that the nature of the relationship between these variables would differ for mothers of children with an ASD and mothers of typically developing children. A moderated-mediation model was tested whereby it was hypothesized that the relationship between children's sleep quality and maternal mental health would be mediated by maternal sleep quality and maternal stress level, and the mediated relationship would differ by child developmental status (i.e., children with autistic spectrum disorders or typically developing children). Ninety typically developing children were matched to 90 children with an autistic spectrum disorder. Children, who ranged from 4 to 12 years, were matched on age, gender, and ethnicity. Results indicate that maternal sleep quality did mediate the relationship between children's sleep and maternal psychopathology; however, this relationship did not differ by child's developmental status. Maternal stress also mediated the relationship between children's sleep and maternal mental health, with the relationship being stronger for mothers of typically developing children than for mothers of children with an autistic spectrum disorder. The direction of the moderation when maternal stress is the mediating variable, may indicate that mothers of children with an autistic spectrum disorder are experiencing relatively more stress from sources other than children's sleep problems.