Correlation between sleep problems and physical activity in children with autism spectrum disorder.

Background: Sleep problems are common among children with autism spectrum disorder, and these problems are closely related to physical activity. This study aimed to investigate the prevalence of sleep problems and physical activity (PA) levels among children with autism spectrum disorder (ASD) and to analyze the correlation between these factors. Methods: A cross-sectional study was conducted involving 312 children with ASD (aged 2.5-12 years) recruited from the Children's Hospital of Zhejiang University School of Medicine between January and December 2024. Their guardians or primary caregivers completed a general information questionnaire and the Children's Sleep Habits Questionnaire (CSHQ). Results: More than 40% of the school-aged children (4-12 years) engaged in moderate-to-vigorous physical activity (MVPA) for less than one hour per day. Significant differences in bedtime habits were observed across different daily exercise durations (F=3.898, P=0.02). Furthermore, the average daily exercise duration was positively correlated with bedtime habits (r=0.144, P<0.05). Conversely, the average daily moderate-intensity exercise duration was negatively correlated with both daytime sleepiness (r=-0.156, P<0.001) and the total CSHQ score (r=-0.114, P<0.05). Conclusions: Sleep problems are highly prevalent and assessment of PA levels are generally low among children with ASD. A significant correlation exists between sleep problems and PA. Therefore, close attention to the PA status of children with ASD is essential for addressing sleep-related issues.