Prevalence and associated factors of sleep disorders in children and adolescents with autism spectrum disorder: a meta-analysis and systematic review

BACKGROUND: Sleep disorders significantly impact the physical rehabilitation of children with autism spectrum disorder. The factors associated with these sleep disorders remain a subject of debate in clinical research. By identifying factors associated with sleep disorders in this population, more effective intervention strategies can be developed for the rehabilitation of children and adolescents with autism spectrum disorder. Therefore, this review aims to conduct an in-depth analysis of the factors associated with sleep disorders in children and adolescents with autism spectrum disorder, providing evidence-based references for advancing clinical prevention strategies. METHODS: A systematic search was conducted in the CNKI, Wanfang, VIP, CBM, PubMed, Web of Science, Embase, CINAHL, and Cochrane Library databases for studies investigating factors associated with sleep disorders in children and adolescents with autism spectrum disorder. The search period spanned from the inception of each database to August 31, 2025. Two researchers independently performed literature screening, quality assessment, and data extraction. Meta-analysis was conducted using Stata MP 17 software. RESULTS: This study included 22 research studies involving a total of 3,771 participants. Meta-analysis results showed that the prevalence of sleep disorders was 60%. with age(young), co-sleeping with parents, nighttime sleep duration, daytime sleep duration, child's screen exposure time, family dysfunction, history of neonatal asphyxia, birth weight (low), parental education level, maternal perinatal nutritional support, child supplements, children are not picky eaters, child behavioral problems, autism severity, and parental screen exposure before child sleep were the primary factors associated with sleep disorders in children and adolescents with autism spectrum disorder (P < 0.05). CONCLUSION: Children and adolescents with autism spectrum disorder experience sleep disorders influenced by multiple factors. Identifying these associated factors can help in developing strategies for managing sleep problems in this population, which may contribute to improving their overall daytime functioning.