Sleep disorders in children with neurodevelopmental disorders: Comparative actigraphy and questionnaire assessment in ASD, ADHD, and controls.

Background: Sleep disturbances are highly prevalent in children with neurodevelopmental disorders (NDD), yet few studies have combined objective and subjective measures. The objectives of this study were to evaluate sleep patterns and sleep hygiene in children with ADHD and ASD compared age-matched typically developing children, using both parent-reported questionnaires and actigraphy, to assess the concordance between these measures, and to determine the clinical applicability of actigraphy in this population.

Methods: Sixty children with NDD (30 ASD, 30 ADHD) and 40 typically developing controls, matched for age, underwent seven nights of actigraphic recording. Parents completed the Sleep Disturbance Scale for Children (SDSC) and Family Inventory of Sleep Habits (FISH).

Results: Actigraphy was well tolerated in the NDD group (88 %), consistent with previous findings. Compared to TD controls, children with NDDs showed significantly higher SDSC scores (p < 0.001) and poorer actigraphic sleep parameters, including lower sleep efficiency (82.0 % vs 87.3 %, p < 0.001) and longer wake after sleep onset (78.8 vs 52.7 min, p < 0.001). Concordance between actigraphy and SDSC was limited (≈53 % in NDD; 15 % in TD). No significant group differences were found in sleep hygiene, although FISH scores correlated with selected actigraphic parameters only in controls.

Conclusions: Sleep disturbances are highly prevalent in NDD, and actigraphy is a reliable, well-tolerated tool for clinical assessment. Given the limited agreement between actigraphy and questionnaires, multimethod approaches may be necessary. Actigraphy should be considered for integration into routine clinical practice to improve sleep evaluation in pediatric NDD populations.