Anxiety and Depression Affect Sleep Quality: A Preliminary Investigation in Crowdsourced Samples of Autistic and Non-Autistic Adults.
Anxiety and depression, not autism itself, explain poor sleep in autistic adults.
01Research in Context
What this study did
Udhnani et al. (2025) asked the adults to fill out three online surveys. Half said they were autistic; half said they were not.
The surveys measured sleep quality, anxiety, and depression. The team used statistics to see if autism alone predicted bad sleep.
What they found
Autistic adults did report worse sleep at first glance. When anxiety and depression were added to the model, the autism label no longer mattered.
In plain words, worry and low mood fully explain why autistic adults in this sample slept poorly.
How this fits with other research
Paavonen et al. (2008) found over half of kids with Asperger syndrome had big sleep problems. The new study updates that picture for adults: the sleep gap vanishes once you count anxiety and depression.
Alvarez-Fernandez et al. (2017) showed autistic adults feel less friend support. Together these papers hint that mental-health variables, not autism traits alone, drive both sleep and social strain.
Schaaf et al. (2015) saw parents under-report mental-health meds in autistic youth. If anxiety is missed in kids, sleep problems may be blamed on autism instead of treatable mood issues.
Why it matters
Before you add bedtime charts or weighted blankets, screen for anxiety and depression. A quick GAD-7 and PHQ-9 can show if mood treatment, not autism coaching, is the fastest route to better sleep.
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02At a glance
03Original abstract
We aimed to compare sleep problems in autistic and non-autistic adults with co-occurring depression and anxiety. The primary research question was whether autism status influences sleep quality, after accounting for the effects of depression and anxiety. We hypothesized that autistic adults would report higher levels of depression, anxiety, and sleep problems compared to non-autistic adults, after controlling for these covariates. We recruited 208 adults (109 non-autistic, 99 autistic) through a crowdsourcing platform, Prolific. Participants completed the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, and the Generalized Anxiety Disorder 7-item scale. Statistical analyses included Mann-Whitney U tests to compare group scores and a generalized linear model to assess the effect of autism status on sleep problems while controlling for depressive and anxiety symptoms. Autistic adults reported significantly higher levels of depressive and anxiety symptoms compared to non-autistic adults. However, after controlling for depression and anxiety, autism status alone did not have a statistically significant effect on overall sleep quality. The findings suggest that while autistic adults experience more severe sleep problems, these issues are closely related to higher levels of depression and anxiety rather than autism status itself. This study contributes to the understanding of sleep difficulties in autistic individuals, highlighting the importance of addressing co-occurring mental health conditions. Further research should explore the specific factors that exacerbate sleep problems in this population.
Journal of autism and developmental disorders, 2025 · doi:10.1002/AUR.2604