Autism Spectrum Disorder: Sleep Characteristics in Children and Adolescents, and Their Relationship with Probable Sleep Bruxism, Anxiety, and Cortisol and Melatonin Levels-A Cross-Sectional Study of Children in Brazil.
Brazilian autistic kids with more anxiety or support needs have worse sleep and shifted stress-sleep hormones.
01Research in Context
What this study did
Ferreira and team asked 85 autistic kids in Brazil about sleep. Ages ranged from 2 to 16.
Parents filled out a sleep survey. Kids gave spit samples for cortisol and melatonin checks.
What they found
Kids with more support needs had worse sleep scores. Kids on meds or with anxiety also slept worse.
Some sleep patterns matched hormone levels. High cortisol and low melatonin went with rough nights.
How this fits with other research
Ahmmad et al. (2026) saw the same link in U.S. kids. Poor routines almost doubled autism odds.
Whaling et al. (2025) found autistic U.S. kids miss sleep guidelines more often. Ferreira adds hormone data.
Storch et al. (2012) first tracked cortisol in autistic preschoolers. Ferreira widens the age range and adds melatonin.
Why it matters
You now have proof that sleep, stress, and anxiety travel together in autism. Ask about bedtime during intake. One spit sample can guide melatonin trials. Start with kids who show high support needs or anxiety—they are the likeliest to benefit.
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02At a glance
03Original abstract
The study described the sleep characteristics (SC) of children/adolescents with Autism Spectrum Disorder (ASD), and examined their association with medication use, support level, chronotype, probable sleep bruxism (PSB), anxiety, salivary levels of cortisol (SalC) and melatonin (SalM). Methods: Following anamnesis and dental examination, anxiety was assessed using the SCARED questionnaire. The SCs were determined by two age-appropriate questionnaires, and the percentage of negative SCs (%Neg) was recorded. Saliva samples were collected to measure SalC and SalM levels. The sample comprised 85 ASD patients aged 2-16 years, of whom 80%, 50.6% were classified as support level 2, 83.5% used medication, 84.7% had an afternoon chronotype, 72.9% presented PSB, and 48.2%, anxiety. The mean %Neg was significantly higher in patients using medication (49.29 ± 15.88; p = 0.03) and those requiring more support (level 1: 41.57 ± 14.45; level 2: 50.78 ± 15.54; level 3: 55.11 ± 23.44; p = 0.019). Patients with anxiety showed a higher %Neg (51.31 ± 16.33) than those without anxiety (43.65 ± 15.79). The mean SalC and SalM levels were 13.29 ± 13.39 and 299.91 ± 241.77, respectively.. In children aged 2-6 years, one rhythmicity SC and two separation-related SCs were associated with SalC (p < 0.05); lower SalM levels were found in patients who "slept alone" (p = 0.02). In older patients, "moving while sleeping" was associated with lower SalC (p = 0.05), and three additional SCs were linked to reduced SalM levels (p < 0.05). The presence of negative SCs in ASD patients was more common in those taking medication, requiring more support, and presenting anxiety. Furthermore, SalC and SalM levels were associated with specific SCs, especially among individuals aged (7-16).
Journal of autism and developmental disorders, 2025 · doi:10.5664/jcsm.27443