Autism & Developmental

Cardiovascular disease risk factors in autistic adults: The impact of sleep quality and antipsychotic medication use.

Bishop et al. (2023) · Autism research : official journal of the International Society for Autism Research 2023
★ The Verdict

Poor sleep and antipsychotic use each raise heart disease signs in autistic adults.

✓ Read this if BCBAs serving autistic teens or adults who take antipsychotics.
✗ Skip if Clinicians working only with young children or clients off medication.

01Research in Context

01

What this study did

Bishop et al. (2023) asked autistic adults about their sleep and medicine use. They also checked blood pressure, weight, and cholesterol. The goal was to see if poor sleep or antipsychotic drugs link to heart disease risk.

02

What they found

People who slept badly had more signs of heart trouble. Those taking antipsychotics also showed higher risk. Both poor sleep and the drugs added to the danger.

03

How this fits with other research

Costa et al. (2020) found that bad sleep lowers quality of life in autistic adults. Lauren’s team shows the same sleep problem hurts the heart. Together they say: fix sleep, help the whole person.

Coffey et al. (2005) used wrist watches to prove most autistic youth wake often at night. Lauren now shows those nights add up to damaged blood vessels years later.

Zheng et al. (2018) report autistic people get schizophrenia three times more often, so doctors often prescribe antipsychotics. Lauren warns these needed drugs may raise heart risk, so check blood pressure and weight at every visit.

04

Why it matters

You can’t stop antipsychotics alone, but you can track sleep and heart numbers. Ask clients about bedtime routines. Use actigraphy or a simple diary. Share results with prescribers so dose and diet change together.

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Start a one-week sleep log with your client and flag any night under 6 hours to the medical team.

02At a glance

Intervention
not applicable
Design
other
Sample size
545
Population
autism spectrum disorder
Finding
positive

03Original abstract

Approximately 40% of American adults are affected by cardiovascular disease (CVD) risk factors (e.g., high blood pressure, high cholesterol, diabetes, and overweight or obesity), and risk among autistic adults may be even higher. Mechanisms underlying the high prevalence of CVD risk factors in autistic people may include known correlates of CVD risk factors in other groups, including high levels of perceived stress, poor sleep quality, and antipsychotic medication use. A sample of 545 autistic adults without intellectual disability aged 18+ were recruited through the Simons Foundation Powering Autism Research, Research Match. Multiple linear regression models examined the association between key independent variables (self-reported perceived stress, sleep quality, and antipsychotic medication use) and CVD risk factors, controlling for demographic variables (age, sex assigned at birth, race, low-income status, autistic traits). Overall, 73.2% of autistic adults in our sample had an overweight/obesity classification, 45.3% had high cholesterol, 39.4% had high blood pressure, and 10.3% had diabetes. Older age, male sex assigned at birth, and poorer sleep quality were associated with a higher number of CVD risk factors. Using antipsychotic medications was associated with an increased likelihood of having diabetes. Poorer sleep quality was associated with an increased likelihood of having an overweight/obesity classification. Self-reported CVD risk factors are highly prevalent among autistic adults. Both improving sleep quality and closely monitoring CVD risk factors among autistic adults who use antipsychotic medications have the potential to reduce risk for CVD.

Autism research : official journal of the International Society for Autism Research, 2023 · doi:10.1097/MJT.0b013e31802e4b9f