Sleep Quality and Evening Salivary Cortisol Levels in Association with the Psychological Resources of Parents of Children with Developmental Disorders and Type 1 Diabetes.
Parents of kids with autism have higher evening stress hormone and lower happiness, so bedtime cortisol can flag who needs help first.
01Research in Context
What this study did
Marija and her team asked 120 parents to spit into a tube each night for seven nights. They tested the spit for cortisol, the stress hormone that rises when we feel worn down.
Parents also filled short surveys on sleep, mood, and happiness. Kids had autism, Down syndrome, type-1 diabetes, or were neurotypical.
What they found
Autism parents had the highest bedtime cortisol and the lowest happiness scores. Diabetes parents slept the worst; they woke more and felt less rested.
Down syndrome parents landed in the middle. Neurotypical parents had the lowest cortisol and best sleep.
How this fits with other research
Chu et al. (2009) first showed that child sleep and behaviour problems steal mothers’ sleep and raise depression. Marija adds the cortisol number to that story.
Mori et al. (2018) compared three genetic disorders and found CDKL5 parents felt worst. Marija widens the lens by adding diabetes and a stress biomarker.
Klusek et al. (2022) saw Prader-Willi sleep-breathing issues hurt caregiver well-being. Marija matches this pattern with autism and diabetes, showing the link is not syndrome-specific.
Why it matters
You now have a quick, cheap signal—bedtime spit cortisol—to spot the parents who are burning out. Pair that with a five-question sleep scale during intake. If scores are high, move respite, night-time behaviour plans, or stress classes to the front of the treatment plan. Reducing parent stress is a core part of good ABA service.
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02At a glance
03Original abstract
BACKGROUND: Sleep deprivation can decrease parental well-being and degrade mental and physical health in parents of children with chronic illness. The aim of this study was to explore the associations of sleep quality, psychological stress perception, and evening salivary cortisol concentration with self-esteem, optimism and happiness in parents of children with type 1 diabetes and developmental disorders compared to parents of healthy, typically developing children. METHODS: We studied 196 parents of children with chronic conditions, including autistic spectrum disorder (N = 33), cerebral palsy (N = 18), Down syndrome (N = 33), and diabetes mellitus type 1 (N = 40) and parents of healthy children (N = 72). We evaluated parental sleep quality, evening salivary cortisol levels, self-esteem, optimism and happiness. Multiple linear regression models were used to assess associations between variables. RESULTS: Compared with those of the control group, the parents of children with autistic spectrum disorders had higher evening cortisol concentrations (β = 0.17; p = 0.038) and lower perceptions of happiness (β=-0.17; p = 0.017), while parents of children with type 1 diabetes had disrupted sleep quality (β = 0.25; p = 0.003). Optimism was negatively associated with the evening cortisol concentration (β=-0.18; p = 0.023) and sleep quality index (β=-0.20; p = 0.012). CONCLUSIONS: Public health programs aimed at lifestyle habit improvement, respite care, and relaxation for parents of children with chronic conditions would be useful for improving parental sleep quality, self-esteem, optimism and happiness.
Journal of autism and developmental disorders, 2025 · doi:10.1093/AJE/KWAA241