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Subjective and objective sleep alterations in medication-naïve children and adolescents with autism spectrum disorder: a systematic review and meta-analysis

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dc.contributor.author신재일-
dc.contributor.author천근아-
dc.contributor.author김희연-
dc.date.accessioned2023-08-09T06:54:43Z-
dc.date.available2023-08-09T06:54:43Z-
dc.date.issued2023-07-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/195998-
dc.description.abstractAims: This study aimed to summarize the evidence on sleep alterations in medication-naïve children and adolescents with autism spectrum disorder (ASD). Methods: We systematically searched PubMed/Medline, Embase and Web of Science databases from inception through March 22, 2021. This study was registered with PROSPERO (CRD42021243881). Any observational study was included that enrolled medication-naïve children and adolescents with ASD and compared objective (actigraphy and polysomnography) or subjective sleep parameters with typically developing (TD) counterparts. We extracted relevant data such as the study design and outcome measures. The methodological quality was assessed through the Newcastle-Ottawa Scale (NOS). A meta-analysis was carried out using the random-effects model by pooling effect sizes as Hedges' g. To assess publication bias, Egger's test and p-curve analysis were done. A priori planned meta-regression and subgroup analysis were also performed to identify potential moderators. Results: Out of 4277 retrieved references, 16 studies were eligible with 981 ASD patients and 1220 TD individuals. The analysis of objective measures showed that medication-naïve ASD patients had significantly longer sleep latency (Hedges' g 0.59; 95% confidence interval [95% CI] 0.26 to 0.92), reduced sleep efficiency (Hedges' g -0.58; 95% CI -0.87 to -0.28), time in bed (Hedges' g -0.64; 95% CI -1.02 to -0.26) and total sleep time (Hedges' g -0.64; 95% CI -1.01 to -0.27). The analysis of subjective measures showed that they had more problems in daytime sleepiness (Hedges' g 0.48; 95% CI 0.26 to 0.71), sleep latency (Hedges' g 1.15; 95% CI 0.72 to 1.58), initiating and maintaining sleep (Hedges' g 0.86; 95% CI 0.39 to 1.33) and sleep hyperhidrosis (Hedges' g 0.48; 95% CI 0.29 to 0.66). Potential publication bias was detected for sleep latency, sleep period time and total sleep time measured by polysomnography. Some sleep alterations were moderated by age, sex and concurrent intellectual disability. The median NOS score was 8 (interquartile range 7.25-8.75). Conclusion: We found that medication-naïve children and adolescents with ASD presented significantly more subjective and objective sleep alterations compared to TD and identified possible moderators of these differences. Future research requires an analysis of how these sleep alterations are linked to core symptom severity and comorbid behavioural problems, which would provide an integrated therapeutic intervention for ASD. However, our results should be interpreted in light of the potential publication bias.-
dc.description.statementOfResponsibilityopen-
dc.formatapplication/pdf-
dc.languageEnglish-
dc.publisherCambridge University Press-
dc.relation.isPartOfEPIDEMIOLOGY AND PSYCHIATRIC SCIENCES-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHAdolescent-
dc.subject.MESHAutism Spectrum Disorder* / complications-
dc.subject.MESHChild-
dc.subject.MESHComorbidity-
dc.subject.MESHHumans-
dc.subject.MESHObservational Studies as Topic-
dc.subject.MESHOutcome Assessment, Health Care-
dc.subject.MESHSleep-
dc.titleSubjective and objective sleep alterations in medication-naïve children and adolescents with autism spectrum disorder: a systematic review and meta-analysis-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Pediatrics (소아과학교실)-
dc.contributor.googleauthorHeeyeon Kim-
dc.contributor.googleauthorJae Han Kim-
dc.contributor.googleauthorJunghwan Kim-
dc.contributor.googleauthorJong Yeob Kim-
dc.contributor.googleauthorSamuele Cortese-
dc.contributor.googleauthorLee Smith-
dc.contributor.googleauthorAi Koyanagi-
dc.contributor.googleauthorJoaquim Radua-
dc.contributor.googleauthorPaolo Fusar-Poli-
dc.contributor.googleauthorAndre F Carvalho-
dc.contributor.googleauthorGonzalo Salazar de Pablo-
dc.contributor.googleauthorJae Il Shin-
dc.contributor.googleauthorKeun-Ah Cheon-
dc.contributor.googleauthorMarco Solmi-
dc.identifier.doi10.1017/S2045796023000574-
dc.contributor.localIdA02142-
dc.contributor.localIdA04027-
dc.relation.journalcodeJ03614-
dc.identifier.pmid37469173-
dc.subject.keywordautism spectrum disorder-
dc.subject.keywordmedication-naïve-
dc.subject.keywordmeta-analysis-
dc.subject.keywordsleep alterations-
dc.contributor.alternativeNameShin, Jae Il-
dc.contributor.affiliatedAuthor신재일-
dc.contributor.affiliatedAuthor천근아-
dc.citation.volume32-
dc.citation.startPagee48-
dc.identifier.bibliographicCitationEPIDEMIOLOGY AND PSYCHIATRIC SCIENCES, Vol.32 : e48, 2023-07-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Psychiatry (정신과학교실) > 1. Journal Papers

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