Article révisé par les pairs
Résumé : Abstract Introduction Sleep problems affect up to 81% of autistic children. Studies suggest a link between sleep quality, sleep-wake rhythms, and language development in early childhood, highlighting the need for objective sleep measures. However, obtaining which measures is challenging in young autistic children, particularly due to their sensory sensitivities. Actigraphy, a less invasive tool, shows promise for autism. However, autism is a highly heterogenous condition, and to date, no study has explored which individual characteristics predict effective actigraphic monitoring. The present study assesses the feasibility of actigraphy in autistic children and identifies profiles that support long-term monitoring. Methods Data were collected for the multi-site BeLAS (Belgian ‘Language in Autism’ Study) project (Université Libre de Bruxelles, KU-Leuven, Ghent University). A cohort of 214 autistic children (2-6 years, 155 boys, mean age = 53.35 months) were instructed to wear an actigraph wGT3X-BT for 14 days. Parents completed a sleep diary and the Children’s Sleep Habits Questionnaire (CSHQ). Valid recordings required at least 5 days for sleep quality or 7 consecutive for circadian rhythm analysis, along with correct diary completion (with a ≤ 30 min discrepancy between diary and actimetric sleep start and end times). Logistic regression was used to predict actimetry wearability with age, IQ, total-CSHQ and ADOS-2 (Autism Diagnostic Observation Scale) comparison scores as predictors. Odds ratios (OR) and their 95% confidence intervals (CI) were calculated. Results Actigraphy was completed by 54% of participants. Data loss occurred due to intolerance (42%), technical issues (2%), and lost devices (2%). Logistic regression identified higher non-verbal IQ (OR=1.03, CI [1.01; 1.06]), lower ADOS comparison scores (OR=0.80, CI [0.63; 0.99]), and fewer sleep issues (as indicated by the total-CSHQ) (OR= 0.95, CI [0.90; 0.99]) as significant predictors of successful actigraphy recordings, with no age or site effect. Among participants who wore the actimeter, 85% provided usable data for sleep quality, and 71% for circadian rhythms analysis. Conclusion Continuous actigraphy is feasible in preschool-aged autistic children, despite a significant data loss rate (46%). Successful actigraphy recordings were predicted by higher non-verbal intelligence, fewer sleep issues and less autistic characteristics. Support (if any) The FNRS-FWO Excellence of Science EOS grant No. 40007492

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