Sleep patterns in autistic children and adolescents and their caregivers during the COVID-19 pandemic lockdown: A systematic review

Background: Sleep patterns significantly influence health and wellbeing, with disturbances to sleep quality and duration, and increased sleep disorders commonly affecting autistic people. The COVID-19 pandemic lockdown altered daily routines for almost all people, impacting their sleep patterns. Aim: This study aimed to systematically review studies on sleep patterns among autistic children, adolescents, and their caregivers during the COVID-19 lockdown. Methods: In April 2023, six databases (PubMed, Embase, Web of Science, Scopus, ProQuest Central, and CINAHL) were searched for quantitative and qualitative studies. Data from eligible studies were extracted and analyzed through narrative synthesis. Results: Thirty-four studies were included, with thirty-one focusing on autistic children and adolescents and three on caregivers. Autistic males and mothers were the predominant demographic groups in the studies. The findings regarding sleep quality, duration, and disorders were inconsistent; some studies reported improvements, while others noted worsening sleep or no changes. The most common negative impacts in autistic children and adolescents were decreased sleep quality and an increase in sleep disorders. All caregiver studies indicated significant declines in sleep quality and duration. Conclusion: The COVID-19 lockdown adversely affected sleep patterns in many autistic children, adolescents, and their caregivers. To address these challenges during extreme circumstances such as lockdowns, strategies are needed to maintain or improve sleep quality and reduce the risk of negative sleep patterns in these populations.