Sleep disturbances and sensory processing and integration in children and adolescents with autism spectrum disorder: a systematic review

: Sleep disorders and sensory abnormalities are highly represented in individuals with autism spectrum disorder and represent an important burden for these subjects and their families. Exploring the frequently co-occurring relationship between these two disturbances may be crucial for its therapeutic and rehabilitative implications. Following PRISMA 2020, we systematically reviewed studies examining associations between sleep disturbances and sensory abnormalities in children/adolescents (2-18 years) with autism spectrum disorder based on the following databases searched: MEDLINE, PsycARTICLES, PsycInfo, Psychology and Behavioral Sciences Collection, CINAHL (EBSCOhost), Scopus, and Web of Science. Final search: May 31st, 2025. Eligible designs included observational and interventional human studies reporting quantitative sleep-sensory outcomes. Sixteen studies met inclusion criteria; significant positive associations emerged between sleep problems (especially insomnia symptoms and night wakings) and sensory dysfunctions (notably sensory sensitivity/avoidance; tactile and vestibular domains). Only a minority of these studies have been conducted in older children/adolescents. Two longitudinal non-intervention studies suggested covariation over time. Use of predominantly parent-reported instruments and heterogeneous designs limited quantitative synthesis. Objective measures (e.g., actigraphy, electrodermal activity) were rarely used and showed variable concordance with questionnaires. Sleep issues and sensory dysfunctions appear connected in ASD, but more evidence is needed to determine causality. Future research should use longitudinal intervention trials and both objective and subjective assessments to see if treating sleep or sensory symptoms leads to improvement.