The Importance of Sleep and Social Well-Being in Depression Among Patients with Autism

Amanda Richdale, PhD

Findings from a new investigation underscored the importance of addressing sleep quality and social well-being when treating depression in young adults with autism. After analyzing these relationships in this population, investigators found that over a 2-year period, depression and fatigue scores remained stable while sleep quality deteriorated.¹

The study also found that fatigue trended towards mediating the relationship between sleep quality and depression, while social well-being was a significant partial mediator of this relationship. Overall, the results provided valuable insights into the complex relationships between social well-being, sleep quality, fatigue, and depression in young autistic adults.

Fatigue and Social Contribution Predict Depression

According to Amanda Richdale, PhD, Olga Tennison Autism Research Centre, La Trobe University, Victoria, Australia, and a team of investigators, the study highlights the need for further research to identify the specific mechanisms through which these factors contribute to depression in patients with autism, as well as to develop effective interventions to address these factors and improve mental health outcomes in this population.

Depression and poor sleep quality are common co-occurring conditions in individuals with autism, and have been associated with reduced social support and loneliness. Previous studies in non-autistic populations have shown that poor sleep quality and daytime fatigue also contribute to depression. However, the specific contributions of sleep quality and fatigue to depressive symptoms, and how they interact with social factors to influence depression in autism, have not been fully explored.

To address this gap in knowledge, an investigation was performed using data from a longitudinal study. The aim was to examine the relationships between social well-being, sleep quality, fatigue, and depression among the young adult population with autism.

While depression and fatigue scores did not change significantly over the 2-year period, results showed the worsening of sleep quality. The T1 regression model was significant, with fatigue and social contribution individually predicting depression symptomatology, explaining 36% of the variance in depression. The longitudinal regression model was also significant, with social contribution at T1 being the only significant predictor of depression at T2, explaining 57% of the variance in depression.

Additionally, fatigue and social well-being were independently associated with depression, suggesting that while both factors are important in predicting depression in autistic individuals, they may have different mechanisms of action, investigators noted. For instance, fatigue may lead to depression through its impact on mood and cognition, while social well-being may be protective against depression by providing a sense of belonging and social support.

Examining Sleep and Social-Wellbeing in Autism

The study population included 114 young adults with autism, aged 15-25 years (57% men), who were part of the SASLA online, longitudinal study. The participants completed surveys at baseline and at a 2-year follow-up.

Hierarchical multiple regression models were used to analyze the association between social well-being, sleep quality, and fatigue on depression at both time points. In addition, 2 mediation models were conducted to predict depression from sleep quality through fatigue, and sleep quality through social well-being, respectively.

“Our first hypothesis—that sleep quality, fatigue, social integration and social contribution, and depressive symptomatology would be significantly associated was generally supported,” investigators wrote. “Sleep quality, fatigue and depressive symptomatology were significantly associated at both time points, excepting T1 depression and T2 sleep quality.”

References:

1. Richdale, A. L., Chetcuti, L., Hayward, S. M., Abdullahi, I., Morris, E. M. J., & Lawson, L. P. (2023). The impact of sleep quality, fatigue and social well-being on depressive symptomatology in autistic older adolescents and young adults. Autism Research, 1– 14. https://doi.org/10.1002/aur.2899