Correlation between circadian cycle disorders and autism: an integrative literature review

*Correspondence: [e-mail].

Abstract

Background: Sleep is essential in a child's development. Poor sleep quality is related to health impairments, even affecting the development quotient (DQ). Children with Autistic Spectrum Disorder (ASD) need specific attention with regard to sleep quality, as their neurodevelopmental disorder can be the cause of lower sleep efficiency and also be intensified by it.

Objective: Search the literature for the relationship between circadian cycle disorders and autism.

Methods: This study is an integrative, qualitative and descriptive review of the literature. For the elaboration of the research, the combination of descriptors, available in Health Sciences Descriptors (DeCs) was used together with the Boolean operator “AND”. These descriptors were: Circadian Rhythm Sleep Disorders; Autism. In addition, the PICO strategy was used to develop the guiding question “What is the correlation between Circadian Cycle Disorders and Autism in children?”. Meanwhile, the databases available in the Virtual Health Library (VHL) and in the PubMed database were used. The following inclusion criteria were met: studies available in full with free access, published in the last 5 years, in English, Spanish or Portuguese.

Results: 12 articles were included in the review. Of these, all reported a link between autism and circadian rhythm disorders (CRD), with the main link being direct melatonin deficiency (50%). Thus, 25% of the studies analyzed the role of pineal gland volume (PGV), with 2 articles reporting no correlation between the factors and 1 that the PGV acted as a modest contributor to the hormone deficit. On the other hand, 1 article made this association between CRD and the increase in the habenula in children with autism. Furthermore, at the genetic level, 25% of the studies reported disturbances in the expression of the clock gene, which regulates the circadian cycle, and 16.6% reported post-translational and post-transcriptional modification, with emphasis on miRNA alterations. In the gestational analysis, 1 article demonstrates that the immature or interrupted formation of the ultradian rhythm during the fetal period can generate CRD. Regarding the manifestations, 41.6% of the articles reported behavioral alterations, with social withdrawal (16.6%) and stereotyped behaviors (16.6%) being the most common, with 1 article reporting that stereotypes cause impairment in sleep and 1 that CRD accentuates stereotyped movements.

Conclusion: In terms of emotions, the main report was increased irritability.

Publication History

Article published online:
12 May 2025