Associations of autistic traits, sleep/circadian factors, and mental health in a community-based survey study

Autistic individuals experience a heightened risk of depression and lower quality of life; however, the biological underpinnings for this increased risk remain to be established. We assessed whether disruption of self-reported sleep and circadian factors mediates the associations of autistic traits with depression symptom severity and quality of life in a community-based survey study. A total of 838 participants (mean: 52.8 [SD = 1.3] years, 70 % females) from a large-scale observational survey completed the Autism Quotient Scale, Hospital Anxiety and Depression Scale, Cantril Ladder quality of life, Insomnia Severity Index, Pittsburgh Sleep Quality Index, and the Munich Chronotype Questionnaire. Higher autistic traits were significantly associated with higher depression symptom severity (p = 0.04) and significantly lower quality of life (p < 0.001). Insomnia severity and chronotype partly mediated the association of autistic traits and depression symptom severity (standardized beta = -0.02, 95 % CI = [-0.04, -0.001]), and its association with quality of life (standardized beta = -0.02, 95 % CI = [-0.04, -0.001]). Our findings indicate that autistic traits are associated with depression severity and lower quality of life, mediated by insomnia severity and chronotype. Future studies targeting insomnia complaints and late chronotype in this population may help alleviate their mental health complaints and increase quality of life.