JMIR Publications

ABSTRACT

Background:

Sleep disturbances are prevalent in autism spectrum disorders (ASD) and worsen daytime functioning, yet their neural bases remain poorly understood. This may reflect the challenges of laboratory-based polysomnography for individuals with ASD, including sensory sensitivities and difficulty adapting to changes in routine. The advent of wearable EEG devices allows for remote data collection in the home and facilitates large-scale sleep studies.

Objective:

The aim of this study is to test the hypothesis that thalamocortical circuit dysfunction contributes to poor sleep in ASD by characterizing sleep oscillations that rely on this circuitry. To achieve this goal, we monitored sleep in the home using wearable EEG headbands in adolescents with ASD, including those who are profoundly affected, and their typically developing peers. When necessary, we employed a desensitization protocol to gradually acclimate participants to wearing the headband overnight to promote the inclusion of individuals with sensory sensitivities and high support needs.

Methods:

Participants and their families completed assessments and questionnaires and received remote training to use a wearable EEG headband. Those needing time to acclimate followed a personalized two-week desensitization protocol with a practice headband. Sleep was monitored at home for three consecutive nights, the first of which was for adaptation to the headband. Sleep data quality was checked daily and remote technical support was provided as needed. Using sleep rhythms as physiological biomarkers of thalamocortical circuit function, we will test the hypothesis that abnormal circuit function in ASD will correlate with worse sleep quality.

Results:

This study was funded by the Simons Foundation Autism Research Initiative (SFARI) and approved by the Mass General Brigham Institutional Review Board in November 2021. Data collection was conducted between July 2023 and November 2025. A total of 148 subjects completed the study. Data analysis is underway and results will be published in October 2026.

Conclusions:

At-home sleep monitoring enables larger samples that are needed to characterize the neural underpinnings of sleep disturbances across the autism spectrum. The personalized desensitization protocol promotes inclusivity by accommodating individuals often excluded from research due to sensory or behavioral challenges. These methods are adaptable for other conditions and research goals beyond ASD, such as longitudinal studies across development or characterizing sleep in other neurodevelopmental disorders. Desensitization protocols may also increase the tolerability of diagnostic lab-based sleep studies and other medical procedures, improving both patient experience and quality of care. Clinical Trial: N/A