Sleep disturbance as a predictor of anxiety in children with Fetal Alcohol Spectrum Disorders and typically developing children


This is the largest study to examine sleep in FASD.
We report that a significant proportion of anxiety can be predicted by sleep problems. This is true for both TD and FASD populations.
Children with FASD experienced significantly higher levels of sleep problems and anxiety than TD children, the majority at clinical levels.
Sleep interventions should be a clinical priority for children with FASD.



High levels of anxiety and sleep problems are common features of Fetal Alcohol Spectrum Disorders (FASD). The strong association between sleep and anxiety has been documented in typically developing (TD) populations and is thought to be bidirectional. The association between sleep and anxiety in children with FASD has not yet been examined.


Caregivers of children with FASD (n = 91) and TD children (n = 103) aged 6–16 completed the Children’s Sleep Habits Questionnaire (CSHQ), Spence Children’s Anxiety Scale (SCAS), and a background questionnaire. Hierarchical multiple regression analyses, group comparisons and ANCOVA interaction models were used to test the associations between sleep and anxiety within and between the two groups.


Sleep disturbances and anxiety were at clinical levels for the majority of the FASD group, and significantly higher in the FASD group than the TD group. After controlling for age and sex, 27 % of the variance in anxiety scores in TD children was attributable to sleep problems, and 33 % in children with FASD.


This study highlights associations between parent-reported sleep and anxiety in FASD. Sleep disturbances were significant predictors of anxiety in both children with FASD and in TD children. Given the importance of sleep to healthy neurodevelopment, there is a pressing need for sleep intervention studies in children with FASD. Early identification and intervention for sleep problems in this condition should be a therapeutic priority.

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The opinions expressed in this post are those of the authors. They do not purport to reflect the opinions or views of the Edmonton and area Fetal Alcohol Network Society, its stakeholders or funders.

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