The Effect of Sleep–Wake Routines on the Negative Emotional States and Aggressive Behaviors in Adults with Autism Spectrum Disorders (ASD) during the COVID-19 Outbreak

Disruption in routine may be related to experiencing negative emotional states and to aggressive behaviors in individuals with Autism Spectrum Disorder (ASD). The lockdown because of COVID-19 contributed to the disruption of individuals’ routines, including the sleep–wake cycle. The current study tested a relationship between the adherence to the sleep–wake routine and aggressive behaviors via the mediation role of negative emotional states (i.e., anxiety and anger). Forty-three parents of adults with ASD completed a web-based questionnaire about their life condition during the first lockdown (April–May 2020). Preliminary analyses showed a worsening in the adults’ aggressive behaviors during the lockdown in comparison to before it (Z = −3.130; p = 0.002). In the mediation models, the relationship between the adherence to the sleep–wake routines and aggressive behaviors was significant. The models showed the hypothesized mediated relationships among the adherence to the sleep–wake routines, negative emotional states, and aggressive behaviors (Model 1: F ((1, 41)) = 10.478, p < 0.001; Model 2: F((1, 41)) = 9.826, p = 0.003). The findings confirmed the potential protective role of the adherence to the sleep–wake routines for the emotional and behavioral adjustment of adults with autism. Theoretical and practical contributions of the study were discussed; indeed, our results may inform parent-coaching as well as intervention programs for individuals with ASD given that adequate sleep hygiene may contribute to improvements in internalizing/externalizing behaviors.